Estimation of the Effects of Air Pollution on Hospitalization Expenditures for Asthma

This article aims to estimate the effects of air pollutants (PM2.5, PM10, SO2, and NO2) on the hospitalization expenses of adult patients admitted due to asthma. The data is sourced from the medical health database of a city in Southwest China, which involves approximately 14 million residents. A generalized additive model using a Poisson distribution was utilized to identify the effects of air pollution on the cost of hospitalization due to asthma. Hospital admissions were stratified by sex, age, season, and type of medical insurance to specialize the results. Air pollution significantly affects hospitalization expenses for asthma. These effects were more significant in the male, non-senior subgroups than in the female, senior subgroups. The difference also significantly existed in different insurance type subgroups. Air pollution has adverse effects on hospitalization expenses for asthma. Climate change is now deeply affecting the world in the aspects of economy and health. Based on our research, policymakers can establish more effective air pollution reduction policies and measures that can control the levels of ambient air pollutants, which help save health care resources and improve the welfare of the population by easing the climate change.

Download Full-text

Air pollution and hospital admissions and deaths due to respiratory infections in megacity of Tehran: A time series analysis

Journal of Air Pollution and Health ◽

10.18502/japh.v6i1.7601 ◽

2021 ◽

Author(s):

Zahra Namvar ◽

Mostafa Hadei ◽

Seyed Saeed Hashemi ◽

Elahe Shahhosseini ◽

Philip K. Hopke ◽

...

Keyword(s):

Air Pollution ◽

Air Pollutants ◽

Hospital Admissions ◽

Respiratory Infections ◽

Positive Association ◽

Ambient Air ◽

Age Group ◽

Distributed Lag ◽

Ambient Air Pollutants ◽

Short Term Exposure

Introduction: Air pollution is one of the main causes for the significant increase of respiratory infections in Tehran. In the present study, we investigated the associations between short-term exposure to ambient air pollutants with the hospital admissions and deaths. Materials and methods: Health data from 39915 hospital admissions and 2459 registered deaths associated with these hospital admissions for respiratory infections were obtained from the Ministry of Health and Medical Education during 2014-2017. We used the distributed lag non-linear model (DLNM) for the analyses. Results: There was a statistically positive association between PM2.5 and AURI in the age group of 16 years and younger at lags 6 (RR 1.31; 1.05-1.64) and 7 (RR 1.50; 1.09-2.06). AURI admissions was associated with O3 in the age group of 16 and 65 years at lag 7 with RR 1.13 (1.00-1.27). ALRI admissions was associated with CO in the age group of 65 years and older at lag 0 with RR 1.12 (1.02-1.23). PM10 was associated with ALRI daily hospital admissions at lag 0 for males. ALRI admissions were associated with NO2 for females at lag 0. There was a positive association between ALRI deaths and SO2 in the age group of 65 years and older at lags 4 and 5 with RR 1.04 (1.00-1.09) and 1.03 (1.00-1.07), respectively. Conclusion: Exposure to outdoor air pollutants including PM10, PM2.5, SO2, NO2, O3, and CO was associated with hospital admissions for AURI and ALRI at different lags. Moreover, exposure to SO2 was associated with deaths for ALRI.

Download Full-text

Ambient Air Pollution and Hospital Admissions for Peptic Ulcers in Taipei: A Time-Stratified Case-Crossover Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16111916 ◽

2019 ◽

Vol 16 (11) ◽

pp. 1916 ◽

Cited By ~ 5

Author(s):

Shang-Shyue Tsai ◽

Hui-Fen Chiu ◽

Chun-Yuh Yang

Keyword(s):

