Association between atmospheric concentration of particulate matters and inpatient and outpatient visits for chronic respiratory diseases in Xiamen, China.
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ABSTRACT:
SUBMITTER: Zhong TL
PROVIDER: S-EPMC8280060 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
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Association between atmospheric concentration of particulate matters and inpatient and outpatient visits for chronic respiratory diseases in Xiamen, China.
Zhong Tao-Ling TL Zhang Yi-Wei YW Yao Xiang-Yang XY Xu Guang-Hui GH Liu Hui H Xu Qiu-Shi QS Sun Wei W Li Zhi-Bin ZB Yang Yun-Gang YG Wu Jin-Zhun JZ Zheng Chao C Li Qi-Yuan QY Zhou Lin-Fu LF
Chinese medical journal 20210225 13
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Project description:BackgroundNon-optimum temperatures are associated with increased risk of respiratory diseases, but the effects of apparent temperature (AT) on respiratory diseases remain to be investigated.MethodsUsing daily data from 2016 to 2020 in Ganzhou, a large city in southern China, we analyzed the impact of AT on outpatient and inpatient visits for respiratory diseases. We considered total respiratory diseases and five subtypes (influenza and pneumonia, upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), asthma and chronic obstructive pulmonary disease [COPD]). Our analysis employed a distributed lag nonlinear model (DLNM) combined with a generalized additive model (GAM).ResultsWe recorded 94,952 outpatients and 72,410 inpatients for respiratory diseases. We found AT significantly non-linearly associated with daily outpatient and inpatient visits for total respiratory diseases, influenza and pneumonia, and URTI, primarily during comfortable AT levels, while it was exclusively related with daily inpatient visits for LRTI and COPD. Moderate heat (32.1 °C, the 75.0th centile) was observed with a significant effect on both daily outpatient and inpatient visits for total respiratory diseases at a relative risk of 1.561 (1.161, 2.098) and 1.276 (1.027, 1.585), respectively (both P < 0.05), while the results of inpatients became insignificant with the adjustment for CO and O3. The attributable fractions in outpatients and inpatients were as follows: total respiratory diseases (24.43% and 18.69%), influenza and pneumonia (31.54% and 17.33%), URTI (23.03% and 32.91%), LRTI (37.49% and 30.00%), asthma (9.83% and 3.39%), and COPD (30.67% and 10.65%). Stratified analyses showed that children ≤5 years old were more susceptible to moderate heat than older participants.ConclusionsIn conclusion, our results indicated moderate heat increase the risk of daily outpatient and inpatient visits for respiratory diseases, especially among children under the age of 5.
| S-EPMC10965414 | biostudies-literature
Project description:BackgroundLima is one of the more polluted cities in Latin America. High levels of PM2.5 have been shown to increase health center outpatient visits of respiratory diseases.MethodsHealth center outpatient visits for children < 5 years for childhood respiratory disease (acute lower respiratory infections (ALRI), pneumonia and acute bronchiolitis/asthma) from 498 public clinics in Lima were available on a weekly basis from 2011 to 2015 from Peru's Ministry of Health (MINSA). The association between the average weekly concentrations of PM2.5 was evaluated in relation to the number of weekly health center outpatient visits for children. Weekly PM2.5 values were estimated using a recently developed model that combined data observed from ground monitors, with data from space satellite and meteorology. Ground monitoring data came from 10 fixed stations of the Peruvian National Service of Meteorology and Hydrology (SENAMHI) and from 6 mobile stations located in San Juan de Miraflores by Johns Hopkins University. We conducted a time-series analysis using a negative binomial model.ResultsWe found a significant association between exposure to PM2.5 and all three types of respiratory diseases, across all age groups. For an interquartile increase in PM2.5, we found an increase of 6% for acute lower respiratory infections, an increase of 16-19% for pneumonia, and an increase of 10% for acute bronchiolitis / asthma.ConclusionsHigher emissions of environmental pollutants such as PM2,5 could be a trigger for the increase of health center outpatients visits for respiratory diseases (ALRI, pneumonia and asthma), which are themselves risk factors for mortality for children in Lima province, Peru.
