Study Of The Relationship Between Air Pollutants And Daily Hospitalization For Musculoskeletal Disorders Based On A DLNM

Objective:To explore the relationship between the exposure effect of atmospheric pollutants on daily hospitalization of musculoskeletal system diseases and the effect model,to identify the key diseases and vulnerable populations endangered by atmospheric pollutants,and to provide theoretical basis for the formulation of reasonable and effective early warning mechanisms,health policies,and medical resource allocation systems.Methods:Data on daily hospitalization volume of musculoskeletal system diseases and daily concentrations of SO₂,NO₂,O₃,CO,PM_2.5,PM₁₀,average temperature,average wind speed,and precipitation during the period from 01/01/2016 to 12/31/2019 in a three large tertiary hospitals in Changsha,Hunan Province were collected;line graphs and time series graphs were used to investigate disease hospitalization volume,air pollutants,and meteorological factors A descriptive analysis was conducted to explore the relationship between hospitalizations,meteorological factors and air pollutants through correlation analysis;a distribution lag nonlinear model was constructed to explore the exposure-lag-effect relationship between six air pollutants and daily hospitalizations of musculoskeletal system diseases.Results:The relationship between the exposure effects of the six air pollutants on hospitalizations for musculoskeletal disorders was variable and differed by gender,age,and season.In the cold season,PM_2.5exposure showed a typical exposure lag effect on hospitalizations in patients with osteoarthritis（CRR:2.217,95%CI:1.010-4.867）;PM₁₀short-term exposure showed a typical lag effect on hip fracture patients with a maximum CRR value of 1.213（95%CI:1.013-1.454）;The effect of PM₁₀on daily hospitalizations in patients with osteoporosis was only observed in the cold season,with a maximum CRR of 1.953（95%CI:1.024-3.724）;the effect of SO₂exposure on hospitalizations in patients with osteoarthritis showed both immediate and lagged effects,while the effect on daily hospitalizations in patients with osteoporosis and hip fractures was mainly immediate,in addition The effect of NO₂exposure on total daily hospitalizations for musculoskeletal disorders was statistically different at days 8-14 after exposure,with a maximum CRR of 1.156（95%CI:1.019-1.313）,with women and those over 65 years of age being the vulnerable groups for NO₂exposure,and the priority diseases affected by NO₂were osteoarthritis The priority diseases affected by NO₂were osteoarthritis,ischemic necrosis of the femoral head and rheumatoid arthritis;those aged 0-17 years were the vulnerable population for O₃exposure;there was a significant effect of CO exposure on total daily hospitalization for musculoskeletal disorders,with a significant effect period of 1-9 days after exposure and a maximum CRR value of 2.867（95%CI:1.188-6.918）;females,those aged 0-17 years,those aged 18-40 years and those aged 65 years or older were vulnerable populations affected by it;ischemic necrosis of the femoral head and rheumatoid arthritis were the priority diseases affected by CO exposure.Conclusions:（1）During the study period,the daily average concentrations of PM_2.5,PM₁₀,NO₂,O₃,and CO in air in Changsha City,Hunan Province,had significant seasonal fluctuations,and notably,the daily average concentration of SO₂gradually decreased after mid-2018.（2）The total daily hospitalizations of musculoskeletal system diseases in Changsha gradually increased,and among the five specific diseases included in the study,the daily hospitalizations of osteoarthritis,femoral head ischemic necrosis,osteoporosis,and hip fracture were relatively stable,while the daily hospitalizations of rheumatoid arthritis decreased year by year.（3）The exposure-lag-effect relationships and effect patterns of air pollution on hospitalizations for musculoskeletal system diseases were different,and there were differences in gender,age,and season;osteoarthritis,rheumatoid arthritis,ischemic necrosis of the femoral head,hip fracture,and osteoporosis were the diseases that were focused on the effects of air pollutants;the female population,people aged 0-17 years,and people aged 65 years or older seemed to be more to be affected by air pollutants.