Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study.

Publisher: Oxford University Press Country of Publication: England NLM ID: 7802871 Publication Model: Print Cited Medium: Internet ISSN: 1464-3685 (Electronic) Linking ISSN: 03005771 NLM ISO Abbreviation: Int J Epidemiol Subsets: MEDLINE

Original Publication: [London] Oxford University Press.

Air Pollution*/adverse effects ; Air Pollution*/analysis ; Respiratory Tract Diseases*/epidemiology ; Bronchitis*; Child ; Female ; Humans ; Cross-Over Studies ; Hospitalization ; Particulate Matter/adverse effects ; Particulate Matter/analysis ; Hospitals ; China/epidemiology ; Environmental Exposure/adverse effects

Background: The associations between fine and coarse particulate matter (PM2.5 and PM2.5-10) air pollution and hospital admissions for full-spectrum respiratory diseases were rarely investigated, especially for age-specific associations. We aim to estimate the age-specific associations of short-term exposures to PM2.5 and PM2.5-10 with hospital admissions for full-spectrum respiratory diseases in China.
Methods: We conducted an individual-level case-crossover study based on a nationwide hospital-based registry including 153 hospitals across 20 provincial regions in China in 2013-20. We applied conditional logistic regression models and distributed lag models to estimate the exposure- and lag-response associations.
Results: A total of 1 399 955 hospital admission records for various respiratory diseases were identified. The associations of PM2.5 and PM2.5-10 with total respiratory hospitalizations lasted for 4 days, and an interquartile range increase in PM2.5 (34.5 μg/m3) and PM2.5-10 (26.0 μg/m3) was associated with 1.73% [95% confidence interval (95% CI): 1.34%, 2.12%)] and 1.70% (95% CI: 1.31%, 2.10%) increases, respectively, in total respiratory hospitalizations over lag 0-4 days. Acute respiratory infections (i.e. pneumonia, bronchitis and bronchiolitis) were consistently associated with PM2.5 or PM2.5-10 exposure across different age groups. We found the disease spectrum varied by age, including rarely reported findings (i.e. acute laryngitis and tracheitis, and influenza) among children and well-established associations (i.e. chronic obstructive pulmonary disease, asthma, acute bronchitis and emphysema) among older populations. Besides, the associations were stronger in females, children and older populations.
Conclusions: This nationwide case-crossover study provides robust evidence that short-term exposure to both PM2.5 and PM2.5-10 was associated with increased hospital admissions for a wide range of respiratory diseases, and the spectra of respiratory diseases varied by age. Females, children and older populations were more susceptible.
(© The Author(s) 2023; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Keywords: Particulate matter; case-crossover study; full-spectrum respiratory disease; hospital admission

0 (Particulate Matter)

Date Created: 20230509 Date Completed: 20230929 Latest Revision: 20230929

20230929

10.1093/ije/dyad056

37159523