Ambient air pollutants relate to hospital admissions for chronic obstructive pulmonary disease in Ganzhou, China

Abstract

OBJECTIVE To evaluate the relationship between ambient air pollutants and chronic obstructive pulmonary disease in relatively low-polluted areas in China. METHODS Atmospheric pollutants levels and meteorological data were obtained from January 2016 to December 2020. The medical database including daily hospital admissions for chronic obstructive pulmonary disease (ICD10: J44) was derived from the First Affiliated Hospital of Gannan Medical University. The generalized additive model was used to analyze the percentage change with 95% confidence interval in daily hospital admissions for chronic obstructive pulmonary disease associated with a 10 µg/m3 increase in atmospheric pollutants levels. RESULTS In total, occurred 4,980 chronic obstructive pulmonary disease hospital admissions (not including emergency department visits) during 2016–2020. The mean concentrations of daily PM2.5, PM10, SO2, NO2, O3, and CO were 37.5 μg/m3, 60.1 μg/m3, 18.7 μg/m3, 23.5 μg/m3, 70.0 μg/m3, and 1.2 mg/m3 in Ganzhou. Each 10 µg/m3 increment of PM2.5, PM10, NO2, and O3 were significantly associated with 2.8% (95%CI: 1.0–4.7), 1.3% (95%CI: 0.3–2.4), 2.8% (95%CI: 0.4–5.4), and 1.5% (95%CI: 0.2–2.7) elevation in daily chronic obstructive pulmonary disease hospital admissions. The estimates of delayed effects of PM2.5, PM10, NO2, and O3 were observed at lag6, lag6, lag8, lag1, respectively. The health effects of particulate pollutants (PM2.5 and PM10) may be independent of other pollutants. The adverse effects of air pollutants were more evident in the warm season (May–Oct) than in the cold season (Nov–Apr). CONCLUSION Our study demonstrated that elevated concentrations of atmospheric pollutant (PM2.5, PM10, NO2, and O3), especially particulate pollutants, can be associated with increased daily count of hospital admissions for chronic obstructive pulmonary disease , which may promote further understanding of the potential hazards of relatively low levels of air pollution on chronic obstructive pulmonary disease and other respiratory disorders.

Short-Term Effects of Ambient Air Pollution on Chronic Obstructive Pulmonary Disease Admissions in Jiuquan, China

“…Unfortunately, our findings for particulate matter do not align with several previous reports in the literature that have been conducted in some other regional countries or cities [13][14][15][16][17][18][19]. We observed that short-term exposure to PM 2.5 or PM 10 did not correlate significantly with COPD morbidity, which was consistent with findings from Berlin, Germany, and Jinan, China, the authors of the above two articles identified that PM 2.5 and PM 10 were also not found to significantly influence COPD hospitalizations in their study [12,20], while the results of some prior studies in Zhangjiakou, China; Zigong, China; Beijing, China; Ganzhou, China; Ningbo, Guangzhou, China; Gyeonggi-do, South Korea; and Istanbul, Turkey, found a statistically significant positive relationship between PM 2.5 , PM 10 , and COPD morbidity [13][14][15][16][17][18][19][20][21]. A recent systematic review, comprising 19 timeseries studies from around the globe, also estimated that the same PM 2.5 increase would result in a 1.60 percent increase in COPD admissions [22].…”

“…Two other timeseries analyses conducted in Ningbo and Jinan, respectively, found no statistically notable correlation between O 3 exposure and COPD admissions [12,14]. However, the findings of a few other studies were not in agreement with the results of this investigation, and there was a positive association between O 3 and COPD admissions [15][16][17]. One reason for the differences in the study data could be that ozone (O 3 ) production mechanisms are complex.…”

“…Then the 24 h average concentrations of PM 2.5 , PM 10 , SO 2 , NO 2 , and CO were calculated and represented as daily average concentrations, and the O 3 concentration was an 8 h maximum value concentration (O 3 8h) from all verified monitoring locations. Similar to the methods used in a number of earlier studies [10][11][12]14,15], we calculated the average air pollution concentrations from the 2 monitoring sites to represent the overall exposure for all people. Daily meteorological information, which comprised temperature and relative humidity, was supplied by the China Meteorological Data Service Center (http://data.cma.cn/, accessed on 12 March 2020).…”

“…In China, greater emphasis was placed on the prevention and management of air pollution in heavily polluted cities, such as Beijing, compared to cities with lower pollution levels, even though some publications suggested that cities that had lower air pollution levels indicated higher risks of COPD [14,15].…”