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Zhu A, Cao Y, Li C, Yu J, Liu M, Xu K, Ruan Y. Effects of major air pollutants on angina hospitalizations: a correlation study. BMC Public Health 2024; 24:1877. [PMID: 39004712 PMCID: PMC11247793 DOI: 10.1186/s12889-024-19380-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Angina is a crucial risk signal for cardiovascular disease. However, few studies have evaluated the effects of ambient air pollution exposure on angina. OBJECTIVE We aimed to explore the short-term effects of air pollution on hospitalization for angina and its lag effects. METHODS We collected data on air pollutant concentrations and angina hospitalizations from 2013 to 2020. Distributed lag nonlinear model (DLNM) was used to evaluate the short-term effects of air pollutants on angina hospitalization under different lag structures. Stratified analysis by sex, age and season was obtained. RESULTS A total of 39,110 cases of angina hospitalization were included in the study. The results showed a significant positive correlation between PM2.5, SO2, NO2, and CO and angina hospitalization. Their maximum harmful effects were observed at lag0-7 (RR = 1.042; 95% CI: 1.017, 1.068), lag0-3 (RR = 1.067; 95% CI: 1.005, 1.133), lag0-6 (RR = 1.078; 95% CI: 1.041, 1.117), and lag0-6 (RR = 1.244; 95% CI: 1.109, 1.397), respectively. PM10 did not have an overall risk effect on angina hospitalization, but it did have a risk effect on women and the elderly. O3 was significantly negatively correlated with angina hospitalization, with the most pronounced effect observed at lag0-6 (RR = 0.960; 95% CI: 0.940, 0.982). Stratified analysis results showed that women and the elderly were more susceptible to pollutants, and the adverse effects of pollutants were stronger in the cold season. CONCLUSION Short-term exposure to PM2.5, SO2, NO2, and CO increases the risk of hospitalization for angina.
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Affiliation(s)
- Anning Zhu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Yongqin Cao
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, PR China
| | - Chunlan Li
- Third People's Hospital of Gansu Province, Lanzhou, 730000, PR China
| | - Jingze Yu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Miaoxin Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Ke Xu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Ye Ruan
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China.
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Yu J, Zhu A, Liu M, Dong J, Chen R, Tian T, Liu T, Ma L, Ruan Y. Association Between Air Pollution and Cardiovascular Disease Hospitalizations in Lanzhou City, 2013-2020: A Time Series Analysis. GEOHEALTH 2024; 8:e2022GH000780. [PMID: 38173697 PMCID: PMC10762694 DOI: 10.1029/2022gh000780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 11/29/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024]
Abstract
Extensive evidence has shown that air pollution increases the risk of cardiovascular disease (CVD) admissions. We aimed to explore the short-term effect of air pollution on CVD admissions in Lanzhou residents and their lag effects. Meteorological data, air pollution data, and a total of 309,561 daily hospitalizations for CVD among urban residents in Lanzhou were collected from 2013 to 2020. Distributed lag non-linear model was used to analyze the relationship between air pollutants and CVD admissions, stratified by gender, age, and season. PM2.5, NO2, and CO have the strongest harmful effects at lag03, while SO2 at lag3. The relative risks of CVD admissions were 1.0013(95% CI: 1.0003, 1.0023), 1.0032(95% CI: 1.0008, 1.0056), and 1.0040(95% CI: 1.0024, 1.0057) when PM2.5, SO2, and NO2 concentrations were increased by 10 μg/m³, respectively. Each 1 mg/m3 increase in CO concentration was associated with a relative risk of cardiovascular hospitalization of risk was 1.0909(95% CI: 1.0367, 1.1479). We observed a relative risk of 0.9981(95% CI: 0.9972, 0.9991) for each 10 μg/m³ increase in O3 for CVD admissions at lag06. We found a significant lag effects of air pollutants on CVD admissions. NO2 and CO pose a greater risk of hospitalization for women, while PM2.5 and SO2 have a greater impact on men. PM2.5, NO2, and CO have a greater impact on CVD admissions in individuals aged <65 years, whereas SO2 affects those aged ≥65 years. Our research indicates a possible short-term impact of air pollution on CVD. Local public health and environmental policies should take these preliminary findings into account.
