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

Abstract

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.