Air Pollution ◽

Peptic Ulcer ◽

Crossover Study ◽

Air Pollutants ◽

Hospital Admissions ◽

Ambient Air ◽

Air Pollutant ◽

Ambient Air Pollution ◽

Research Database ◽

Case Crossover

Very few studies have been performed to determine whether there is a relationship between air pollution and increases in hospitalizations for peptic ulcer, and for those that have occurred, their results may not be completely relevant to Taiwan, where the mixture of ambient air pollutants differ. We performed a time-stratified case-crossover study to investigate the possible association between air pollutant levels and hospital admissions for peptic ulcer in Taipei, Taiwan. To do this, we collected air pollution data from Taiwan's Environmental Protection Agency and hospital admissions for peptic ulcer data for the years 2009–2013 from Taiwan's National Health Insurance's research database. We used conditional logistic regression to analyze the possible association between the two, taking temperature and relative humidity into account. Risk was expressed as odds ratios and significance was expressed with 95% confidence intervals. In our single pollutant model, peptic ulcer admissions were significantly associated with all pollutants (PM10, PM2.5, SO2, NO2, CO, and O3) on warm days (>23 °C). On cool days (<23 °C), peptic ulcer admissions were significantly associated with PM10, NO2, and O3. In our two-pollutant models, peptic ulcer admissions were significantly associated NO2 and O3 when combined with each of the other pollutants on warm days, and with PM10, NO2, and O3 on cool days. It was concluded that the likelihood of peptic ulcer hospitalizations in Taipei rose significantly with increases in air pollutants during the study period.

Download Full-text

Ambient PM2.5 and PM10 Exposure and Respiratory Disease Hospitalization in Kandy, Sri Lanka

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189617 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9617

Author(s):

Sajith Priyankara ◽

Mahesh Senarathna ◽

Rohan Jayaratne ◽

Lidia Morawska ◽

Sachith Abeysundara ◽

...

Keyword(s):

Air Pollution ◽

Sri Lanka ◽

Respiratory Disease ◽

Hospital Admissions ◽

Additive Model ◽

Ambient Air ◽

Ambient Air Pollution ◽

Increased Risk ◽

Pm2.5 And Pm10 ◽

Pm10 Exposure

Evidence of associations between exposure to ambient air pollution and health outcomes are sparse in the South Asian region due to limited air pollution exposure and quality health data. This study investigated the potential impacts of ambient particulate matter (PM) on respiratory disease hospitalization in Kandy, Sri Lanka for the year 2019. The Generalized Additive Model (GAM) was applied to estimate the short-term effect of ambient PM on respiratory disease hospitalization. As the second analysis, respiratory disease hospitalizations during two distinct air pollution periods were analyzed. Each 10 μg/m3 increase in same-day exposure to PM2.5 and PM10 was associated with an increased risk of respiratory disease hospitalization by 1.95% (0.25, 3.67) and 1.63% (0.16, 3.12), respectively. The effect of PM2.5 or PM10 on asthma hospitalizations were 4.67% (1.23, 8.23) and 4.04% (1.06, 7.11), respectively (p < 0.05). The 65+ years age group had a higher risk associated with PM2.5 and PM10 exposure and hospital admissions for all respiratory diseases on the same day (2.74% and 2.28%, respectively). Compared to the lower ambient air pollution period, higher increased hospital admissions were observed among those aged above 65 years, males, and COPD and pneumonia hospital admissions during the high ambient air pollution period. Active efforts are crucial to improve ambient air quality in this region to reduce the health effects.

Download Full-text

Acute effects of ambient air pollution on lower respiratory infections in Guangzhou children of China

10.21203/rs.3.rs-350683/v1 ◽

2021 ◽

Author(s):

Huawen Zhong ◽

Linlin Yang ◽

Wei Qiang ◽

Yongxian Zhou ◽

Lintong Wei ◽

...

Keyword(s):

