Attributable risks of emergency hospital visits due to air pollutants in China

A multi-city study

Gongbo Chen, Yongming Zhang, Wenyi Zhang, Shanshan Li, Gail Williams, Guy B Marks, Bin Jalaludin, Michael J. Abramson, Fengming Luo, Dong Kwon Yang, Xin-Zhuan Su, Qichang Lin, Laiyu Liu, Jiangtao Lin, Yuming Guo

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19 Citations (Scopus)

Abstract

Air pollution is associated with risks of mortality in China, but the evidence is still limited for morbidity. This study aims to examine overall effects of ambient air pollutants on emergency hospital visits (EHVs) at the national level in China and calculate corresponding attributable risks. We collected daily data for EHVs from 33 largest hospitals in China between Oct 2013 and Dec 2014, as well as daily measurements of particulate matter (PM10 and PM2.5: particles with aerodynamic diameter < 10 μm and 2.5 μm, respectively), nitrogen dioxide (NO2) and sulphur dioxide (SO2) from 31 cities where the hospitals were located. Firstly, quasi-Poisson regression with a constrained distributed lag model (CDLM) was employed to examine city-specific associations of EHVs with each pollutant. Then, the effects at the national scale were pooled with a random-effect meta-analysis. Daily EHVs was significantly associated with a 10 μg/m3 increase in PM2.5 at lag 0–2 days [cumulative relative risk (RR) and 95% confidence intervals (CI): 1.006 (1.002, 1.009)], PM10 at lag 0–1 days [1.004 (1.002, 1.006)], NO2 at lag 0–1 days [1.015 (1.010, 1.019)] and SO2 at lag 0–2 days [1.022 (1.014, 1.030)]. The effect estimates were not modified by sex, but stronger effects were observed among children than adults. Overall, 3.34% of EHVs may result from exposure to ambient PM2.5, 3.96% to PM10, 5.90% to NO2 and 5.38% to SO2. Exposure to outdoor air pollution has acute effects on EHVs. Effective measures to control air pollution levels in China could potentially reduce demands for emergency hospital services.

Original languageEnglish
Pages (from-to)43-49
Number of pages7
JournalEnvironmental Pollution
Volume228
DOIs
Publication statusPublished - 1 Sep 2017

Cite this

Chen, Gongbo ; Zhang, Yongming ; Zhang, Wenyi ; Li, Shanshan ; Williams, Gail ; Marks, Guy B ; Jalaludin, Bin ; Abramson, Michael J. ; Luo, Fengming ; Yang, Dong Kwon ; Su, Xin-Zhuan ; Lin, Qichang ; Liu, Laiyu ; Lin, Jiangtao ; Guo, Yuming. / Attributable risks of emergency hospital visits due to air pollutants in China : A multi-city study. In: Environmental Pollution. 2017 ; Vol. 228. pp. 43-49.
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title = "Attributable risks of emergency hospital visits due to air pollutants in China: A multi-city study",
abstract = "Air pollution is associated with risks of mortality in China, but the evidence is still limited for morbidity. This study aims to examine overall effects of ambient air pollutants on emergency hospital visits (EHVs) at the national level in China and calculate corresponding attributable risks. We collected daily data for EHVs from 33 largest hospitals in China between Oct 2013 and Dec 2014, as well as daily measurements of particulate matter (PM10 and PM2.5: particles with aerodynamic diameter < 10 μm and 2.5 μm, respectively), nitrogen dioxide (NO2) and sulphur dioxide (SO2) from 31 cities where the hospitals were located. Firstly, quasi-Poisson regression with a constrained distributed lag model (CDLM) was employed to examine city-specific associations of EHVs with each pollutant. Then, the effects at the national scale were pooled with a random-effect meta-analysis. Daily EHVs was significantly associated with a 10 μg/m3 increase in PM2.5 at lag 0–2 days [cumulative relative risk (RR) and 95{\%} confidence intervals (CI): 1.006 (1.002, 1.009)], PM10 at lag 0–1 days [1.004 (1.002, 1.006)], NO2 at lag 0–1 days [1.015 (1.010, 1.019)] and SO2 at lag 0–2 days [1.022 (1.014, 1.030)]. The effect estimates were not modified by sex, but stronger effects were observed among children than adults. Overall, 3.34{\%} of EHVs may result from exposure to ambient PM2.5, 3.96{\%} to PM10, 5.90{\%} to NO2 and 5.38{\%} to SO2. Exposure to outdoor air pollution has acute effects on EHVs. Effective measures to control air pollution levels in China could potentially reduce demands for emergency hospital services.",
author = "Gongbo Chen and Yongming Zhang and Wenyi Zhang and Shanshan Li and Gail Williams and Marks, {Guy B} and Bin Jalaludin and Abramson, {Michael J.} and Fengming Luo and Yang, {Dong Kwon} and Xin-Zhuan Su and Qichang Lin and Laiyu Liu and Jiangtao Lin and Yuming Guo",
year = "2017",
month = "9",
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doi = "10.1016/j.envpol.2017.05.026",
language = "English",
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Chen, G, Zhang, Y, Zhang, W, Li, S, Williams, G, Marks, GB, Jalaludin, B, Abramson, MJ, Luo, F, Yang, DK, Su, X-Z, Lin, Q, Liu, L, Lin, J & Guo, Y 2017, 'Attributable risks of emergency hospital visits due to air pollutants in China: A multi-city study', Environmental Pollution, vol. 228, pp. 43-49. https://doi.org/10.1016/j.envpol.2017.05.026

