Associations between daily outpatient visits for respiratory diseases and ambient fine particulate matter and ozone levels in Shanghai, China

et al. 2020

BMC Public Health

Background: Previous studies have suggested that there is an association between air pollutants and circulatory and respiratory diseases; however, relatively few have analyzed the association between air pollutants and outpatient visits based on the mortality, hospitalization rates, etc., especially in areas with relatively good air quality. Therefore, we conducted this study to research the association between air pollutants and outpatient visits in Fuzhou, China. Methods: We used a generalized linear Poisson model to study the association between air pollution and outpatient visits for respiratory and circulatory diseases from 2016 to 2018 in Fuzhou, China. Results: In the single pollutant model, nitrogen dioxide (NO 2) had a significant effect. For lag day 0 to lag day 5, the effect decreased with every 10 μg/L increase in NO 2. The daily maximum 8-h mean ozone (O 3-8h) and upper respiratory outpatient visits were positively associated during the cold period [lag2, excess risk (ER) (95% confidence interval (CI)): 1.68% (0.44-2.94%)], while O 3-8h and respiratory disease were positively associated during the warm period [lag5, ER (95% CI): 1.10% (0.11-2.10%) and lag4, ER (95% CI): 1.02% (0.032-2.02%)]. Similarly, particulate matter (PM) with an average aerodynamic diameter of less than 10 μm (PM 10) and lower respiratory diseases were positively associated during the warm period [lag0, ER (95% CI): 1.68% (0.44-2.94%)]. When the concentration of O 3-8h was higher than 100 μg/L, there was a positive effect on circulatory [lag5, ER (95% CI): 2.83% (0.65-5.06%)], respiratory [lag5, ER (95% CI): 2.47% (0.85-4.11%)] and upper respiratory [lag5, ER (95% CI): 3.06% (1.38-4.77%)] outpatient visits. The variation in O 3-8h changed slightly when we adjusted for other air pollutants, and after adjusting for O 3-8h, the ERs of the other air pollutants changed slightly. After adjusting for PM with an average aerodynamic diameter of less than 2.5 μm (PM 2.5), the ERs of the other air pollutants increased, and after adjusting for NO 2 , the ER of PM decreased.

Section: Introductionmentioning

confidence: 99%

Temporal cross-correlations between air pollutants and outpatient visits for respiratory and circulatory system diseases in Fuzhou, China

et al. 2020

BMC Public Health

“…The interaction between PM and NO 2 was strong, and the effect of 8-h O 3 was independent. Previous studies also found a strong correlation between PM and gaseous air pollution, with the exception of O 3 , which did not change much after the other air pollutants were added to the model [6,18]. Some mechanics studies noted that inflammation, oxidative stress, changes in systemic coagulation functioning and reduced cardiac autonomic control occurred after exposure to gaseous air pollutants and PM [44,45], which may trigger respiratory and cardiovascular events as well as high concentrations of air pollutants, except 8-h O 3 , during the same period (the cold season).…”

Section: Discussionmentioning

confidence: 66%

Temporal cross-correlations between air pollutants and outpatient visits for respiratory and circulatory system diseases in Fuzhou, China

et al. 2020

Preprint

Background: Previous studies have suggested that there is an association between air pollutants and circulatory and respiratory diseases, but relatively few have analyzed the association between air pollutants and outpatient visits considering mortality, hospitalization rates, etc., especially areas with relatively good air quality. Therefore, we conducted this study to research the association between air pollutants and outpatient visits in Fuzhou, China. Methods: We used a generalized linear Poisson model to study the association between air pollution and outpatient visits for respiratory and circulatory diseases during 2016-2018 in Fuzhou, China. Results: In the single pollutant model, nitrogen dioxide (NO2) had a significant effect. For lag day 0 to lag day 5, the effect decreased with every 10 µg/L increase in NO2. Daily maximum 8-h mean ozone (8-h O3) and upper respiratory outpatient visits were positively associated during the cold period [lag2, excess risk (ER) (95% confidence interval (CI)): 1.68% (0.44%-2.94%)], while 8-h O3 and respiratory disease were positively associated during the warm period [lag5, ER (95% CI): 1.10% (0.11%-2.10%) and lag4, ER (95% CI): 1.02% (0.032%-2.02%)]. Similarly, particulate matter (PM) with an average aerodynamic diameter of less than 10 μm (PM10) and lower respiratory diseases were positively associated during the warm period [lag0, ER (95% CI): 1.68% (0.44%-2.94%)]. When the concentration of 8-h O3 was higher than 100 μg/L, there was a positive effect on circulatory [lag5, ER (95% CI): 2.83% (0.65%-5.06%)], respiratory [lag5, ER (95% CI): 2.47% (0.85%-4.11%)] and upper respiratory [lag5, ER (95% CI): 3.06% (1.38%-4.77%)] outpatient visits. The variation in 8-h O3 changed slightly when we adjusted for the other air pollutants, and after adjusting for 8-h O3, the ERs of the other air pollutants changed slightly. After adjusting for PM with an average aerodynamic diameter of less than 2.5 μm (PM2.5), the ERs of the other air pollutants increased, and after adjusting for NO2, the ER of PM decreased. Conclusion: Exposure to ambient NO2, O3, PM2.5 and PM10 was associated with an increase in respiratory and circulatory system-related outpatient visits in Fuzhou, China.