Air Pollution ◽

Air Pollutants ◽

Regression Models ◽

Hospital Admissions ◽

Respiratory Infections ◽

Ambient Air ◽

Ambient Air Pollution ◽

Time Lags ◽

Pathogenic Microorganisms ◽

Guangzhou City

Abstract Background Daily concentrations of air pollution are associated with lower respiratory diseases. This study investigated the short-term association of ambient air pollution with daily hospital admissions due to pneumonia among children aged 0–17 in Guangzhou city of China.Methods Daily ambient air pollution concentrations were extracted from the databases of the Chinese Environmental Monitoring Center. Children hospital admission counts for pneumonia during 2013–2018 were sourced from the Guangdong Maternal and Child Healthcare Hospital. Associations between outdoor air pollution levels and hospital admissions were estimated for time lags of zero up to seven days using Quasi-Poisson regression models, adjusted for seasonal variations, meteorological variables, day of week and holidays. The associations between clinical pathogenic microorganism inspection results for pneumonia and air pollutants were calculated using Lasso regression models.Results Ambient air pollutants were all positively associated with children hospital admissions due to pneumonia of all ages. Significant associations were found for air pollutants except for inhalable particulate matter (PM) \(\le\)10 µm in aerodynamic diameter (PM10) in children aged 0–17 years. Increments of an interquartile range (IQR) (279.10µg/m3 and 28.42µg/m3, respectively) in the 7-day-average level of carbon monoxide (CO) and nitrogen dioxide (NO2) were associated with a 26.17% (95% confidence interval (CI) 1.40%-56.98%) and 25.09% (95%CI 0.54%-55.64%) increase in pneumonia hospitalizations for children aged 6–17, respectively. An IQR increase in CO concentrations (279.10µg/m3) was associated with a 15.15% (95%CI 4.34%-27.08%) increase in pneumonia hospitalizations for children aged 1–5. Estimates for CO were statistically significant among children aged 1–5 years in summer. The associations remained stable in two-pollutant models. Daily cases of microbial detection for pneumonia were positively associated with daily NO2 concentration. The pneumonia hospitalizations due to Mycoplasma pneumonia, Flu A virus and Flu B virus, the predominant pathogenic microorganisms detected in children aged 0–5 are apparently associated with levels of PMs, CO, NO2 and O3.Conclusions Strong associations among hospital admissions for lower respiratory infections, pathogenic microorganisms and daily levels of air pollution confirm the urgent need to adopt sustainable improving ambient air quality policies in Guangzhou city to protect children's health.

Download Full-text

Acute Effects of Ambient Air Pollution on Lower Respiratory Infections in Guangzhou Children of China

10.21203/rs.3.rs-350683/v2 ◽

2021 ◽

Author(s):

Huawen Zhong ◽

Linlin Yang ◽

Wei Qiang ◽

Yongxian Zhou ◽

Lintong Wei ◽

...

Keyword(s):

Air Pollution ◽

Air Pollutants ◽

Hospital Admissions ◽

Respiratory Infections ◽

Ambient Air ◽

Ambient Air Pollution ◽

Guangzhou City ◽

Microbial Detection ◽

Mycoplasma Pneumonia ◽

Inhalable Particulate Matter

Abstract Daily concentrations of air pollution are associated with lower respiratory diseases. We investigated the short-term association of ambient air pollution with daily hospital admissions due to pneumonia among children aged 0−17 in Guangzhou city of China. Ambient air pollutants were all positively associated with children hospital admissions due to pneumonia of all ages. Significant associations were found for air pollutants except for inhalable particulate matter (PM) \(\le\)10 µm in aerodynamic diameter (PM10) in children of all ages. Increments of an interquartile range (IQR) (279.10µg/m3 and 28.42µg/m3, respectively) in the 7-day-average level of carbon monoxide (CO) and nitrogen dioxide (NO2) were associated with a 26.17% (95% confidence interval (CI) 1.40%-56.98%) and 25.09% (95%CI 0.54%-55.64%) increase in pneumonia hospitalizations for children aged 6−17, respectively. An IQR increase in CO concentrations was associated with a 15.15% (95%CI 4.34%-27.08%) increase in pneumonia hospitalizations for children aged 1−5. Daily cases of microbial detection for pneumonia were positively associated with daily NO2 concentration. The pneumonia hospitalizations due to Mycoplasma pneumonia, Flu A virus and Flu B virus, the predominant pathogenic microorganisms detected in children aged 0−5 are apparently associated with levels of PMs, CO, NO2 and O3.

