Associations between air pollutants and hospital admissions for chronic obstructive pulmonary disease in Jinan: potential benefits from air quality improvements

Abstract

Evidence between air pollution and chronic obstructive pulmonary disease (COPD) is inconsistent and limited in China. In this study, we aim to examine the associations between air pollutants and hospital admissions for COPD, hoping to provide practical advice for prevention and control of COPD. Hospital admissions for COPD were collected from a Grade-A tertiary hospital in Jinan from 2014 to 2020. A generalized additive model (GAM) was used to examine the associations between air pollutants and hospital admissions for COPD. Stratified analysis was also conducted for gender, age (20–74 and ≥75 years), and season (warm and cold). The avoidable number of COPD hospital admissions was calculated when air pollutants were controlled under national and WHO standards. Over the study period, a total of 4,012 hospital admissions for COPD were recorded. The daily hospital admissions of COPD increased by 2.36% (95% CI : 0.13–4.65%) and 2.39% (95% CI : 0.19–4.65%) for per 10 μg/m 3 increase of NO 2 and SO 2 concentrations at lag2, respectively. There was no statistically significant difference in health effects caused by increased concentrations of PM 2.5 , PM 10 , CO, and O 3 . The health effects of increased SO 2 concentration were stronger in women, the ≥75 years old people and the cold season. About 2 (95% CI : 0–3), 64 (95% CI : 4–132) and 86 (95% CI : 6–177) COPD admissions would be avoided when the SO 2 concentration was controlled below the NAAQS-II (150 μg/m 3 ), NAAQS-I (50 μg/m 3 ), and WHO’s AQG2021 standard (40 μg/m 3 ), respectively. These findings suggest that short-term exposure to NO 2 and SO 2 was associated with increased risks of daily COPD admissions, especially for females and the elderly. The control of SO 2 and NO 2 under the national and WHO standards could avoid more COPD admissions and obtain greater health benefits. Supplementary Information The online version contains supplementary material available at 10.1007/s11356-023-25567-8.

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

“…We evaluated the optimal df for time with 7, for temperature and relative humidity with 3 to control the long-term and seasonal trends and the effect of temperature and relative humidity. Previous studies showed that the delayed effects of air pollution on COPD morbidity could last for several days, and the biggest air pollution lag effects occur within 7 days [10][11][12]14]. Therefore, we decided to use a maximum lag of 7 days in the DLNM for each pollutant, as in the three documents mentioned above [10][11][12]14].…”

“…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 contrast, analyzing 255597 hospital admission visits in Qingdao, Yang et al confirmed that only NO 2 and SO 2 exhibited distinct cumulative lag correlations with COPD admission [11]. Similarly, a study in Jinan, China, found that there was an absence of statistically significant variation in the health impacts induced by elevated levels of PM 2.5 , PM 10 , CO, and O 3 [12]. In Istanbul, Turkey, Ko et al found a direct correlation between air pollutants (PM 10 , PM 2.5 , and NO 2 ) and an increase in hospital admissions for COPD [13].…”

COPD Exacerbation: Why It Is Important to Avoid ICU Admission

“…In total, 20-40% of all AECOPD events are triggered by non-infectious conditions, such as cardiovascular comorbidities (in particular heart failure), pulmonary embolisms, extra-pulmonary infections, and pneumothorax [63]. Moreover, some precipitating factors of AECOPD could also be represented by air pollution and/or cold air exposure, allergen exposure, tobacco smoking, and, not negligibly, a poor adherence with COPD therapies, including oxygen [64][65][66][67]. Interactions between all the possible triggers (the pathogens, indoor and outdoor pollution) and a patient's characteristics increase the inflammation in the lower airways, leading to tissue damage.…”

The Impact of Air Pollution on Asthma Severity among Residents Living near the Main Industrial Complex in Oman: A Cross-Sectional Study

“…Air pollution is a substantial environmental issue with profound implications for public wellbeing, particularly respiratory health. Industrial air pollution is a significant concern, with numerous studies highlighting its adverse effects on respiratory health [1][2][3]. Industrial activities, such as the combustion of fossil fuels, emit a wide range of pollutants, among which fine particulate matter (PM2.5) is prominent.…”