Abstract
At present, evidence of the associations between carbon monoxide (CO) and respiratory diseases (RD) in Northwest China is limited and controversial. The aim of this study is to evaluate the impact of ambient CO on outpatient visits for RD in Lanzhou, China. The daily amount of outpatient visits for total and cause-specific RD, air pollutant, and weather variables were collected in Lanzhou, China from 1st January 2013 to 31st December 2019. A generalized additive model and distributed lag nonlinear model were used to assess associations between CO and outpatient visits for RD. During the study period, a total of 1,623,361 RD outpatient visits were recorded. For each interquartile range (IQR) (0.77 mg/m3) increase in CO, the relative risk (RR) was 1.163 (95% CI: 1.138, 1.188) for total RD at lag07, 1.153 (95% CI: 1.128,1.179) for upper respiratory tract infection (URTI) at lag07, 1.379 (95% CI: 1.338,1.422) for pneumonia at lag07, 1.029 (95% CI: 0.997,1.062) for chronic obstructive pulmonary disease (COPD) lag04, 1.068 (95% CI: 1.028,1.110) for asthma lag03, and 1.212 (95% CI: 1.178,1.247) for bronchitis lag07, respectively. In the subgroup analyses, the impacts of CO were more pronounced on total RD, pneumonia, COPD, and bronchitis in males than females, while the opposite was true in URTI and asthma. The impact of CO on RD was the strongest for children under 15 years-of-age. We also found significantly stronger effects during cold seasons compared to warm seasons. In addition, we observed a roughly linear exposure–response curve between CO and RD with no threshold effect. This study in Lanzhou revealed a remarkable association between CO level and an elevated risk of total and cause-specific RD outpatient visits, especially for pneumonia.
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Abbreviations
- CO:
-
Carbon monoxide
- RD:
-
Respiratory diseases
- URTI:
-
Upper respiratory tract infection
- COPD:
-
Chronic obstructive pulmonary disease
- GAM:
-
Generalized additive model
- DLNM:
-
Distributed lag nonlinear model
- PC:
-
Percentage change
- RR:
-
Relative risk
- Q-AIC:
-
Quasi-Akaike information criterion
- CI:
-
Confidence intervals
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The authors acknowledge the dedication and cooperation of all the participants in this study.
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This research was supported by the National Natural Science Foundation of China (72264002), the Fundamental Research Funds for the Central Universities, Lanzhou University, China (lzujbky-2022–44), and this research was supported by Gansu key research and development program under Grant No.23YFFA0033.
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Jiancheng Wang and Hairong Bao contributed to the conception or design of the work. Jianhua You, Yaocong Liu, and Jiyuan Dong are major contributors in writing the manuscript.
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Yaocong Liu and Jiyuan Dong are the co-first authors.
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Liu, Y., You, J., Dong, J. et al. Ambient carbon monoxide and relative risk of daily hospital outpatient visits for respiratory diseases in Lanzhou, China. Int J Biometeorol 67, 1913–1925 (2023). https://doi.org/10.1007/s00484-023-02550-z
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DOI: https://doi.org/10.1007/s00484-023-02550-z