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Affiliation(s)
- Jingze Yu
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Anning Zhu
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Miaoxin Liu
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Jiyuan Dong
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Rentong Chen
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Tian Tian
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Tong Liu
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Li Ma
- School of Public HealthLanzhou UniversityLanzhouPR China
| | - Ye Ruan
- School of Public HealthLanzhou UniversityLanzhouPR China
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You J, Liu Y, Dong J, Wang J, Bao H. Ambient carbon monoxide and the risk of cardiovascular disease emergency room visits: a time-series study in Lanzhou, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:7621-7636. [PMID: 37395909 DOI: 10.1007/s10653-023-01653-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/07/2023] [Indexed: 07/04/2023]
Abstract
Until now, the epidemiological evidence on the association between short-term exposure to ambient carbon monoxide (CO) and cardiovascular diseases (CVDs) is relatively lacking and controversial. This study aims to examine the relationship between ambient CO and daily emergency room visits (ERVs) for total and cause-specific CVD in Lanzhou, China. A distributed lag nonlinear model was used to examine the association. For every 1 mg/m3 increase in the CO concentration, the relative risks of daily ERVs were 1.041 (95% CI: 1.017, 1.065) for total CVD, 1.065 (95% CI: 1.018, 1.114) for ischemic heart disease (IHD), 1.083 (95% CI: 1.020, 1.149) for heart rhythm disturbances (HRD), 1.062 (95% CI: 1.011, 1.115) for heart failure (HF), and 1.057 (95% CI: 1.017, 1.098) for cerebrovascular diseases (CD). For the two different gender subgroups, the short-term impact of CO on total CVD, IHD, and CD was relatively stronger for the females than for the males, while the opposite was true for HRD and HF. In the age subgroup analyses, the effect of ambient CO on total CVD and IHD appeared to be greater for the age ≥ 65 years group, while the opposite was true for HRD, HF, and CD. The associations for all disease categories were stronger in cold seasons than in warm seasons. We also observed a nearly linear correlation between CO and CVD ERVs. In conclusion, the study showed that exposure to ambient CO may increase the risks of ERVs for total and cause-specific CVD. Besides, CO-ERVs associations may vary by gender and age.
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Affiliation(s)
- Jianhua You
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Yaocong Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Jiancheng Wang
- Gansu Provincial Hospital, Lanzhou, 730050, People's Republic of China
| | - Hairong Bao
- Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, China
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Wang J, Huang Z, Liu X, Yang C, Yang H, Liao J, Jiao K, Chen Q, Ma X, Liao J, Ma L. Effects of ambient air pollution on cause-specific hospitalizations in Wuhan during 2017-2019. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 253:114686. [PMID: 36863162 DOI: 10.1016/j.ecoenv.2023.114686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Few studies have focused on the associations between air pollutants and multiple organ system diseases in the entire hospitalized population. The present study aims to explore the short-term effects of six routinely monitored air pollutants on the broad causes of hospital admissions and estimate the resulting hospital admission burdens. METHODS Daily hospital admission records from 2017 to 2019 were obtained from the Wuhan Information center of Health and Family Planning. Generalized additive models (GAMs) were employed to evaluate the effects of air pollutants on the percent increase in the cause-specific daily number of hospital admissions. Increased hospital admission numbers, days, and expenses were also estimated. RESULTS A total of 2636,026 hospital admissions were identified. We found that both PM2.5 and PM10 increased the risk of hospital admissions for most disease categories. Short-term exposure to PM2.5 was positively associated with hospitalizations of several rarely studied disease categories, such as diseases of the eye and adnexa (2.83%, 95%CI: 0.96-4.73%, P < 0.01) and diseases of the musculoskeletal system and connective tissue (2.17%, 95% CI: 0.88-3.47%, P < 0.001). NO2 was observed to have a robust effect on diseases of the respiratory system (1.36%, 95%CI: 0.74-1.98%, P < 0.001). CO was significantly associated with hospital admissions for six disease categories. Furthermore, each 10-μg/m3 increase in PM2.5 was associated with an annual increase of 13,444 hospital admissions (95% CI: 6239-20,649), 124,344 admission days (95% CI: 57,705-190,983), and 166-million-yuan admission expenses (95% CI: 77-255). CONCLUSION Our study suggested that particulate matter (PM) had a short-term effect on hospital admissions of most major disease categories and resulted in a considerable hospital admission burden. In addition, the health effects of NO2 and CO emissions require more attention in megacities.
