Background There are few studies on the effects of air pollutants on acute lower respiratory tract infections (ALRI) in children. Here, we investigated the relationship of fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), and nitrogen dioxide (NO2) with the daily number of hospitalizations for ALRI in children in Sichuan Province, China, and to estimate the economic burden of disease due to exposure to air pollutants. Methods We collected records of 192,079 cases of childhood ALRI hospitalization between January 1, 2017 and December 31, 2018 from nine municipal/prefecture medical institutions as well as the simultaneous meteorological and air pollution data from 183 monitoring sites in Sichuan Province. A time series-generalized additive model was used to analyze exposure responses and lagged effects while assessing the economic burden caused by air pollutant exposure after controlling for long-term trends, seasonality, day of the week, and meteorological factors. Results Our single-pollutant model shows that for each 10 μg/m3 increase in air pollutant concentration (1 μg/m3 for SO2), the effect estimates of PM2.5, PM10, SO2, and NO2 for pneumonia reached their maximum at lag4, lag010, lag010, and lag07, respectively, with relative risk (RR) values of 1.0064 (95% CI, 1.0004–1.0124), 1.0168(95% CI 1.0089–1.0248), 1.0278 (95% CI 1.0157–1.0400), and 1.0378 (95% CI, 1.0072–1.0692). By contrast, the effect estimates of PM2.5, PM10, SO2, and NO2 for bronchitis all reached their maximum at lag010, with RRs of 1.0133 (95% CI 1.0025–1.0242), 1.0161(95% CI 1.0085–1.0238), 1.0135 (95% CI 1.0025–1.0247), and 1.1133(95% CI 1.0739–1.1541). In addition, children aged 5–14 years were more vulnerable to air pollutants than those aged 0–4 years (p < 0.05). According to the World Health Organization’s air quality guidelines, the number of ALRI hospitalizations attributed to PM2.5, PM10, and NO2 pollution during the study period was 7551, 10,151, and 7575, respectively, while the incurring economic burden was CNY 2847.06, 3827.27, and 2855.91 million. Conclusion This study shows that in Sichuan Province, elevated daily average concentrations of four air pollutants lead to increases in numbers of childhood ALRI hospitalizations and cause a serious economic burden.

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Background Atrial fibrillation (AF) is the most common arrhythmia, resulting in serious cardiovascular diseases. Air pollution may cause heart rate disturbance, but there is no clear or consistent evidence that short-term exposure to air pollution leads to an increased risk of hospitalisation for symptomatic episodes of AF. This study aimed to assess the impact of short-term exposure to air pollution on inpatient numbers. Methods The inpatient records of AF cases in nine cities of the Sichuan Province, China and air pollution and meteorological data from 183 monitoring stations from 2017 to 2018 were collected. The impact of short-term exposure to air pollution on AF inpatients was evaluated using a time-stratified crossover case study design. The economic burden of AF attributable to air pollution was also estimated. Results A total of 5,958 patients with AF from 123 medical institutions were included in the analysis. Air pollutants had a significant impact on the number of patients with AF. The number increased by 2.5% (95% confidence interval [CI] = 1.006 to 1.044) and 1.8% (95% CI = 1.003–1.033) for every 10 µg/m3 increase in PM2.5, PM10, concentration, respectively. Moreover, the number increased by 12.7% (95% CI = 1.006 to 1.262) for every 10 µg/m3 increase of SO2 concentration. For every 0.1 μg/m3 increase in CO concentration, the number of inpatients with AF increased by 3.9% (95% CI = 1.010–1.070). People aged 65 years or older and women were more likely to be affected by air pollutants. The AF in 430 and 209 inpatients were attributable to PM2.5 and PM10, respectively. The total hospitalization expenses attributed to excessive exposure to PM2.5 and PM10 were 13.98 million CNY and 6.68 million CNY, respectively. Furthermore, the out-of-pocket expenses were 6.81 million CNY and 3.28 million CNY, respectively. Conclusions This study showed a strong correlation between air pollution and AF. Hence, there is a need to reduce air pollution to control health risks.

Background: Many previous studies have already proved the relationship between air pollutants and respiratory diseases. However, limited studies have so far assessed the impacts of air particulate matter exposure on the older adults patients with pneumonia. This study aims to reveal the impacts of short-term exposure to air particulate matter on the daily number of the older adults patients hospitalized due to pneumonia and calculate the economic costs attributable to this exposure.Methods: A time-stratified case-crossover study design was adopted. Hospitalization data were collected from hospitals above county levels from 9 cities in Sichuan Province, China from January 1, 2018 to December 31, 2019. A sample of 43,746 pneumonia patients aged over 65 was retrieved. After adjusting for the influence of temperature and humidity, we analyzed the relationships between the daily number of the older adults pneumonia inpatients and the levels of air particulate matters (PM2.5, and PM10) and their relevant economic burdens. Then, stratification analyses were conducted based on patient age, gender, season, and whether the patient has comorbidity.Results: Short-term exposure to air particulate matter pollution was correlated with the increase of the older adults pneumonia inpatients. The single pollutant model showed that PM2.5 and PM10 had the greatest impact on the number of the older adults pneumonia inpatients at lag7 and lag4, respectively. For every 10 μg/m3 increase in PM2.5 and PM10 concentrations, the daily number of the older adults pneumonia inpatients increased by 1.5% (95% CI: 1.010-1.021) and 1.0% (95% CI: 1.006-1.014), respectively. The 65-79 year-olds were more susceptible to air particulate pollutants (P < 0.05). During the study period, the total hospitalization costs and out-of-pocket expenses attributable to PM2.5 and PM10 exposure were 44.60 million CNY and 16.03 million CNY, respectively, with PM2.5 being the primary influencing factor.Conclusion: Short-term exposure to air particulate pollution increased the risks of hospitalization for pneumonia in the 65 plus age group, increasing economic burdens on the society and involved families. These findings can further support the policies aiming to reduce the number of the older adults pneumonia inpatients by controlling air particulate pollutant concentrations.