Abstract
Particulate matter (PM) air pollution is one of the major causes of morbidity and mortality in China. In this study, we estimated the short-term effects of PM on cause-specific hospitalization in Yichang, China. Daily data for PM level, meteorological factors, and hospital admissions (total hospitalization counts = 391,960) in Yichang between 2015 and 2017 were collected. We conducted a time-series study and applied a generalized additive model to evaluate the association between every 10 μg/m3 increment of PM and percent increase of hospitalization. We found positive and statistically significant associations between PM and hospital admissions for multiple outcomes, including all-cause, total respiratory, total cardiovascular diseases, and disease subcategories (hypertensive disease, coronary heart disease, stroke and the stroke subtype, chronic obstructive pulmonary disease, and lower respiratory infection). Each 10 μg/m3 increase in PM2.5 at Lag01 (a moving average of Lag0 to Lag1), was significantly associated with an increase of 1.31% (95% CI: 0.79%, 1.83%), 1.12% (95% CI: 0.40%, 1.84%), and 1.14% (95% CI: 0.53%, 1.75%) in hospitalizations for all-cause, CVD, and respiratory, respectively. The association for PM10 with all-cause, CVD, and respiratory admissions was similar but weaker than PM2.5. The effect on admissions persisted for up to 7 days, and peaked at Lag01. The associations between PM and all-cause hospitalizations were stronger among older individuals and in cold seasons. It is therefore important to continue implementation of emission abatement and other effective measures in Yichang and other cities in China.
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References
Atkinson RW, Kang S, Anderson HR, Mills IC, Walton HA (2014) Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis. Thorax 69:660–665. https://doi.org/10.1136/thoraxjnl-2013-204492
Bell ML, Zanobetti A, Dominici F (2013) Evidence on vulnerability and susceptibility to health risks associated with short-term exposure to particulate matter: a systematic review and meta-analysis. Am J Epidemiol 178:865–876. https://doi.org/10.1093/aje/kwt090
Cai J, Zhao A, Zhao J, Chen R, Wang W, Ha S, Xu X, Kan H (2014) Acute effects of air pollution on asthma hospitalization in Shanghai, China. Environ Pollut 191:139–144. https://doi.org/10.1016/j.envpol.2014.04.028
Chen R, Chu C, Tan J, Cao J, Song W, Xu X, Jiang C, Ma W, Yang C, Chen B, Gui Y, Kan H (2010) Ambient air pollution and hospital admission in Shanghai, China. J Hazard Mater 181:234–240. https://doi.org/10.1016/j.jhazmat.2010.05.002
Chen R, Yin P, Meng X, Liu C, Wang L, Xu X, Ross JA, Tse LA, Zhao Z, Kan H, Zhou M (2017) Fine particulate air pollution and daily mortality. A nationwide analysis in 272 Chinese cities. Am J Respir Crit Care Med 196:73–81. https://doi.org/10.1164/rccm.201609-1862OC
Chen C, Liu C, Chen R, Wang W, Li W, Kan H, Fu C (2018) Ambient air pollution and daily hospital admissions for mental disorders in Shanghai, China. Sci Total Environ 613-614:324–330. https://doi.org/10.1016/j.scitotenv.2017.09.098
Cohen AJ, Brauer M, Burnett R, Anderson HR, Frostad J, Estep K, Balakrishnan K, Brunekreef B, Dandona L, Dandona R, Feigin V, Freedman G, Hubbell B, Jobling A, Kan H, Knibbs L, Liu Y, Martin R, Morawska L, Pope CA 3rd, Shin H, Straif K, Shaddick G, Thomas M, van Dingenen R, van Donkelaar A, Vos T, Murray CJL, Forouzanfar MH (2017) Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet 389:1907–1918. https://doi.org/10.1016/S0140-6736(17)30505-6
Dominici F, Peng RD, Bell ML, Pham L, McDermott A, Zeger SL, Samet JM (2006) Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA 295:1127–1134. https://doi.org/10.1001/jama.295.10.1127
Fiordelisi A, Piscitelli P, Trimarco B, Coscioni E, Iaccarino G, Sorriento D (2017) The mechanisms of air pollution and particulate matter in cardiovascular diseases. Heart Fail Rev 22:337–347. https://doi.org/10.1007/s10741-017-9606-7