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Affiliation(s)
- Jing Wang
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China
| | - Zenghui Huang
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China
| | - Xingyuan Liu
- Wuhan Information Center of Health and Family Planning, Wuhan 430021, China
| | - Can Yang
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China
| | - Haomin Yang
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China
| | - Jianpeng Liao
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China
| | - Kuizhuang Jiao
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China
| | - Qihao Chen
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China
| | - Xuxi Ma
- Department of Global Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Jingling Liao
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, No. 2 Huangjiahu West Road, Hongshan District, Wuhan 430081, China
| | - Lu Ma
- Department of Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuhan 430071, China.
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Tang EJ, Zhou YM, Yang LL, Wang N, Jiang YX, Xiao H, Hu YG, Li DW, Li N, Huang QS, Du N, Li YF, Ji AL, Zhou LX, Cai TJ. The association between short-term ambient sulfur dioxide exposure and hospitalization costs of ischemic stroke: a hospital-based study in Chongqing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:17459-17471. [PMID: 36194329 DOI: 10.1007/s11356-022-23254-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Evidence of the short-term effects of ambient sulfur dioxide (SO2) exposure on the economic burden of ischemic stroke is limited. This study aimed to explore the association between short-term ambient SO2 exposure and hospitalization costs for ischemic stroke in Chongqing, the most populous city in China. The hospital-based study included 7271 ischemic stroke inpatients. Multiple linear regression models were used to estimate the association between SO2 concentration and hospitalization costs. Propensity score matching was used to compare the patients' characteristics when exposed to SO2 concentrations above and below 20 μg/m3. It is found that short-term SO2 exposure was positively correlated with the hospitalization costs of ischemic stroke. The association was more evident in males, people younger than 65, and people hospitalized in the cool seasons. Besides, among the components of hospitalization costs, medicine costs were most significantly associated with SO2. More interesting, the lower concentration of SO2, the higher costs associated with 1 μg/m3 SO2 change. Above all, SO2 was positively associated with hospitalization costs of ischemic stroke, even at its low levels. The measures to reduce the level of SO2 can help reduce the burden of ischemic stroke.
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Affiliation(s)
- En-Jie Tang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Li-Li Yang
- Department of Information, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Nan Wang
- Medical Department, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Yue-Xu Jiang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Department of Nutrition and Food Hygiene, School of Public Health Guizhou Medical University, Guiyang, 550025, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Da-Wei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Na Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Department of Nutrition and Food Hygiene, School of Public Health Guizhou Medical University, Guiyang, 550025, China
| | - Qing-Song Huang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Department of Nutrition and Food Hygiene, School of Public Health Guizhou Medical University, Guiyang, 550025, China
| | - Ning Du
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China
| | - Lai-Xin Zhou
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Huang QS, Zhou LX, Yang LL, Jiang YX, Xiao H, Li DW, Zhou YM, Hu YG, Li N, Li YF, Ji AL, Luo P, Cai TJ. Association between ambient carbon monoxide levels and hospitalization costs of patients with myocardial infarction: Potential effect modification by ABO blood group. ENVIRONMENTAL RESEARCH 2023; 216:114516. [PMID: 36220442 DOI: 10.1016/j.envres.2022.114516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
Previous researches have reported the association between air pollution and various diseases. However, few researches have investigated whether air pollutants are associated with the economic loss resulting from patients' hospitalization, especially the economic loss of hospitalization due to acute cardiovascular events. The purpose of our research was to explore the association between the levels of carbon monoxide (CO), taken as an index of pollution, and the hospitalization costs of myocardial infarction (MI), and the potential effect modification by the ABO blood group. A total of 3237 MI inpatients were included in this study. A multiple linear regression model was used to evaluate the association between ambient CO levels and hospitalization costs of MI patients. Moreover, we performed stratified analyses by age, gender, body mass index (BMI), season, hypertension, and ABO blood types. There was a positive association between the levels of CO in the air and the costs of hospitalization caused by MI. Furthermore, such association was stronger in males, BMI ≥25, <65 years, with hypertension, and non-O blood group. Interestingly, we found the association was particularly significant in patients with blood group B. Overall, our study first found that ambient CO levels could have an impact on the hospitalization costs for MI patients, and those with blood group B can be more sensitive.