“…The interaction between PM and NO 2 was strong, and the effect of O 3 was independent. Previous studies also found that there was a strong correlation between PM and gaseous air pollution, with the exception of O 3 , which did not change much after adding the other air pollutants into the model [6,17]. Some mechanics studies noted that inflammation, oxidative stress, changes in systemic coagulation functioning and reduced cardiac autonomic control appeared after exposure to gaseous air pollutants and PM [39,40], which may trigger respiratory and cardiovascular events as well as high concentrations of air pollutants, except O 3 , in the same period (cold period).…”

Section: Discussionmentioning

confidence: 72%

“…At Fig.3A, single air pollutant model shows that NO 2 had a significant effect on the ER of total respiratory, lower respiratory, upper respiratory and circulatory diseases. There was a single-day lag effect that is most obvious at lag0, increasing by 5.11% (95%CI: 3.31%-6.95%) for total respiratory, 6.04% (95%CI: 3.91%-8.21%) for upper respiratory 3.23% (95%CI: 0.46%-6.08%) for lower respiratory, and 4.75% (95%CI: 6.81%-2.73%) for circulatory outpatient visits. The cumulative lag effect is the most obvious at lag0-5, increasing by 9.43% (95%CI: 6.31%-12.65%) for total respiratory, 10.96% (95%CI: 7.22%-14.84%) for upper respiratory, 7.69% (95%CI: 2.96%-12.64%) for lower respiratory, and 8.14% (95CI: 4.74%-11.65%) for circulatory diseases.…”

Section: Association Of Air Pollutants and Outpatient Visitsmentioning

confidence: 94%

See 1 more Smart Citation

Temporal Cross-Correlations between air pollutants and outpatient visits for respiratory and circulatory system diseases in coastal area of China

et al. 2019

Preprint

Background Some previous studies have suggested that there is an association between air pollutants and circulatory and respiratory diseases. However, the association of air pollutants and outpatient visits considering mortality, hospitalization rates, etc. has been analyzed in relatively few studies.Methods We used a generalized linear Poisson model was constructed to study the association between air pollution and outpatient visits for respiratory and circulatory diseases during 2016-2018 in coastal area of China.Results In the single pollutant model, NO 2 had a significant effect. For lag day 0 to lag day 5, the effect decreased with every 10 µg/L increase in NO 2 . O 3 and upper respiratory outpatient visits were positively associated in the cold period [lag2, ER (95%CI): 1.68% (0.44%-2.94%)], while O 3 and respiratory disease were positively associated in the warm period [lag5, ER (95%CI): 1.10% (0.11%-2.10%) and lag4, ER (95%CI): 1.02% (0.032%-2.02%)]. Similarly, PM 10 and lower respiratory diseases were positively associated in the warm period [lag0, ER (95%CI): 1.68% (0.44%-2.94%)]. When the concentration of O 3 was higher than 100 μg/L, there was a positive effect on circulatory [lag5, ER (95%CI): 2.83% (0.65%-5.06%)], respiratory [lag5, ER (95%CI): 2.47% (0.85%-4.11%)] and upper respiratory [lag5, ER (95%CI): 3.06% (1.38%-4.77%)] outpatient visits. The variation in O 3 changed slightly when we adjusted for the other air pollutants, and after adjusting for O 3 , the ERs of the other air pollutants changed slightly. After adjusting for PM 2.5 , the ER of the other air pollutants increased, and after adjusting for NO 2 , the ER of particulate matter (PM) decreased.Conclusion Exposure to ambient NO 2 , O 3 , PM 2.5 and PM 10 was associated with an increase in respiratory and circulatory system outpatient visits in coastal area of China.