Fung KY, Krewski D, Chen Y, Burnett R, Cakmak S (2003) Comparison of time series and case-crossover analyses of air pollution and hospital admission data. Int J Epidemiol 32:1064–1070
Goldman GT, Mulholland JA, Russell AG, Strickland MJ, Klein M, Waller LA, Tolbert PE (2011) Impact of exposure measurement error in air pollution epidemiology: effect of error type in time-series studies. Environ Health 10:61. https://doi.org/10.1186/1476-069X-10-61
Gurung A, Son JY, Bell ML (2017) Particulate matter and risk of hospital admission in the Kathmandu Valley, Nepal: a case-crossover study. Am J Epidemiol 186:573–580. https://doi.org/10.1093/aje/kwx135
Heinrich J, Schikowski T (2018) COPD patients as vulnerable subpopulation for exposure to ambient air pollution. Curr Environ Health Rep 5:70–76. https://doi.org/10.1007/s40572-018-0178-z
Huang F, Luo Y, Guo Y, Tao L, Xu Q, Wang C, Wang A, Li X, Guo J, Yan A, Guo X (2016) Particulate matter and hospital admissions for stroke in Beijing, China: modification effects by ambient temperature. J Am Heart Assoc. https://doi.org/10.1161/JAHA.116.003437
Kennedy T, Ghio AJ, Reed W, Samet J, Zagorski J, Quay J, Carter J, Dailey L, Hoidal JR, Devlin RB (1998) Copper-dependent inflammation and nuclear factor-kappaB activation by particulate air pollution. Am J Respir Cell Mol Biol 19:366–378. https://doi.org/10.1165/ajrcmb.19.3.3042
Kim SY, Peel JL, Hannigan MP, Dutton SJ, Sheppard L, Clark ML, Vedal S (2012) The temporal lag structure of short-term associations of fine particulate matter chemical constituents and cardiovascular and respiratory hospitalizations. Environ Health Perspect 120:1094–1099. https://doi.org/10.1289/ehp.1104721
Le Tertre A, Medina S, Samoli E, Forsberg B, Michelozzi P, Boumghar A, Vonk JM, Bellini A, Atkinson R, Ayres JG, Sunyer J, Schwartz J, Katsouyanni K (2002) Short-term effects of particulate air pollution on cardiovascular diseases in eight European cities. J Epidemiol Community Health 56:773–779
Liu H, Tian Y, Xu Y, Huang Z, Huang C, Hu Y, Zhang J (2017) Association between ambient air pollution and hospitalization for ischemic and hemorrhagic stroke in China: a multicity case-crossover study. Environ Pollut 230:234–241. https://doi.org/10.1016/j.envpol.2017.06.057
Lu F, Xu D, Cheng Y, Dong S, Guo C, Jiang X, Zheng X (2015) Systematic review and meta-analysis of the adverse health effects of ambient PM2.5 and PM10 pollution in the Chinese population. Environ Res 136:196–204. https://doi.org/10.1016/j.envres.2014.06.029
McGowan JA, Hider RN, Chacko E, Town GI (2002) Particulate air pollution and hospital admissions in Christchurch, New Zealand. Aust N Z J Public Health 26:23–29
Newell K, Kartsonaki C, Lam K, Kurmi OP (2017) Cardiorespiratory health effects of particulate ambient air pollution exposure in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Planet Health 1:e368–e380. https://doi.org/10.1016/S2542-5196(17)30166-3
Nhung N, Schindler C, Dien TM, Probst-Hensch N, Perez L, Kunzli N (2018) Acute effects of ambient air pollution on lower respiratory infections in Hanoi children: an eight-year time series study. Environ Int 110:139–148. https://doi.org/10.1016/j.envint.2017.10.024
Pui DYH, Chen SC, Zuo Z (2014) PM 2.5 in China: measurements, sources, visibility and health effects, and mitigation. Particuology 13:1–26
Ren M, Fang X, Li M, Sun S, Pei L, Xu Q, Ye X, Cao Y (2017, 2017) Concentration-response relationship between PM2.5 and daily respiratory deaths in China: a systematic review and metaregression analysis of time-series studies. Biomed Res Int:5806185. https://doi.org/10.1155/2017/5806185
Schikowski T, Mills IC, Anderson HR, Cohen A, Hansell A, Kauffmann F, Kramer U, Marcon A, Perez L, Sunyer J, Probst-Hensch N, Kunzli N (2014) Ambient air pollution: a cause of COPD? Eur Respir J 43:250–263. https://doi.org/10.1183/09031936.00100112
Serinelli M, Vigotti MA, Stafoggia M, Berti G, Bisanti L, Mallone S, Pacelli B, Tessari R, Forastiere F (2010) Particulate matter and out-of-hospital coronary deaths in eight Italian cities. Occup Environ Med 67:301–306. https://doi.org/10.1136/oem.2009.046359