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Affiliation(s)
- Qing-Song Huang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Lai-Xin Zhou
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Li-Li Yang
- Department of Information, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Yue-Xu Jiang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Da-Wei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Na Li
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China
| | - Peng Luo
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
| | - Tong-Jian Cai
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Jia H, Xu J, Ning L, Feng T, Cao P, Gao S, Shang P, Yu X. Ambient air pollution, temperature and hospital admissions due to respiratory diseases in a cold, industrial city. J Glob Health 2022; 12:04085. [PMID: 36243957 PMCID: PMC9569423 DOI: 10.7189/jogh.12.04085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The influences of air pollution exposure and temperature on respiratory diseases have become major global health concerns. This study investigated the relationship between ambient air pollutant concentrations and temperature in cold industrial cities that have the risk of hospitalization for respiratory diseases. Methods A time-series study was conducted in Changchun, China, from 2015 to 2019 to analyse the number of daily admissions for respiratory diseases, air pollutant concentrations, and meteorological factors. Time-series decomposition was applied to analyse the trend and characteristics of the number of admissions. Generalized additive models and distributed lag nonlinear models were constructed to explore the effects of air pollutant concentrations and temperature on the number of admissions. Results The number of daily admissions showed an increasing trend, and the seasonal fluctuation was obvious, with more daily admissions in winter and spring than in summer and autumn. There were positive and gradually decreasing lag effects of PM10, PM2.5, NO2, and CO concentrations on the number of admissions, whereas O3 showed a J-shaped trend. The results showed that within the 7-day lag period, 0.5°C was the temperature associated with the lowest relative risk of admission due to respiratory disease, and extremely low and high temperatures (<-18°C, >27°C, respectively) increased the risk of hospitalization for respiratory diseases by 8.3% and 12.1%, respectively. Conclusions From 2015 to 2019, respiratory diseases in Changchun showed an increasing trend with obvious seasonality. The increased concentrations of SO2, NO2, CO, PM2.5, O3 and PM10 lead to an increased risk of hospitalization for respiratory diseases, with a significant lag effect. Both extreme heat and cold could lead to increases in the risk of admission due to respiratory disease.
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Affiliation(s)
- Huanhuan Jia
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Jiaying Xu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Liangwen Ning
- School of Public Administration, Jilin University, Changchun City, Jilin Province, China
| | - Tianyu Feng
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Peng Cao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Shang Gao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Panpan Shang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Xihe Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
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Jiang YX, Zhou LX, Yang LL, Huang QS, Xiao H, Li DW, Zhou YM, Hu YG, Tang EJ, Li YF, Ji AL, Luo P, Cai TJ. The association between short-term exposure to ambient carbon monoxide and hospitalization costs for bronchitis patients: A hospital-based study. ENVIRONMENTAL RESEARCH 2022; 210:112945. [PMID: 35202627 DOI: 10.1016/j.envres.2022.112945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/28/2021] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
Ambient carbon monoxide (CO) is associated with bronchitis morbidity, but there is no evidence concerning its correlation with hospitalization costs for bronchitis patients. This study aimed to investigate the relationship between short-term ambient CO exposure and hospitalization costs for bronchitis patients in Chongqing, China. Baseline data for 3162 hospitalized bronchitis patients from November 2013 to December 2019 were collected. Multiple linear regression analysis was used to determine the association, delayed and cumulative, between short-term CO exposure and hospitalization costs. Additionally, subgroup analyses were performed by gender, age, season, and comorbidity. Positive association between CO and hospitalization costs for bronchitis patients was observed. The strongest association was observed at lag 015 days, with per 1 mg/m3 increase of CO concentrations corresponded to 5834.40 Chinese Yuan (CNY) (95% CI: 2318.71, 9350.08; P < 0.001) (845.97 US dollars) increment in hospitalization costs. Stratified analysis results showed that the association was more obvious among those males, elderly, with comorbidities, and in warm seasons. More importantly, there was strongest correlation between CO and bronchitis patients with coronary heart disease. In summary, short-term exposure to ambient CO, even lower than Chinese and WHO standards, can be associated with increased hospitalization costs for bronchitis. Controlling CO exposure can be helpful to reduce medical burden associated with bronchitis patients. The results also suggest that when setting air quality standards and formulating preventive measures, susceptible subpopulations ought to be considered.
