Attributable Risk and Economic Cost of Cardiovascular Hospital Admissions Due to Ambient Particulate Matter in Wuhan, China

Abstract

Although the adverse effects of ambient particulate matter (PM) on cardiovascular disease (CVD) have been previously documented, information about their economic consequence was insufficient. This study aimed to evaluate the attributable risk and economic cost of cardiovascular hospitalizations due to ambient PM. Data of CVD hospitalizations and PM concentrations from 1 January 2015 to 31 December 2017 were collected in Wuhan, China. A generalized additive model was applied to quantify the PM-attributable CVD hospitalizations, and total attributable hospitalization costs were calculated via multiplying the total attributable cases by the case-average hospitalization costs. A total of 45,714 CVD hospitalizations were included in this study. The results showed that a 10 µg/m3 increase in PM2.5 and PM10 concentrations at lag7 day, respectively, contributed to a 1.01% (95% confidence interval: 0.67–1.34) and 0.48% (0.26–0.70) increase in CVD hospitalizations. During the study period, 1487 and 983 CVD hospitalizations were attributable to PM2.5 and PM10, equaling an economic cost of 29.27 and 19.34 million RMB (1 RMB = 0.1424 USD), respectively, and significant differences in PM-attributable hospitalizations and economic burden were found between gender and age groups. Our study added evidence in heavily polluted megacities regarding the increased health risk and economic cost of CVD hospitalizations associated with ambient particulate pollution.

The short-term effects and burden of particle air pollution on hospitalization for coronary heart disease: a time-stratified case-crossover study in Sichuan, China

“…x 0 , as the base case from the air quality guideline of WHO, is the theoretical minimum threshold levels, below which PM pollution has no effect on HAs [ 39 ]. The largest effect in the single pollutant models is involved to estimate the attributable to exceeding PM pollution [ 19 ].…”

“…As exposure to PM pollution being ubiquitous, especially for residents in developing countries exposing to high levels of contaminants, PM pollution contributes comparably to public health crisis. Particularly, like the areas of China which with high PM pollution levels, this would contribute to increase the considerable health and economic burden [ 18 , 19 ]. Like Sichuan Province, it ranked as the fourth of heavily air polluted regions in China, with high annual mean PM levels [ 20 ].…”

Short-Term Associations of Ambient Fine Particulate Matter (PM2.5) with All-Cause Hospital Admissions and Total Charges in 12 Japanese Cities

“…Our results imply that ambient PM 2.5 exposure before a hospital admission event was associated with the subsequent total charge of the admission. However, earlier investigations on costs often used fixed per-patient costs and implicitly did not consider the variation [ 8 , 9 , 43 ]. As their results neglected an increase in per-patient costs, these studies might have underestimated the associations between ambient PM 2.5 concentrations and hospital admission costs.…”

Effects of particulate matter on hospital admissions for respiratory diseases: an ecological study based on 12.5 years of time series data in Shanghai

“…All results were presented as percentage change with a 95% confidence interval (CI) for each 10 μg/m 3 increase of PM. Percentage change was calculated using the following formula [ 14 ]: where β is the regression coefficient of PM from the GAM model.…”

“…The attributable fraction (AF) and attributable number (AN) of hospital admissions due to PM exposure were estimated using the following formula based on a previous study [ 14 ]: where AF is the daily attributable fraction, AN is the daily attributable number of hospital admissions due to PM, N is the daily hospital admissions, β is the regression coefficient (from the main model above), C is the daily PM concentration, and C 0 is the reference PM concentration. The reference concentrations were from the air quality guidelines of the WHO: 24-h mean: 15 μg/m 3 for PM 2.5 and 45 μg/m 3 for PM 10 .…”