| S-EPMC6964058 | biostudies-literature
Project description:This study reported cumulative 6-day (lag 0-5 days) relative risks (RR) and confidence intervals (CI) of daily outpatient visits for total respiratory disease (RD), asthma, and chronic airway obstruction not otherwise classified (CAO) associated with three ozone metrics (daily 1-h maximum (O3, 1 h max), 8-h average maximum (O3, 8 h max), 24-h average (O3, 24 h avg)), and an alternative oxidant indicator (Ox) in Taipei Metropolitan, using distributed lag non-linear models after controlling for potential confounders. The Ox showed the strongest association with outpatient visits for total RD (RR = 1.10, 95% CI: 1.10, 1.11) and asthma (RR = 1.18, 95% CI: 1.00, 1.39) in the cold season. The O3, 24 h avg appeared to be the optimal ozone metric associating with total RD than O3, 1 h max and O3, 8 h max based on model selection. In conclusion, outpatient visits for total RD associated with ozone vary with ozone metrics, disease and season.
| S-EPMC7127381 | biostudies-literature
Project description:Numerous studies have revealed an association between particulate matter (PM) and emergency room (ER) visits, although few studies have investigated the association between health and PM components. The present study evaluated the associations of ER visits for cardiovascular and respiratory diseases with PM2.5 components, including organic carbon (OC), elemental carbon (EC), and ion species (SO42-, NO3-, and NH4+). Statistical analyses were performed using the time-series approach, and generalized linear models with natural spline functions were used to adjust for the non-linear relationship between the confounders and ER visits. Our single-pollutant models revealed that the greatest increase in cardiovascular ER visits was associated with NH4+ (relative risk: 1.05; 95% confidence interval: 1.01-1.09), which was followed by OC, SO42-, NO3-, and EC. The associations of cardiovascular ER visits with EC and OC varied according to age and sex, with elderly and female patients exhibiting stronger associations. Lagged SO42- was associated with respiratory ER visits. To the best of our knowledge, this is the first study to evaluate the associations between ER visits and PM components in South Korea. As PM components are related to traffic and industrial sources, and exhibited positive associations with ER visits, our results may help improve air pollution regulation and public health.
| S-EPMC5557583 | biostudies-literature
Project description:The burden of lower respiratory infections is primarily evident in the developing countries. However, the association between size-specific particulate matter and acute lower respiratory infection (ALRI) outpatient visits in the developing countries has been less studied. We obtained data on ALRI outpatient visits (N = 105,639) from a tertiary hospital in Guangzhou, China between 2013 and 2019. Over-dispersed generalized additive Poisson models were employed to evaluate the excess risk (ER) associated with the size-specific particulate matter, such as inhalable particulate matter (PM10), coarse particulate matter (PMc), and fine particulate matter (PM2.5). Counterfactual analyses were used to examine the potential percent reduction of ALRI outpatient visits if the levels of air pollution recommended by the WHO were followed. There were 35,310 pneumonia, 68,218 bronchiolitis, and 2,111 asthma outpatient visits included. Each 10 μg/m3 increase of 3-day moving averages of particulate matter was associated with a significant ER (95% CI) of outpatient visits of pneumonia (PM2.5: 3.71% [2.91, 4.52%]; PMc: 9.19% [6.94, 11.49%]; PM10: 4.36% [3.21, 5.52%]), bronchiolitis (PM2.5: 3.21% [2.49, 3.93%]; PMc: 9.13% [7.09, 11.21%]; PM10: 3.12% [2.10, 4.15%]), and asthma (PM2.5: 3.45% [1.18, 5.78%]; PMc: 11.69% [4.45, 19.43%]; PM10: 3.33% [0.26, 6.49%]). The association between particulate matter and pneumonia outpatient visits was more evident in men patients and in the cold seasons. Counterfactual analyses showed that PM2.5 was associated with a larger potential decline of ALRI outpatient visits compared with PMc and PM10 (pneumonia: 11.07%, 95% CI: [7.99, 14.30%]; bronchiolitis: 6.30% [4.17, 8.53%]; asthma: 8.14% [2.65, 14.33%]) if the air pollutants were diminished to the level of the reference guidelines. In conclusion, short-term exposures to PM2.5, PMc, and PM10 are associated with ALRI outpatient visits, and PM2.5 is associated with the highest potential decline in outpatient visits if it could be reduced to the levels recommended by the WHO.
