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The impact of main air pollutants on respiratory emergency department visits and the modification effects of temperature in Beijing, China

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Abstract

Research indicates that air pollution is a risk factor of an increased occurrence of diseases. However, evidence is limited on the effects of the pollution index on disease and whether temperature modifies the effects. The objectives were (i) to explore the effects of the Air Pollution Index (API) and specific indices for pollutants (PM10, NO2, and SO2) on respiratory emergency department (ED) visits in Beijing and (ii) to investigate whether temperature modified the effects of main air pollutants on respiratory ED visits. A quasi-Poisson generalized additive model was employed to examine the association of API and indices for pollutants with respiratory disease. Bivariate response surface model and stratification model (cold days, moderately cold days, moderately hot days, and hot days) were used to analyze the modification effects of temperature on air pollution and respiratory disease. The results showed that (i) the effects of API on respiratory diseases were similar to the index for PM10 in Beijing. (ii) API and PM10 were associated with increased respiratory ED visits on cold days and moderately cold days. Furthermore, the effects of PM10 on respiratory disease on moderately cold days [Relative risk (RR) = 1.006 per 10 μg/m3, 95% CI 1.002–1.009] were stronger than on cold days (RR = 1.004 per 10 μg/m3, 95% CI 1.000–1.008). (iii) PM10 (API) had a greater impact on children aged 10 to 17 years and females on moderately cold days, while the elderly had an increased risk of respiratory disease to PM10 (RR = 1.008 per 10 μg/m3, 95% CI 1.002–1.013) and API (RR = 1.013 per 10, 95% CI 1.004–1.022) on cold days. In conclusion, temperature can modify the association between API and respiratory morbidity. A stronger correlation existed between PM10 and respiratory diseases on moderately cold days, while the effects of cold days were less than that attributable to moderately cold days.

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Data availability

The datasets generated and analyzed during the current study are not publicly available due hospital research policy but are available from the corresponding author on reasonable request.

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Funding

This study was funded by National Key Research Project of China -Strategy on Black Carbon Reduction and Evaluation of the Health Effects of Climate Change (Grant numbers: 2016YFA0602004), Innovation Fund Project on Public Meteorological Service Center of China Meteorological Administration in 2020 (Grant numbers: K2020010) and the Fundamental Research Funds for the Central Universities of Lanzhou University (Grant numbers: lzujbky-2019-9).

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Authors and Affiliations

  1. Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China

    Xuping Song, Liangzhen Jiang, Jinhui Tian & Kehu Yang

  2. Evidence-based Medicine Center, School of Basic Medical Science, Lanzhou University, Lanzhou, 730000, China

    Xuping Song, Liangzhen Jiang, Jinhui Tian & Kehu Yang

  3. College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610000, Sichuan, China

    Shigong Wang

  4. Second Clinical College, Lanzhou University, Lanzhou, 730000, China

    Xinyi Wang & Hongdan Guan

  5. First Clinical College, Lanzhou University, Lanzhou, 730000, China

    Nan Zhang

Authors
  1. Xuping Song
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  2. Liangzhen Jiang
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  3. Shigong Wang
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  4. Jinhui Tian
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  7. Hongdan Guan
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  8. Nan Zhang
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Contributions

Conceptualization: Wang SG, Song XP; Methodology: Wang SG, Song XP, Tian JH, Yang KH; Collection and assembly of data: Song XP, Wang XY, Guan HD, Zhang N; Writing—original draft preparation: Song XP, Jiang LZ, Wang XY, Guan HD, Zhang N; Writing—review and editing: Wang SG, Tian JH, Yang KH; Supervision: Wang SG.

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Correspondence to Shigong Wang.

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Responsible editor: Lotfi Aleya

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Table S1

Intervals of pollutant concentrations and corresponding API (DOCX 14 kb)

Fig. S1

Relative risks in respiratory ED visits associated with API and specific indices for pollutants (PM10, NO2, and SO2) per 10 increase stratified by age, gender and disease at lag 02 (PNG 1550 kb)

High resolution image (EPS 3782 kb)

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Song, X., Jiang, L., Wang, S. et al. The impact of main air pollutants on respiratory emergency department visits and the modification effects of temperature in Beijing, China. Environ Sci Pollut Res 28, 6990–7000 (2021). https://doi.org/10.1007/s11356-020-10949-z

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  • DOI: https://doi.org/10.1007/s11356-020-10949-z

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