Effect of Ambient Fine Particulate (PM2.5) on Hospital Admissions for Respiratory and Cardiovascular Diseases in Wuhan, China

Abstract Background: The positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of megalopolis. In addition, due to the lack of accurate methods of assessing individual PM2.5 exposure, further studies are still necessary to be launched in China.Methods: The study was conducted in Wuhan, a megacity in central China with about 10.8929 million population. Daily hospital admission records, from October 2016 to December 2018, were obtained from Wuhan Information center of Health and Family Planning, which administrates all the hospitals in Wuhan. The daily air pollution concentration and weather variable in Wuhan during the study period were collected. We developed Land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposures to PM2.5. We also conducted stratification analyses by age, sex and season.Results: A total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 for total cardiovascular diseases and 159,365 for total respiratory diseases. We found short-term PM2.5 exposure was associated with increased risk of cardiorespiratory hospital admission in Wuhan. Per 10 μg/m3 increase of PM2.5 at lag0~2 days was associated with 1.23% (95%CI: 1.01–1.45%) and 1.95% (95%CI: 1.63–2.27%) elevated risk of admission from cardiovascular and respiratory diseases respectively. The elderly were at higher PM-induced risks. The associations appeared to be more evident in the cold season than in the warm season.Conclusions: This study contributed evidence to support the short-term effects of PM2.5 on cardiorespiratory hospital admission, which may be helpful for air pollution control and disease prevention in Wuhan.

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Effect of ambient fine particulates (PM2.5) on hospital admissions for respiratory and cardiovascular diseases in Wuhan, China

Respiratory Research ◽

10.1186/s12931-021-01731-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Zhan Ren ◽

Xingyuan Liu ◽

Tianyu Liu ◽

Dieyi Chen ◽

Kuizhuang Jiao ◽

...

Keyword(s):

Air Pollution ◽

Hospital Admission ◽

Hospital Admissions ◽

Conditional Logistic Regression ◽

Warm Season ◽

Central China ◽

Air Pollution Control ◽

Short Term ◽

Short Term Exposure ◽

Increased Risk

Abstract Background Positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of a megalopolis. In addition, most studies in China have used averaged data, which results in variations between monitoring and personal exposure values, creating an inherent and unavoidable type of measurement error. Methods This study was conducted in Wuhan, a megacity in central China with about 10.9 million people. Daily hospital admission records, from October 2016 to December 2018, were obtained from the Wuhan Information center of Health and Family Planning, which administrates all hospitals in Wuhan. Daily air pollution concentrations and weather variables in Wuhan during the study period were collected. We developed a land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposure to PM2.5. We also conducted stratification analyses by age, sex, and season. Results A total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 cardiovascular disease admissions and 159,365 respiratory disease admissions. Short-term exposure to PM2.5 was associated with an increased risk of a cardiorespiratory hospital admission. A 10 μg/m3 increase in PM2.5 (lag0–2 days) was associated with an increase in hospital admissions of 1.23% (95% CI 1.01–1.45%) and 1.95% (95% CI 1.63–2.27%) for cardiovascular and respiratory diseases, respectively. The elderly were at higher PM-induced risk. The associations appeared to be more evident in the cold season than in the warm season. Conclusions This study contributes evidence of short-term effects of PM2.5 on cardiorespiratory hospital admissions, which may be helpful for air pollution control and disease prevention in Wuhan.

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Increased Risk of Hospital Admission for Asthma in Children From Short-Term Exposure to Air Pollution: Case-Crossover Evidence From Northern China

Frontiers in Public Health ◽

10.3389/fpubh.2021.798746 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yakun Zhao ◽

Dehui Kong ◽

Jia Fu ◽

Yongqiao Zhang ◽

Yuxiong Chen ◽

...

Keyword(s):

Air Pollution ◽

Particulate Matter ◽

Hospital Admission ◽

Hospital Admissions ◽

Ambient Air ◽

Short Term ◽

High Quality ◽

Case Crossover ◽

Increased Risk ◽

Asthma In Children

Background: Previous studies suggested that exposure to air pollution could increase risk of asthma attacks in children. The aim of this study is to investigate the short-term effects of exposure to ambient air pollution on asthma hospital admissions in children in Beijing, a city with serious air pollution and high-quality medical care at the same time.Methods: We collected hospital admission data of asthma patients aged ≤ 18 years old from 56 hospitals from 2013 to 2016 in Beijing, China. Time-stratified case-crossover design and conditional Poisson regression were applied to explore the association between risk of asthma admission in children and the daily concentration of six air pollutants [particulate matter ≤ 2.5 μm (PM2.5), particulate matter ≤ 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3)], adjusting for meteorological factors and other pollutants. Additionally, stratified analyses were performed by age, gender, and season.Results: In the single-pollutant models, higher levels of PM2.5, SO2, and NO2 were significantly associated with increased risk of hospital admission for asthma in children. The strongest effect was observed in NO2 at lag06 (RR = 1.25, 95%CI: 1.06-1.48), followed by SO2 at lag05 (RR = 1.17, 95%CI: 1.05–1.31). The robustness of effects of SO2 and NO2 were shown in two-pollutant models. Stratified analyses further indicated that pre-school children (aged ≤ 6 years) were more susceptible to SO2. The effects of SO2 were stronger in the cold season, while the effects of NO2 were stronger in the warm season. No significant sex-specific differences were observed.Conclusions: These results suggested that high levels of air pollution had an adverse effect on childhood asthma, even in a region with high-quality healthcare. Therefore, it will be significant to decrease hospital admissions for asthma in children by controlling air pollution emission and avoiding exposure to air pollution.