| S-EPMC8674437 | biostudies-literature
Project description:Ambient fine particulate matter (PM2.5) is associated with an elevated risk of acute lower respiratory infections (ALRI). However, this association has not been examined using alternative exposure metrics. We collected outpatient data of patients with ALRI aged <14 years from the administrative database of a large tertiary hospital in Guangzhou, China, from 2013 to 2019. Ambient PM2.5 was measured using three metrics: (a) daily mean, (b) daily excessive concentration hours (DECH), and (c) hourly peak. Generalized additive models were fitted to estimate the excess risk (ER) associated with PM2.5. A total of 105,639 ALRI (35,310 pneumonia and 68,218 bronchiolitis) outpatient visits were identified during the study period. An interquartile range increment in PM2.5 DECH was consistently associated with the highest ER of ALRI-related outpatient visits: 12.30% (95% confidence interval [CI]: 9.49-15.18%), compared with 11.20% (95% CI: 8.34-14.13%) for daily mean and 9.73% (95% CI: 6.97-12.55%) for hourly peak. The associations between the three metrics of PM2.5 and ALRI-related outpatient visits were stronger in the cold season than in the warm season. Future studies should consider PM2.5 DECH as an alternative method of exposure measurement, in addition to daily mean and hourly peak concentrations of PM2.5.
| S-EPMC9218103 | biostudies-literature
Project description:BackgroundFew studies have investigated the associations between outdoor air pollution and outpatient visits for respiratory diseases (RDs) in general population.MethodsWe collected daily outpatient data of primary RDs from five hospitals in Jinan during January 2012 and December 2016, as well as daily measurements of air pollutants from the Jinan Environmental Monitoring Center and daily meteorological variables from the China Meteorological Data Sharing Service System. A generalized additive model (GAM) with quasi-Poisson regression was constructed to estimate the associations between daily average concentrations of outdoor air pollutants (PM2.5,PM10, SO2, NO2, CO and O3) and daily outpatient visits of RDs after adjusting for long-time trends, seasonality, the "day of the week" effect, and weather conditions. Subgroup analysis stratified by gender, age group and the type of RDs was conducted.ResultsA total of 1,373,658 outpatient visits for RDs were identified. Increases of 10 μg/m3 in PM2.5, PM10, NO2, CO and O3 were associated with0.168% (95% CI, 0.072-0.265%), 0.149% (95% CI, 0.082-0.215%), 0.527% (95% CI, 0.211-0.843%), 0.013% (95% CI, 0.003-0.023%), and 0.189% (95% CI, 0.032-0.347%) increases in daily outpatient visits for RDs, respectively. PM2.5 and PM10 showed instant and continuous effects, while NO2, CO and O3 showed delayed effects on outpatient visits for RDs. In stratification analysis, PM2.5 and PM10 were associated with acute RDs only.ConclusionsExposure to outdoor air pollutants including PM2.5, PM10, NO2, CO and O3 associated with increased risk of outpatient visits for RDs.
| S-EPMC6292059 | biostudies-literature
Project description:BackgroundPrevious studies have suggested that there is an association between air pollutants and circulatory and respiratory diseases; however, relatively few have analyzed the association between air pollutants and outpatient visits based on the mortality, hospitalization rates, etc., especially in areas with relatively good air quality. Therefore, we conducted this study to research the association between air pollutants and outpatient visits in Fuzhou, China.MethodsWe used a generalized linear Poisson model to study the association between air pollution and outpatient visits for respiratory and circulatory diseases from 2016 to 2018 in Fuzhou, China.ResultsIn the single pollutant model, nitrogen dioxide (NO2) had a significant effect. For lag day 0 to lag day 5, the effect decreased with every 10 μg/L increase in NO2. The daily maximum 8-h mean ozone (O3-8h) and upper respiratory outpatient visits were positively associated during the cold period [lag2, excess risk (ER) (95% confidence interval (CI)): 1.68% (0.44-2.94%)], while O3-8h and respiratory disease were positively associated during the warm period [lag5, ER (95% CI): 1.10% (0.11-2.10%) and lag4, ER (95% CI): 1.02% (0.032-2.02%)]. Similarly, particulate matter (PM) with an average aerodynamic diameter of less than 10 μm (PM10) and lower respiratory diseases were positively associated during the warm period [lag0, ER (95% CI): 1.68% (0.44-2.94%)]. When the concentration of O3-8h was higher than 100 μg/L, there was a positive effect on circulatory [lag5, ER (95% CI): 2.83% (0.65-5.06%)], respiratory [lag5, ER (95% CI): 2.47% (0.85-4.11%)] and upper respiratory [lag5, ER (95% CI): 3.06% (1.38-4.77%)] outpatient visits. The variation in O3-8h changed slightly when we adjusted for other air pollutants, and after adjusting for O3-8h, the ERs of the other air pollutants changed slightly. After adjusting for PM with an average aerodynamic diameter of less than 2.5 μm (PM2.5), the ERs of the other air pollutants increased, and after adjusting for NO2, the ER of PM decreased.ConclusionExposure to ambient NO2, O3, PM2.5 and PM10 was associated with an increase in respiratory and circulatory system-related outpatient visits in Fuzhou, China.