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Affiliation(s)
- Yue-Xu Jiang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Lai-Xin Zhou
- Medical Department, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Li-Li Yang
- Department of Information, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Qing-Song Huang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Da-Wei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - En-Jie Tang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China.
| | - Peng Luo
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Zhang G, Liu X, Zhai S, Song G, Song H, Liang L, Kong Y, Ma R, He X. Rural-urban differences in associations between air pollution and cardiovascular hospital admissions in Guangxi, southwest China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:40711-40723. [PMID: 35083669 DOI: 10.1007/s11356-021-18196-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Epidemiological studies found that exposure to air pollution increases cardiovascular hospitalizations. However, studies on rural-urban differences in associations between hospitalizations for cardiovascular diseases and air pollution are limited. The generalized linear model (GLM) was applied to investigate the associations between cardiovascular hospitalizations and air pollution (SO2, NO2, PM2.5, PM10, CO, and O3) in Guangxi, southwest China, in 2015 (January 1-December 31). The relative risk of pollutants (SO2, NO2) on cardiovascular hospital admissions was significantly different between urban and rural areas. The effect of SO2 on cardiovascular hospitalizations was higher in urban areas than in rural areas at lag0 to lag3 and cumulative lag01 to lag03. In urban areas, there were positive associations between NO2 and cardiovascular hospitalizations at lag0, lag1 and cumulative lag01, lag02. In contrast, the effect of NO2 on cardiovascular hospitalizations was not significant in rural areas. Urban residents were more sensitive than rural residents to SO2 and NO2. Subgroup analyses showed statistically significant differences between rural and urban areas in the association between SO2 and NO2 and cardiovascular hospitalizations for males. For age groups, people aged ≥ 65 years appeared to be more vulnerable to SO2 and NO2 in urban areas. The effects of PM2.5 PM10, CO, and O3 on cardiovascular hospitalizations were consistently negative for all groups. Our findings indicated that there were rural-urban differences in associations between cardiovascular hospitalizations and air pollutants. In rural areas, the risk of cardiovascular hospitalizations was mainly influenced by SO2. Therefore, we expect to pay attention to protecting people from air pollution, particularly for those aged ≥ 65 years in urban areas.
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Affiliation(s)
- Guangli Zhang
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
| | - Xiaoxiao Liu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary AQ2, Calgary, Canada
| | - Shiyan Zhai
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China.
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China.
| | - Genxin Song
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
| | - Hongquan Song
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China
| | - Lizhong Liang
- The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China
| | - Yunfeng Kong
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China
| | - Rui Ma
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
| | - Xinxin He
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
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10
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Qin G, Wang X, Wang T, Nie D, Li Y, Liu Y, Wen H, Huang L, Yu C. Impact of Particulate Matter on Hospitalizations for Respiratory Diseases and Related Economic Losses in Wuhan, China. Front Public Health 2022; 10:797296. [PMID: 35692312 PMCID: PMC9174547 DOI: 10.3389/fpubh.2022.797296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background Prior studies have reported the effects of particulate matter (PM) on respiratory disease (RD) hospitalizations, but few have quantified PM-related economic loss in the central region of China. This investigation aimed to assess the impacts of PM pollution on the risk burden and economic loss of patients admitted with RD. Methods Daily cases of RD admitted to the hospital from 1 January 2015 to 31 December 2020 were collected from two class-A tertiary hospitals in Wuhan, China. Time series analysis incorporated with a generalized additive model (GAM) was adopted to assess the impacts of fine particulate matter (PM2.5) and inhalable particulate matter (PM10) exposures on patients hospitalized with RD. Stratified analyses were performed to investigate underlying effect modification of RD risk by sex, age, and season. The cost of illness (COI) approach was applied to evaluate the related economic losses caused by PM. Results A total of 51,676 inpatients with a primary diagnosis of RD were included for the analysis. PM2.5 and PM10 exposures were associated with increased risks of hospitalizations for RD. Subgroup analysis demonstrated that men and children in the 0–14 years age group were more vulnerable to PM, and the adverse effects were promoted by low temperature in the cold season. A 152.4 million China Yuan (CNY) economic loss could be avoided if concentrations of PM2.5 and PM10 declined to 10 and 20 μg/m3, respectively. Conclusions PM2.5 and PM10 concentrations were positively associated with RD hospitalization. Men and children were more vulnerable to PM. Effective air pollution control measures can reduce hospitalizations significantly and save economic loss substantially.