Stafoggia M, Schwartz J, Forastiere F, Perucci CA (2008) Does temperature modify the association between air pollution and mortality? A multicity case-crossover analysis in Italy. Am J Epidemiol 167:1476–1485. https://doi.org/10.1093/aje/kwn074
Stafoggia M, Samoli E, Alessandrini E, Cadum E, Ostro B, Berti G, Faustini A, Jacquemin B, Linares C, Pascal M, Randi G, Ranzi A, Stivanello E, Forastiere F (2013) Short-term associations between fine and coarse particulate matter and hospitalizations in southern Europe: results from the MED-PARTICLES project. Environ Health Perspect 121:1026–1033. https://doi.org/10.1289/ehp.1206151
Su C, Breitner S, Schneider A, Liu L, Franck U, Peters A, Pan X (2016) Short-term effects of fine particulate air pollution on cardiovascular hospital emergency room visits: a time-series study in Beijing, China. Int Arch Occup Environ Health 89:641–657. https://doi.org/10.1007/s00420-015-1102-6
Suwa T, Hogg JC, Quinlan KB, Ohgami A, Vincent R, van Eeden SF (2002) Particulate air pollution induces progression of atherosclerosis. J Am Coll Cardiol 39:935–942
Tao Y, Mi S, Zhou S, Wang S, Xie X (2014) Air pollution and hospital admissions for respiratory diseases in Lanzhou, China. Environ Pollut 185:196–201. https://doi.org/10.1016/j.envpol.2013.10.035
Tian Y, Xiang X, Wu Y, Cao Y, Song J, Sun K, Liu H, Hu Y (2017) Fine particulate air pollution and first hospital admissions for ischemic stroke in Beijing, China. Sci Rep 7:3897. https://doi.org/10.1038/s41598-017-04312-5
Tian Y, Liu H, Zhao Z, Xiang X, Li M, Juan J, Song J, Cao Y, Wang X, Chen L, Wei C, Hu Y, Gao P (2018a) Association between ambient air pollution and daily hospital admissions for ischemic stroke: a nationwide time-series analysis. PLoS Med 15:e1002668. https://doi.org/10.1371/journal.Pmed.1002668
Tian Y, Liu H, Liang T, Xiang X, Li M, Juan J, Song J, Cao Y, Wang X, Chen L, Wei C, Gao P, Hu Y (2018b) Ambient air pollution and daily hospital admissions: a nationwide study in 218 Chinese cities. Environ Pollut 242:1042–1049. https://doi.org/10.1016/j.envpol.2018.07.116
Wang MZ, Zheng S, Wang SG, Tao Y, Shang KZ (2013) The weather temperature and air pollution interaction and its effect on hospital admissions due to respiratory system diseases in western China. Biomed Environ Sci 26:403–407. https://doi.org/10.3967/0895-3988.2013.05.011
Xia T, Korge P, Weiss JN, Li N, Venkatesen MI, Sioutas C, Nel A (2004) Quinones and aromatic chemical compounds in particulate matter induce mitochondrial dysfunction: implications for ultrafine particle toxicity. Environ Health Perspect 112:1347–1358. https://doi.org/10.1289/ehp.7167
Xu A, Mu Z, Jiang B, Wang W, Yu H, Zhang L, Li J (2017) Acute effects of particulate air pollution on ischemic heart disease hospitalizations in Shanghai China. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph14020168
Yin P, He G, Fan M, Chiu KY, Fan M, Liu C, Xue A, Liu T, Pan Y, Mu Q, Zhou M (2017) Particulate air pollution and mortality in 38 of China’s largest cities: time series analysis. BMJ 356:j667. https://doi.org/10.1136/bmj.j667
Zanobetti A, Franklin M, Koutrakis P, Schwartz J (2009) Fine particulate air pollution and its components in association with cause-specific emergency admissions. Environ Health 8:58. https://doi.org/10.1186/1476-069X-8-58
Zhou M, Liu Y, Wang L, Kuang X, Xu X, Kan H (2014) Particulate air pollution and mortality in a cohort of Chinese men. Environ Pollut 186:1–6. https://doi.org/10.1016/j.envpol.2013.11.010
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Yao, C., Wang, Y., Williams, C. et al. The association between high particulate matter pollution and daily cause-specific hospital admissions: a time-series study in Yichang, China. Environ Sci Pollut Res 27, 5240–5250 (2020). https://doi.org/10.1007/s11356-019-06734-2
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DOI: https://doi.org/10.1007/s11356-019-06734-2