| S-EPMC7370472 | biostudies-literature
Project description:Previous epidemiological studies have linked short-term exposure to particulate matter with outpatient visits for respiratory diseases. However, evidence on ultrafine particle (UFP) is still scarce in China. To investigate the association between short-term UFP exposure and outpatient visits for respiratory diseases as well as the corresponding lag patterns, information on outpatient visits for main respiratory diseases during January 1, 2017, to December 31, 2019 was collected from electronic medical records of two large tertiary hospitals in Shanghai, China. Generalized additive models employing a Quasi-Poisson distribution were employed to investigate the relationships between UFP and respiratory diseases. We computed the percentage change and its corresponding 95% confidence interval (CI) for outpatient visits related to respiratory diseases per interquartile range (IQR) increase in UFP concentrations. Based on a total of 1,034,394 hospital visits for respiratory diseases in Shanghai, China, we found that the strongest associations of total UFP with acute upper respiratory tract infection (AURTI), bronchitis, chronic obstructive pulmonary disease (COPD), and pneumonia occurred at lag 03, 03, 0, and 03 days, respectively. Each IQR increase in the total UFP concentrations was associated with increments of 9.02% (95% CI: 8.64-9.40%), 3.94% (95% CI: 2.84-5.06%), 4.10% (95% CI: 3.01-5.20%), and 10.15% (95% CI: 9.32-10.99%) for AURTI, bronchitis, COPD, and pneumonia, respectively. Almost linear concentration-response relationship curves without apparent thresholds were observed between total UFP and outpatient-department visits for four respiratory diseases. Stratified analyses illustrated significantly stronger associations of total UFP with AURTI, bronchitis, and pneumonia among female patients, while that with COPD was stronger among male patients. After adjustment of criteria air pollutants, these associations all remained robust. This time-series study indicates that short-term exposure to UFP was associated with increased risk of hospital visits for respiratory diseases, underscoring the importance of reducing ambient UFP concentrations for respiratory diseases control and prevention.
| S-EPMC10791965 | biostudies-literature
Project description:PurposeThe association between atmospheric particulate matter and emergency room visits for cerebrovascular disease were evaluated in Beijing.MethodsA generalized additive model was used to evaluate the associations between particulate matter and cerebrovascular disease, based on the daily data of meteorological elements, PM concentrations, and emergency room (ER) visits for cerebrovascular disease in Beijing from 2009 to 2012. Long-term trends and the effects of holidays, the day of the week, and confounding factors were controlled to determine the lag effect at 0-6 days. Single- and double-pollutant models were employed for different age and sex groups.ResultsThe effect of PM2.5 concentration on the number of daily ER visits for cerebrovascular disease was much stronger than that of PM10 concentration. PM2.5 and PM10 had maximum RR values of 1.096 and 1.054 at lag 6 for patients aged 61-75 years. For each inter-quartile range (IQR) increase in PM10 concentration, the maximum RR values for the total, males, females, aged 15-60 years, aged 61-75 years, and aged > 75 years were 1.024, 1.044, 1.043, 1.038, 1.054, and 1.032, respectively. For each IQR increase in PM2.5 concentration, the maximum RR values for the total, males, females, aged 15-60 years, aged 61-75 years, and aged > 75 years were 1.038, 1.064, 1.076, 1.054, 1.096, and 1.049, respectively. The RR values of the double-pollutant models were lower than those of the single-pollutant models.ConclusionThis study showed that the effects of PM pollution on cerebrovascular disease were different among different gender and age groups, and aged 61-75 years were mostly sensitive to particulate matters. The effects of PM2.5 on cerebrovascular disease were stronger than those of PM10. Our results can provide scientific evidence for the local government to take effective measures to improve air quality and the health of residents.Supplementary informationThe online version contains supplementary material available at 10.1007/s40201-021-00776-w.
| S-EPMC9163215 | biostudies-literature