Short-term Effects Of Ambient Air Pollution On Hospital Admissions For Respiratory Disease In Wuhan

OBJECTIVE:This study aimed to collect and analyze the data of air pollutants and the information of respiratory disease inpatients,to investigate the distribution characteristics of air pollutant and the associations between daily ambient air pollution and hospital admissions for respiratory disease,to find out the vulnerable people most affected by air pollution,in the hope to facilitate better environmental health policies and early warning of air pollution.METHODS:The hospital admissions for respiratory disease discharged from January 2017 to December 2018 were first enrolled in Wuhan,China.The data of air pollutants,including PM10,PM2.5,CO,SO2,O3 and NO2,and meteorological data were collected in the same area and time period.The distribution characteristics of meteorological factors,air pollutant and hospital admissions were described.The correlation coefficient between air pollutant,meteorological factors and hospital admissions were quantified by using Spearman correlation coefficient.After controlling meteorological factors,long-term time trend,holiday and day of week,the associations between ambient air pollution and daily hospital admissions for respiratory disease were investigated by using generalized additive model.The effects of air pollution on the hospital admissions among different genders and age groups were evaluated by subgroup analysis.The nonlinear exposure-effect relationship between air pollutant and hospital admissions was investigated,which described the trend of population health under the dynamic change of pollutant concentration.RESULTS:During the study period,the local air pollution was serious.The average annual concentrations of NO2,PM10 and PM2.5 were 44.95 μg/m3,83.12 μg/m3 and 49.60 μg/m3 respectively,both exceeding the secondary standard limits of national air quality.The hospital admissions ware positively correlated with PM10,PM2.5,CO,SO2 and NO2(P<0.05),and negatively correlation with O3 and average temperature(P<0.05).The results of the generalized additive model showed that the influence of PM10 and PM2.5 decreases with the increase of the lag days.The significant estimate effects in the hospital admissions of respiratory disease were found for per 10 μg/m3 increase in NO2,PM10 and PM2.5 at day 0,were 0.67%(95%CI:0.02%～1.32%),0.40%(95%CI:0.16%～0.64%)and 0.68%(95%CI:0.25%～1.10%),respectively.The effect that each 10 μg/m3 increase in PM2.5 was associated with an increase of 0.44%(95%CI:0.13%～0.74%)admissions among women,which was greater than in man.Both NO2 and PM2.5 were strongly associated with increased admission in women,but exhibited no effects in men.Group aged 0～14 years was significantly affected by NO2,PM10 and PM2.5 associated risks,but no significant effect in the population aged over 65 years.Among the group aged 15～64 years,only PM2.5 was strongly associated with increased hospital admissions of respiratory disease.Conclusion:There are differences in the impact of different air pollutants on the hospital admissions of respiratory disease are different in different populations,most of which are reflected in the immediate effect.Vulnerable populations affected by air pollution include women and children under 14 years old.The government and environmental protection departments should develop policies and guidelines according to the health of the local population to reduce the effect of air pollution.