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Affiliation(s)
- Guiyu Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xuyan Wang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tong Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Dewei Nie
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine of Peking Union Medical College, Beijing, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Haoyu Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Lihong Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Chuanhua Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
- *Correspondence: Chuanhua Yu
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11
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Guo X, Song Q, Wang H, Li N, Su W, Liang M, Sun C, Ding X, Liang Q, Sun Y. Systematic review and meta-analysis of studies between short-term exposure to ambient carbon monoxide and non-accidental, cardiovascular, and respiratory mortality in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:35707-35722. [PMID: 35257337 DOI: 10.1007/s11356-022-19464-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Although a growing number of original epidemiological studies imply a link between ambient pollution exposure and mortality risk, the findings associated with carbon monoxide (CO) exposure are inconsistent. Thus, we conducted a systematic review and meta-analysis of epidemiological studies to evaluate the correlations between ambient CO and non-accidental, cardiovascular, and respiratory mortality in China. Eight databases were searched from inception to 15 May 2021. A random-effect model was used to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs). Subgroup analyses as well as sensitivity analyses were performed. The I square value (I2) was used to assess heterogeneity among different studies. The assessment of publication bias on included studies was examined by funnel plot and Egger's test. The influence of a potential publication bias on findings was explored by using the trim-and-fill procedure. Ultimately, a total of 19 studies were included in our analysis. The pooled relative risk for each 1 mg/m3 increase of ambient carbon monoxide was 1.0220 (95%CI: 1.0102-1.0339) for non-accidental mortality, 1.0304 (95%CI:1.0154-1.0457) for cardiovascular mortality, and 1.0318 (95%CI:1.0132-1.0506) for respiratory mortality. None of subgroup analyses could explain the source of heterogeneity. Exclusion of any single study did not materially alter the pooled effect estimates. Although it was suggestive of publication bias, findings were generally similar with principal findings when we explored the influence of a potential publication bias using the trim-and-fill method. Our meta-analysis demonstrated that exposure to ambient CO was positive with risk of deaths from all non-accidental causes, total cardiovascular, and respiratory diseases. Based on these findings, tougher intervention policies and initiatives to reduce the health effects of CO exposure should be established.
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Affiliation(s)
- Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Chenyu Sun
- Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
- Centre for Evidence-Based Practice, Anhui Medical University, Hefei, 230032, Anhui, People's Republic of China.
