Abstract
Effects of air pollution on asthma vary in different study areas, and long-term time series research on the effects of air pollution on asthma outpatients and emergency hospital visits has not been conducted in Northeast China. We assessed the impact of air pollutants on the risk of asthma outpatients and emergency hospital visits in Shenyang, China. A distributed lag non-linear model with a Poisson regression was used to assess the short-term effects of air pollutants on asthma outpatient and emergency hospital visits between January 1, 2013 and December 31, 2017. Confounding factors were adjusted using natural cubic splines. Ozone (O3), carbon monoxide (CO), and suspended particulates < 10 μm in aerodynamic diameter (PM10) were positively associated with the number of asthma hospital visits. The largest cumulative effects of O3, CO, and PM10 on hospital visits were on lag day 2 (RR = 1.163, 95% CI 1.051–1.287) for 0–5-year-old childhood asthma, on lag day 3 (RR = 1.386, 95% CI 1.136–1.69) for asthma in winter, and on lag day 10 (RR = 1.148, 95% CI 0.942–1.399) for female asthma, respectively. The cumulative effect of air pollution represented by the air quality index (AQI) was largest on lag day 10 for 0–5-year-old childhood asthma with an increase of 28.6% (95% CI 6.5–55.4) hospital visits every IQR increment of the AQI. CO, O3, and PM10 were the main air pollutants in Shenyang city. Children with bronchitis asthma were more vulnerable to air pollution during the cold season.
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Data used in this article were governmentally confidential and are available upon request.
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Acknowledgments
The authors thank the computerized information center of HSIC for assisting with the retrieval of daily patient records and the Bureau of Meteorology and Environment Protection Authority in Shenyang for providing original daily meteorological data and pollutant concentrations.
Funding
This study was funded by the National Key R&D Program of China-“Northeast Natural Population Cohort Study” (Project ID: 2017YFC0907401) and 345 Talent Project by Shengjing Hospital of China Medical University.
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Hehua Zhang was in charge of the data analysis and writing of the manuscript; Shu Liu, Zongjiao Chen, and Biao Zu completed the data processing; and Qing Chang was in charge of the data analysis and quality check.
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As the study did not include any personal data, it was qualified as negligible risk research and was exempt from the ethical review of the Human Research Ethics Committee of the Shengjing Hospital of China Medical University.
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Chang, Q., Liu, S., Chen, Z. et al. Association between air pollutants and outpatient and emergency hospital visits for childhood asthma in Shenyang city of China. Int J Biometeorol 64, 1539–1548 (2020). https://doi.org/10.1007/s00484-020-01934-9
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DOI: https://doi.org/10.1007/s00484-020-01934-9