Download Full-text

Association between short-term exposure to ambient air pollution and hospital admissions for transient ischemic attacks in Beijing, China

Environmental Science and Pollution Research ◽

10.1007/s11356-020-10963-1 ◽

2020 ◽

Author(s):

Runhua Zhang ◽

Yong Jiang ◽

Guitao Zhang ◽

Miaoxin Yu ◽

Yongjun Wang ◽

...

Keyword(s):

Air Pollution ◽

Air Pollutants ◽

Hospital Admissions ◽

Ambient Air ◽

Additive Models ◽

Pollution Monitoring ◽

Ambient Air Pollution ◽

Exposure Response ◽

Short Term Exposure ◽

Beijing China

Abstract Numerous studies have examined the associations between air pollution and stroke. However, little is known about the associations between air pollution and transient ischemic attack (TIA). In this study, we aimed to conduct a time-series study to systematically examine the associations between hospital admissions for TIA and air pollutants. Admissions for TIA (ICD-10: G45) from 1 January 2014 to 31 December 2016 were identified based on the primary diagnosis from 134 hospitals in Beijing, China. Hourly measurements of air pollutants were obtained from the National Air Pollution Monitoring System. Generalized additive models with quasi-Poisson regression were used to determine the associations for each pollutant. Additionally, stratified analysis was implemented to examine whether age, gender, temperature, and season were the potential effect modifiers. Restricted cubic spline was applied to investigate the exposure-response curve. In total, 109,975 hospital admissions for TIA were included. The positive associations were detected between PM2.5, PM10, SO2, NO2, and CO and hospital admissions for TIA. The effects of PM2.5 and PM10 in men are stronger than in women. Additionally, the effects of PM2.5, PM10, SO2, and O3 are more pronounced on warm days than cool days. From exposure-response curves, we observe a nearly linear relationship for PM2.5, PM10, CO, and NO2. Further studies are needed to verify the association. This research contributes evidence on the association between air pollution and admissions for TIA in the low- and middle-income countries and may promote related public health policy development.

Download Full-text

The association between ambient air pollution and pulmonary tuberculosis: a systematic review protocol

Environmental Evidence ◽

10.1186/s13750-020-00213-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Christian Akem Dimala ◽

Benjamin Momo Kadia ◽

Anna Hansell

Keyword(s):

Systematic Review ◽

Air Pollution ◽

Pulmonary Tuberculosis ◽

Hospital Admission ◽

Air Pollutants ◽

Hospital Admissions ◽

Ambient Air ◽

Risk Of Bias ◽

Ambient Air Pollution ◽

Cochrane Library

Abstract Background There is inconclusive evidence on the association between ambient air pollution and pulmonary tuberculosis-related hospital admission and mortality. This review aims to assess if and to what extent, selected air pollutants are associated to pulmonary tuberculosis (PTB) incidence, hospital admissions and mortality. Methods This will be a systematic review and meta-analysis of studies published in English between January 1st, 1946 and October 31st, 2020, quantitatively assessing the association between air pollutants and PTB incidence, hospital admissions and mortality. A comprehensive search strategy will be used to search the databases: Medline, Embase, Scopus and The Cochrane Library. Retrieved studies will be screened based on the set eligibility criteria and data will be extracted from eligible studies. Extracted data will be analysed on STATA version 14.0 software. Studies included will be assessed for their quality using the respective Study Quality Assessment Tools of the National Health Institute. The quality of the evidence on the study outcomes will be graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The risk of bias will be assessed using Cochrane’s Risk of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool. Study characteristics, socio-demographic and clinical characteristics across eligible studies will be summarised and presented. Pooled estimates of the measures of association between air pollutants and PTB incidence, hospital admission and mortality will be obtained through random-effect meta-analyses models and the respective I2 test statistics will be reported. Meta-regression analyses will be done in case of significant between-study heterogeneity.

