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Impact of haze and air pollution-related hazards on hospital admissions in Guangzhou, China


Guangzhou is a metropolitan in south China with unique pollutants and geographic location. Unlike those in western countries and the rest of China, the appearance of haze in Guangzhou is often (about 278 days per year on average of 4 years). Little is known about the influence of these hazes on health. In this study, we investigated whether short-term exposures to haze and air pollution are associated with hospital admissions in Guangzhou. The relationships between haze, air pollution, and daily hospital admissions during 2008–2011 were assessed using generalized additive model. Studies were categorized by gender, age, season, lag, and disease category. In haze episodes, an increase in air pollutant emissions corresponded to 3.46 (95 % CI, 1.67, 5.27) increase in excessive risk (ER) of total hospital admissions at lag 1, 11.42 (95 % CI, 4.32, 18.99) and 11.57 (95 % CI, 4.38, 19.26) increases in ERs of cardiovascular illnesses at lags 2 and 4 days, respectively. As to total hospital admissions, an increase in NO2 was associated with a 0.73 (95 % CI, 0.11, 1.35) and a 0.28 (95 % CI, 0.11, 0.46) increases in ERs at lag 5 and lag 05, respectively. For respiratory illnesses, increases in NO2 was associated with a 1.94 (95 % CI, 0.50, 3.40) increase in ER at lag 0, especially among chronic obstructive pulmonary disease. Haze (at lag1) and air pollution (for NO2 at lag 5 and for SO2 at lag3) both presented more drastic effects on the 19 to 64 years old and in the females. Together, we demonstrated that haze pollution was associated with total and cardiovascular illnesses. NO2 was the sole pollutant with the largest risk of hospital admissions for total and respiratory diseases in both single- and multi-pollutant models.

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Chronic obstructive pulmonary disease


Upper respiratory infection


Ischemic heart disease

PM10 :

A diameter measuring less than 10 μm

SO2 :

Sulfur dioxide

NO2 :

Nitrogen dioxide


Generalized additive model


Excessive risk


Confidence interval


The International Classification of Disease 10th Revision


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This work was supported by the National Natural Science Foundation of China (81070043, 81071917, 81173112, 81170052, 81220108001), the Chinese Central Government Key Research Projects of the 973 grants (2009CB522107), a Changjiang Scholars and Innovative Research Team in University grant (IRT0961), a Guangdong Natural Science Foundation team grant (1035101200300000), the Guangdong Department of Science and Technology of China (2009B050700041, 2010B031600301), the Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2008) China, a Guangdong Department of Education research grant (cxzd1025), and Guangzhou Department of Education Yangcheng Scholarships (10A058S, 12A001S). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Conflicts of interest

The authors have declared that no competing interests exist.

Author information

Correspondence to Haidong Kan or Wenju Lu.

Additional information

Zili Zhang and Jian Wang contributed equally to this article.

Responsible editor: Constantini Samara

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Zhang, Z., Wang, J., Chen, L. et al. Impact of haze and air pollution-related hazards on hospital admissions in Guangzhou, China. Environ Sci Pollut Res 21, 4236–4244 (2014). https://doi.org/10.1007/s11356-013-2374-6

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  • Air pollutants
  • Hospital admissions
  • Haze
  • Respiratory and cardiovascular diseases