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Influence of air pollution on hospital admissions for cardiovascular and respiratory diseases in Nis, Serbia

Vojnosanitetski pregled ◽

10.2298/vsp1006473m ◽

2010 ◽

Vol 67 (6) ◽

pp. 473-479 ◽

Cited By ~ 4

Author(s):

Zoran Milosevic ◽

Dragan Bogdanovic ◽

Sladjana Jovic ◽

Aleksandra Stankovic ◽

Suzana Milutinovic ◽

...

Keyword(s):

Air Pollution ◽

Sulphur Dioxide ◽

Respiratory Diseases ◽

Hospital Admissions ◽

Age Groups ◽

Children And Youth ◽

Age Group ◽

Short Term ◽

Limit Values ◽

Black Smoke

Background/Aim. In studies that investigate the health effects of short-term air pollution exposure, population-wide changes in acute outcomes such as mortality, hospital admissions and healthcare visits are linked to short-term variations in ambient pollutant concentrations. The aim of this study was to estimate the association between daily outdoor black smoke and sulphur dioxide levels and hospital admissions for cardiovascular and respiratory diseases in Nis, within a period 2001-2005. Methods. A time series analysis was performed using separated regression models for each pollutant and disease group, by age groups and population as a whole. The effects of copollutant, meteorological factors and cyclic oscillations in hospitalization numbers were controlled. Results. A significant increase in hospital admissions was associated with a 10 ?g/m3 increase in the concentration of black smoke, for cardiovascular diseases: 3.14% (< 0.01) in children and youth under 19 years of age, 1.85% (< 0.001) in 19-64 age group, and 0.84% (< 0.05) in all ages, and for respiratory diseases: 1.77% (< 0.05) in 19-64 age group, and 0.91% (< 0.05) in all ages. The effects on hospitalizations for respiratory diseases in children and youth under 19 years of age, and for cardiovascular and respiratory diseases in the elderly were not statistically significant. The increase of sulphur dioxide level was associated with the increased number of hospitalizations, for both cardiovascular and respiratory diseases in all age groups, but the influence was not statistically significant. Conclusion. Outdoor pollutants concentrations in urban area of Nis were below regulated limit values during most of the investigated period days but it is shown that even such a level of pollution has a significant effect on hospital admissions for cardiovascular and respiratory diseases.

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Fatal opioid overdoses during and shortly after hospital admissions in England: A case-crossover study

PLoS Medicine ◽

10.1371/journal.pmed.1003759 ◽

2021 ◽

Vol 18 (10) ◽

pp. e1003759

Author(s):

Dan Lewer ◽

Brian Eastwood ◽

Martin White ◽

Thomas D. Brothers ◽

Martin McCusker ◽

...

Keyword(s):

Drug Use ◽

Hospital Admission ◽

Crossover Study ◽

Hospital Admissions ◽

Conditional Logistic Regression ◽

Early Discharge ◽

Odds Ratios ◽

Drug Poisoning ◽

Case Crossover ◽

Increased Risk

Background Hospital patients who use illicit opioids such as heroin may use drugs during an admission or leave the hospital in order to use drugs. There have been reports of patients found dead from drug poisoning on the hospital premises or shortly after leaving the hospital. This study examines whether hospital admission and discharge are associated with increased risk of opioid-related death. Methods and findings We conducted a case-crossover study of opioid-related deaths in England. Our study included 13,609 deaths between January 1, 2010 and December 31, 2019 among individuals aged 18 to 64. For each death, we sampled 5 control days from the period 730 to 28 days before death. We used data from the national Hospital Episode Statistics database to determine the time proximity of deaths and control days to hospital admissions. We estimated the association between hospital admission and opioid-related death using conditional logistic regression, with a reference category of time neither admitted to the hospital nor within 14 days of discharge. A total of 236/13,609 deaths (1.7%) occurred following drug use while admitted to the hospital. The risk during hospital admissions was similar or lower than periods neither admitted to the hospital nor recently discharged, with odds ratios 1.03 (95% CI 0.87 to 1.21; p = 0.75) for the first 14 days of an admission and 0.41 (95% CI 0.30 to 0.56; p < 0.001) for days 15 onwards. 1,088/13,609 deaths (8.0%) occurred in the 14 days after discharge. The risk of opioid-related death increased in this period, with odds ratios of 4.39 (95% CI 3.75 to 5.14; p < 0.001) on days 1 to 2 after discharge and 2.09 (95% CI 1.92 to 2.28; p < 0.001) on days 3 to 14. 11,629/13,609 deaths (85.5%) did not occur close to a hospital admission, and the remaining 656/13,609 deaths (4.8%) occurred in hospital following admission due to drug poisoning. Risk was greater for patients discharged from psychiatric admissions, those who left the hospital against medical advice, and those leaving the hospital after admissions of 7 days or more. The main limitation of the method is that it does not control for time-varying health or drug use within individuals; therefore, hospital admissions coinciding with high-risk periods may in part explain the results. Conclusions Discharge from the hospital is associated with an acute increase in the risk of opioid-related death, and 1 in 14 opioid-related deaths in England happens in the 2 weeks after the hospital discharge. This supports interventions that prevent early discharge and improve linkage with community drug treatment and harm reduction services.

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