Download Full-text

A STUDY ON AMBIENT AIR POLLUTION AND HOSPITAL VISITS OF PATIENTS IN TERTIARY HOSPITAL AT NORTH CHENNAI – AN OBSERVATIONAL STUDY

10.36106/gjra/9209247 ◽

2021 ◽

pp. 55-57

Author(s):

Vengada Krishnaraj S. P ◽

Roshan Kumar. M ◽

Vinod Kumar. V

Keyword(s):

Air Pollution ◽

Particulate Matter ◽

Air Pollutants ◽

Respiratory Diseases ◽

Hospital Admissions ◽

Ambient Air ◽

Ambient Air Pollution ◽

Air Pollution Exposure ◽

Pollution Exposure ◽

Respiratory Conditions

BACKGROUND: Air pollution is an important environmental risk factor for human health. Evidence is mounting that ambient air pollution exposure is signicantly associated with respiratory diseases. Ambient air pollution, such as nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM), is associated with mortality and morbidity induced by respiratory diseases. The relationship between air pollutants and respiratory hospital admissions has been reported both in developed countries and in developing countries. Other studies have shown an adverse effect of ambient air pollution exposure on morbidity and mortality, as well as on healthcare costs. AIM OF THE STUDY: To investigate the association between ambient air pollutant exposure and daily hospital admissions for respiratory diseases in both childrens and Adults. METHODOLOGY: The daily emergency hospital admissions for respiratory conditions in the north part of Chennai during 2019- 2020 were recorded. Daily counts of hospital admissions for total respiratory conditions (43 admissions day(-1)), acute respiratory infections including pneumonia (18 day(-1)), chronic obstructive pulmonary disease (COPD) (13 day(-1)), and asthma (4.5 day(-1)) among residents of all ages and among children (0-14 yrs) were analysed. The generalized additive models included spline smooth functions of the day of study, mean temperature, mean humidity, inuenza epidemics, and indicator variables for days of the week and holidays. Total respiratory admissions were signicantly associated with the same-day level of NO2 (2.5% increase per interquartile range (IQR) change, 22.3 microg x m(-3)) and CO (2.8% increase per IQR, 1.5 mg x m(-3)). RESULTS: The daily mean concentrations of pollutants across all studies were 65.2 µg/m3 for PM10, 45.8 µg/m3 for PM2.5, 27.7 µg/m3 for SO2, 35.0 µg/m3 forNO2and1698µg/m3for CO, and 81.1µg/m3for O3. For the single variable models, the linear effect of PM10, PM2.5, and PM1 was evaluated by adjusting for the inuence of temperature. The association between hospital admissions for respiratory disease and the level of particulate matter was statistically signicant at 0-3 daylag in females and overall. In males, no statistically signicant effect was found at lag 3 for PM10 or at lag2-3 for PM2.5 and PM1.The associations between PM2.5 and PM1, and risk of admission were no longer signicant at some lags after adjusting for NO2, SO2, CO, and O3 separately. No associations were found at lag 3 after adjusting for NO2 or at lag 2 and 3 after adjusting for O3. The effects of PM2.5 and PM1 were not changed after adjusting for CO but were weaker after adjusting for other air pollutants (NO2, SO2,and O3). CONCLUSION: The ndings of this study demonstrated that O3 was associated with an increased risk of respiratory-related admissions, especially for children <5years old. The effect was stronger in the winter than in the summer with each increase of 10 µg/m3 of O3 in winter, the risk of admissions for respiratory diseases after 5 days of exposure increased by 6.2% (95% CI3.7% - 8.8%). No signicant association between O3 and hospital admissions for wheeze-associated disorders specically was observed in children.

Download Full-text

Relationship between Air Pollutant Exposure and Gynecologic Cancer Risk

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105353 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5353

Author(s):

Qiwei Yu ◽

Liqiang Zhang ◽

Kun Hou ◽

Jingwen Li ◽

Suhong Liu ◽

...