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12
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Wang Y, Liu Z, Yang L, Zhou J, Li J, Liao HL, Tian XJ. Sepsis-related hospital admissions and ambient air pollution: a time series analysis in 6 Chinese cities. BMC Public Health 2021; 21:1182. [PMID: 34154551 PMCID: PMC8218442 DOI: 10.1186/s12889-021-11220-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/28/2021] [Indexed: 12/29/2022] Open
Abstract
Background Some prevalent but rarely studied causes of hospital admissions, such as sepsis is still unknown whether affected by air pollution. Methods We used time-series regression within generalized additive models to estimate the effect of air pollutant level on the sepsis-related hospital admissions, for the years 2017–18, using data from six cities in Sichuan, China. Potential effect modifications by age and sex were also explored. The effects of air pollutant on hospital stays for sepsis were also quantified. Results Positive associations between short-term exposure to NO2 and O3 and risk of sepsis-related hospital admissions and stays were found. Each 10 μg/m3 increase in short-term NO2 at lag 03 and O3 at lag 4 was associated with an increase of 2.76% (95% CI: 0.67, 4.84%) and 0.64% (95% CI: 0.14, 1.14%) hospital admissions, respectively. An increase of 0.72% (95% CI: 0.05, 1.40%) hospital stay was associated with 10 μg/m3 increase in O3 concentration at lag 4. Besides, the adverse effect of exposure to NO2 was more significant in males and population aged less than 14 years; while more significant in females and population aged 14 ~ 65 and over 65 years for exposure to O3. These associations remained stable after the adjustment of other air pollutants.8. Conclusion Exposure to ambient NO2 and O3 may cause substantial sepsis hospitalizations, and hospital stays in Sichuan, China. These associations were different in subgroup by age and sex. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11220-x.
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Affiliation(s)
- Yu Wang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zhen Liu
- Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, 610057, China
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
| | - Jiushun Zhou
- Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China.
| | - Jia Li
- Management College, Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Hai Lun Liao
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Xing Jun Tian
- Sichuan Administration of TCM, Chengdu, 610016, China
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13
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Wang X, Xu Z, Su H, Ho HC, Song Y, Zheng H, Hossain MZ, Khan MA, Bogale D, Zhang H, Wei J, Cheng J. Ambient particulate matter (PM 1, PM 2.5, PM 10) and childhood pneumonia: The smaller particle, the greater short-term impact? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:145509. [PMID: 33571778 DOI: 10.1016/j.scitotenv.2021.145509] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Smaller sizes of ambient particulate matter (PM) can be more toxic and can be breathed into lower lobes of a lung. Children are particularly vulnerable to PM air pollution because of their adverse effects on both lung functions and lung development. However, it remains unknown whether a smaller PM has a greater short-term impact on childhood pneumonia. AIMS We compared the short-term effects on childhood pneumonia from PM with aerodynamic diameters ≤1 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10), respectively. METHODS Daily time-series data (2016-2018) on pneumonia hospitalizations in children aged 0-17 years, records of air pollution (PM1, PM2.5, PM10, and gaseous pollutants), and weather conditions were obtained for Hefei, China. Effects of different PM were quantified using a quasi-Poisson generalized additive model after controlling for day of the week, holiday, seasonality and long-term time trend, and weather variables. Stratified analyses (gender, age, and season) were also performed. RESULTS For each 10 μg/m3 increase in PM1, PM2.5, and PM10 concentrations over the past three days (lag 0-2), the risk of pneumonia hospitalizations increased by 10.28% (95%CI: 5.88%-14.87%), 1.21% (95%CI: 0.34%-2.09%), and 1.10% (95%CI: 0.44%-1.76%), respectively. Additionally, both boys and girls were at risk of PM1 effects, while PM2.5 and PM10 effects were only seen in boys. Children aged ≤12 months and 1-4 years were affected by PM1, but PM2.5 and PM10 were only associated with children aged 1-4 years. Furthermore, PM1 effects were greater in autumn and winter, while greater PM2.5 and PM10 effects were evident only in autumn. CONCLUSION This study suggests a greater short-term impact on childhood pneumonia from PM1 in comparison to PM2.5 and PM10. Given the serious PM pollution in China and other rapid developing countries due to various combustions and emissions, more investigations are needed to determine the impact of different PM on childhood respiratory health.
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Affiliation(s)
- Xu Wang
- Department of Science and Education, Children's Hospital of Anhui Medical University (Anhui Provincial Children's Hospital), Hefei, Anhui, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Hong Su
- School of Public Health, Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; School of Geography and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Yimeng Song
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China; Smart Cities Research Institute, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Daniel Bogale
- College of Health Sciences, Arsi University, Asela, Ethiopia
| | - Heng Zhang
- Sir Run Run Shaw Hospital (SRRSH), affiliated with the Zhejiang University School of Medicine, Zhejiang, China
| | - Jing Wei
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China; Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA.