Attributable risks of emergency hospital visits due to air pollutants in China : A multi-city study. / Chen, Gongbo; Zhang, Yongming; Zhang, Wenyi; Li, Shanshan; Williams, Gail; Marks, Guy B; Jalaludin, Bin; Abramson, Michael J.; Luo, Fengming; Yang, Dong Kwon; Su, Xin-Zhuan; Lin, Qichang; Liu, Laiyu; Lin, Jiangtao; Guo, Yuming.

In: Environmental Pollution, Vol. 228, 01.09.2017, p. 43-49.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Attributable risks of emergency hospital visits due to air pollutants in China

T2 - A multi-city study

AU - Chen, Gongbo

AU - Zhang, Yongming

AU - Zhang, Wenyi

AU - Li, Shanshan

AU - Williams, Gail

AU - Marks, Guy B

AU - Jalaludin, Bin

AU - Abramson, Michael J.

AU - Luo, Fengming

AU - Yang, Dong Kwon

AU - Su, Xin-Zhuan

AU - Lin, Qichang

AU - Liu, Laiyu

AU - Lin, Jiangtao

AU - Guo, Yuming

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Air pollution is associated with risks of mortality in China, but the evidence is still limited for morbidity. This study aims to examine overall effects of ambient air pollutants on emergency hospital visits (EHVs) at the national level in China and calculate corresponding attributable risks. We collected daily data for EHVs from 33 largest hospitals in China between Oct 2013 and Dec 2014, as well as daily measurements of particulate matter (PM10 and PM2.5: particles with aerodynamic diameter < 10 μm and 2.5 μm, respectively), nitrogen dioxide (NO2) and sulphur dioxide (SO2) from 31 cities where the hospitals were located. Firstly, quasi-Poisson regression with a constrained distributed lag model (CDLM) was employed to examine city-specific associations of EHVs with each pollutant. Then, the effects at the national scale were pooled with a random-effect meta-analysis. Daily EHVs was significantly associated with a 10 μg/m3 increase in PM2.5 at lag 0–2 days [cumulative relative risk (RR) and 95% confidence intervals (CI): 1.006 (1.002, 1.009)], PM10 at lag 0–1 days [1.004 (1.002, 1.006)], NO2 at lag 0–1 days [1.015 (1.010, 1.019)] and SO2 at lag 0–2 days [1.022 (1.014, 1.030)]. The effect estimates were not modified by sex, but stronger effects were observed among children than adults. Overall, 3.34% of EHVs may result from exposure to ambient PM2.5, 3.96% to PM10, 5.90% to NO2 and 5.38% to SO2. Exposure to outdoor air pollution has acute effects on EHVs. Effective measures to control air pollution levels in China could potentially reduce demands for emergency hospital services.

AB - Air pollution is associated with risks of mortality in China, but the evidence is still limited for morbidity. This study aims to examine overall effects of ambient air pollutants on emergency hospital visits (EHVs) at the national level in China and calculate corresponding attributable risks. We collected daily data for EHVs from 33 largest hospitals in China between Oct 2013 and Dec 2014, as well as daily measurements of particulate matter (PM10 and PM2.5: particles with aerodynamic diameter < 10 μm and 2.5 μm, respectively), nitrogen dioxide (NO2) and sulphur dioxide (SO2) from 31 cities where the hospitals were located. Firstly, quasi-Poisson regression with a constrained distributed lag model (CDLM) was employed to examine city-specific associations of EHVs with each pollutant. Then, the effects at the national scale were pooled with a random-effect meta-analysis. Daily EHVs was significantly associated with a 10 μg/m3 increase in PM2.5 at lag 0–2 days [cumulative relative risk (RR) and 95% confidence intervals (CI): 1.006 (1.002, 1.009)], PM10 at lag 0–1 days [1.004 (1.002, 1.006)], NO2 at lag 0–1 days [1.015 (1.010, 1.019)] and SO2 at lag 0–2 days [1.022 (1.014, 1.030)]. The effect estimates were not modified by sex, but stronger effects were observed among children than adults. Overall, 3.34% of EHVs may result from exposure to ambient PM2.5, 3.96% to PM10, 5.90% to NO2 and 5.38% to SO2. Exposure to outdoor air pollution has acute effects on EHVs. Effective measures to control air pollution levels in China could potentially reduce demands for emergency hospital services.

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