Keyword(s):

Air Pollution ◽

Cancer Risk ◽

Air Pollutants ◽

Gynecological Cancer ◽

Gynecologic Cancer ◽

Ambient Air ◽

Air Pollutant ◽

Ambient Air Pollution ◽

Short Term Exposure ◽

Increased Risk

Exposure to air pollution has been suggested to be associated with an increased risk of women’s health disorders. However, it remains unknown to what extent changes in ambient air pollution affect gynecological cancer. In our case–control study, the logistic regression model was combined with the restricted cubic spline to examine the association of short-term exposure to air pollution with gynecological cancer events using the clinical data of 35,989 women in Beijing from December 2008 to December 2017. We assessed the women’s exposure to air pollutants using the monitor located nearest to each woman’s residence and working places, adjusting for age, occupation, ambient temperature, and ambient humidity. The adjusted odds ratios (ORs) were examined to evaluate gynecologic cancer risk in six time windows (Phase 1–Phase 6) of women’s exposure to air pollutants (PM2.5, CO, O3, and SO2) and the highest ORs were found in Phase 4 (240 days). Then, the higher adjusted ORs were found associated with the increased concentrations of each pollutant (PM2.5, CO, O3, and SO2) in Phase 4. For instance, the adjusted OR of gynecological cancer risk for a 1.0-mg m−3 increase in CO exposures was 1.010 (95% CI: 0.881–1.139) below 0.8 mg m−3, 1.032 (95% CI: 0.871–1.194) at 0.8–1.0 mg m−3, 1.059 (95% CI: 0.973–1.145) at 1.0–1.4 mg m−3, and 1.120 (95% CI: 0.993–1.246) above 1.4 mg m−3. The ORs calculated in different air pollution levels accessed us to identify the nonlinear association between women’s exposure to air pollutants (PM2.5, CO, O3, and SO2) and the gynecological cancer risk. This study supports that the gynecologic risks associated with air pollution should be considered in improved public health preventive measures and policymaking to minimize the dangerous effects of air pollution.

Download Full-text

Outdoor air pollution and diminished ovarian reserve among infertile Korean women

Environmental Health and Preventive Medicine ◽

10.1186/s12199-021-00942-4 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Hannah Kim ◽

Seung-Ah Choe ◽

Ok-Jin Kim ◽

Sun-Young Kim ◽

Seulgi Kim ◽

...

Keyword(s):

Air Pollution ◽

Ovarian Reserve ◽

Air Pollutants ◽

Total Population ◽

Secondary Analysis ◽

Reproductive Potential ◽

Ambient Air ◽

Average Concentration ◽

Ambient Air Pollution ◽

Korean Women

AbstractBackgroundMounting evidence implicates an association between ambient air pollution and impaired reproductive potential of human. Our study aimed to assess the association between air pollution and ovarian reserve in young, infertile women.MethodsOur study included 2276 Korean women who attended a single fertility center in 2016–2018. Women’s exposure to air pollution was assessed using concentrations of particulate matter (PM10and PM2.5), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), and ozone (O3) that had been collected at 269 air quality monitoring sites. Exposure estimates were computed for 1, 3, 6, and 12 months prior to the ovarian reserve tests. Anti-Müllerian hormone (AMH) ratio (defined as an observed-to-expected AMH based on age) and low AMH (defined as < 0.5 ng/mL) were employed as indicators of ovarian reserve. We included a clustering effect of 177 districts in generalized estimating equations approach. A secondary analysis was conducted restricting the analyses to Seoul residents to examine the association in highly urbanized setting.ResultsThe mean age was 36.6 ± 4.2 years and AMH level was 3.3 ± 3.1 ng/mL in the study population. Average AMH ratio was 0.8 ± 0.7 and low AMH was observed in 10.3% of women (n=235). The average concentration of six air pollutants was not different between the normal ovarian reserve and low AMH groups for all averaging periods. In multivariable models, an interquartile range (IQR)-increase in 1 month-average PM10was associated with decrease in AMH ratio among total population (β= −0.06, 95% confidence interval: −0.11, 0.00). When we restrict our analysis to those living in Seoul, IQR-increases in 1 and 12 month-average PM2.5were associated with 3% (95% CI: −0.07, 0.00) and 10% (95% CI: −0.18, −0.01) decrease in AMH ratio. The ORs per IQR increase in the six air pollutants were close to null in total population and Seoul residents.ConclusionsIn a cohort of infertile Korean women, there was a suggestive evidence of the negative association between ambient PM concentration and ovarian reserve, highlighting the potential adverse impact of air pollution on women’s fertility.

Download Full-text