| | - Jian Cheng
- School of Public Health, Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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14
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Wang X, Yu Y, Yu C, Shi F, Zhang Y. Associations between acute exposure to ambient air pollution and length of stay for inpatients with ischemic heart disease: a multi-city analysis in central China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:43743-43754. [PMID: 32737787 DOI: 10.1007/s11356-020-10256-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
Ambient air pollution (AAP) has been widely associated with increased morbidity of ischemic heart disease (IHD). However, no prior studies have investigated the effects of AAP exposure on the length of stay (LOS) due to IHD. Hospital data during 2015-2017 were obtained from hospital information system in five cities of Hubei province, China. We collected daily mean concentrations of air pollutants, including PM2.5, PM10, SO2, NO2, O3, and CO, and meteorological data during the same time period. Poisson regression was applied to estimate the acute impacts of AAP on the LOS of IHD inpatients. A total of 42,114 inpatients with primary diagnosis of IHD were included, 50.63% of which were chronic IHD inpatients. Annual average concentrations of PM2.5, PM10, SO2, NO2, O3, and CO were 61.93 μg/m3, 95.47 μg/m3, 18.59 μg/m3, 35.87 μg/m3, 100.30 μg/m3, and 1.117 mg/m3, respectively. After adjusting for temperature, relative humidity, gender, age group, payment method, number of hospital beds, location of hospital, and surgery or not, exposures to PM2.5, PM10, SO2, O3, and CO were associated with increased LOS for all IHD patients in both single- and multi-pollutant models, and stronger associations were observed among chronic IHD patients. In addition, subgroup analyses demonstrated that males and the group aged 65+ years were more vulnerable to air pollution, and the adverse effects were also promoted by low temperature in cold season. This study provides the first investigation of the adverse effects of AAP on the LOS for IHD patients. In order to shorten the LOS of IHD, measures should be taken to strengthen the AAP management and protect the high-risk population.
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Affiliation(s)
- Xuyan Wang
- Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yong Yu
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, China
| | - Chuanhua Yu
- Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
- Global Health Institute, Wuhan University, Wuhan, 430071, China.
| | - Fang Shi
- Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China.
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
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15
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Air Pollution and Emergency Hospital Admissions—Evidences from Lisbon Metropolitan Area, Portugal. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10227997] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The relevance of air pollution in the public health agenda has recently been reinforced—it is known that exposure to it has negative effects in the health of individuals, especially in big cities and metropolitan areas. In this article we observed the evolution of air pollutants (CO, NO, NO2, O3, PM10) emissions and we confront them with health vulnerabilities related to respiratory and circulatory diseases (all circulatory diseases, cardiac diseases, cerebrovascular disease, ischemic heart disease, all respiratory diseases, chronic lower respiratory diseases, acute upper respiratory infections). The study is supported in two databases, one of air pollutants and the other of emergency hospital admissions, in the 2005–2015 period, applied to the Lisbon Metropolitan Area. The analysis was conducted through Ordinary Least Squares (OLS) regression, while also using semi-elasticity to quantify associations. Results showed positive associations between air pollutants and admissions, tendentially higher in respiratory diseases, with CO and O3 having the highest number of associations, and the senior age group being the most impacted. We concluded that O3 is a good predictor for the under-15 age group and PM10 for the over-64 age group; also, there seems to exist a distinction between the urban city core and its suburban areas in air pollution and its relation to emergency hospital admissions.
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16
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Wang X, Yu C, Zhang Y, Shi F, Meng R, Yu Y. Attributable Risk and Economic Cost of Cardiovascular Hospital Admissions Due to Ambient Particulate Matter in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5453. [PMID: 32751102 PMCID: PMC7432018 DOI: 10.3390/ijerph17155453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 07/25/2020] [Accepted: 07/25/2020] [Indexed: 12/25/2022]
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.
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Affiliation(s)
- Xuyan Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.W.); (F.S.)
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.W.); (F.S.)
- Global Health Institute, Wuhan University, Wuhan 430072, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China;
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China; (X.W.); (F.S.)
| | - Runtang Meng
- Department of Preventive Medicine, School of Medicine, Hangzhou Normal University, Hangzhou 311121, China;
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, China
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