The health hazards caused by air pollution vary significantly depending on factors such as the composition of pollutants in the region, climate, and the susceptibility of the population. Although numerous studies have explored the relationship between air quality and pneumonia, specific research evidence from a particular inland energy city like Qingyang in China is still scarce. This study aims to quantify the short-term impact of air pollution in this under-researched region on pneumonia hospitalizations. We collected the medical records of patients with pneumonia from January 1, 2015, to December 31, 2019, and also obtained data on 6 types of common air pollutants and meteorological conditions. We performed a time series analysis using a generalized additive model and a distributed nonlinear lag model. All measured data exhibited pronounced seasonality: particulate matter less than 2.5 μm in diameter, particulate matter less than 10 μm in diameter, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) concentrations and pneumonia admissions were higher in the cold season and lower in the warm season, a pattern conversely mirrored by ozone (O3) concentrations, average temperature, and relative humidity. In the single pollutant model, for every 10 μg/m3 increase in exposure levels of particulate matter less than 2.5 μm in diameter, particulate matter less than 10 μm in diameter, SO2, NO2, and O3 8 hours and for every 1 mg/m3 increase in CO exposure level, the risk of pneumonia admission was 1.004 (0.991, 1.017), 1.004 (0.999, 1.010), 1.035 (1.022, 1.048), 1.221 (1.174, 1.271), 0.999 (0.981, 1.017), and 1.382 (1.230, 1.552), respectively. The strongest effects occur in lag 1, lag 7, lag 07, lag 07, lag 3, and lag 05, respectively. Our study identifies significant gender- and age-specific susceptibilities to air pollution in Qingyang. Men were more vulnerable to SO2, whereas women were more affected by CO. Children aged ≤14 years constituted a high-risk group. Furthermore, we observed a distinct seasonal pattern: SO2, NO2, and CO were key drivers of pneumonia admissions with stronger effects in the cold season, in contrast to O3, which exhibited adverse effects only during the warm season.
Evidence regarding the short-term effects of ambient air pollution on acute exacerbations of chronic obstructive pulmonary disease (AECOPD) across multiple cities in northern China remains limited. This study aimed to evaluate the associations between major ambient air pollutants and AECOPD hospitalizations, as well as their lagged effects. We conducted an ecological time-series study of 14,786 AECOPD hospitalizations recorded at 49 hospitals in Shijiazhuang, Handan, and Chengde, Hebei Province, from January 1, 2018, to December 31, 2020. City-specific associations between daily concentrations of fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and 8-hour ozone and AECOPD hospitalizations were estimated using distributed lag nonlinear models, with adjustment for long-term trends, temperature, relative humidity, day of the week, public holidays, and stages of the coronavirus disease 2019 pandemic. Single-day lag effects from lag 0 to lag 5, cumulative lag effects from lag 0–1 to lag 0–5, effects of extreme pollutant concentrations, and associations stratified by age and sex were evaluated. City-specific estimates were subsequently pooled using random-effects multivariate meta-analysis. Associations were expressed as relative risks with 95% confidence intervals. During the 1096-day study period, 14,786 AECOPD hospitalizations were recorded. Compared with the 25th-percentile concentrations, the 75th-percentile concentrations of PM2.5, PM10, SO2, NO2, and CO generally showed stronger cumulative associations with longer lag periods, with the largest estimates usually observed at lag 0–5 days, whereas single-day effects were weak. All 6 pollutants exhibited nonlinear cumulative exposure–response relationships. Compared with median concentrations, the 99th-percentile concentrations of PM2.5, PM10, SO2, NO2, and CO were associated with higher hospitalization risks. High PM2.5 reached its maximum effect at lag 0–5 days (relative risk, 1.391; 95% confidence interval, 1.169–1.658). Higher 8-hour ozone concentrations were generally associated with lower hospitalization risk. Associations were more pronounced among adults aged ≥65 years and males. Short-term exposure to PM2.5, PM10, SO2, NO2, and CO was associated with increased AECOPD hospitalization risk, with nonlinear, lagged, and cumulative effects. Older adults and females may be more susceptible to ambient air pollution.
Huixia Shi, Jiajun Li, Boyan Li et al.· Medicine· 0 citations
BACKGROUND
Air pollution is an important environmental factor influencing respiratory and cardiovascular diseases, and growing experimental evidence suggests that exposure to air pollutants can also cause neuroinflammation and neuronal damage. However, epidemiological evidence on the impact of air pollution exposure on neurological disorders remains limited. This study aims to evaluate the impact of short-term air pollution exposure on hospital admissions for neurological disorders.
METHODS
A total of 249,717 hospital admissions for neurological disorders in Harbin, China, from 2014 to 2023, were collected in this registry-based cohort study. Distributed lag nonlinear model (DLNM) was used to evaluate the effects of PM2.5, PM10, NO2, CO, and a composite pollution index on overall neurological disorders, specific ICD disease modules and categories. Stratified analyses by sex, age, pandemic period, and season were further performed to identify high-risk subpopulations and examine variations in susceptibility to air pollution. Attributable risk estimations were further performed to assess the disease burden attributable to air pollution.
RESULTS
Exposure to PM2.5 (RR = 1.23, 95% CI: 1.14-1.32), NO2 (RR = 1.18, 95% CI: 1.10-1.27), PM10 (RR = 1.12, 95% CI: 1.06-1.19), and CO (RR = 1.10, 95% CI: 1.03-1.19) was associated with increased hospital admissions for overall neurological disorders. These associations were stronger in the cold season than in the warm season. Attributable risk analysis suggested that PM2.5 contributed the largest burden, accounting for 8.46% (95% CI: 5.46%-10.76%) of admissions. Different ICD disease modules and categories exhibited varying associations with different air pollutants.
CONCLUSIONS
Short-term exposure to air pollution increases the risk of hospital admissions for neurological disorders, particularly during the cold season, with PM2.5 contributing the largest disease burden.
Yong Cao, Qiang Ma, Lanfang Chen et al.· BMC Public Health· 0 citations
Objective To investigate associations between air pollutants and hospitalization of patients with chronic obstructive pulmonary disease (COPD) in Kashi, and to identify susceptible populations. Methods We conducted a retrospective study of COPD patients in Kashi between 2012 and 2022. Daily pollutant concentrations were matched to residential addresses for individual exposure assessment. A time-stratified case-crossover design with conditional logistic regression was used to evaluate associations between pollutants and COPD hospitalization. Stratified analyses were performed by age, gender, smoking history and hospitalization season. Sensitivity analysis was conducted by excluding hospitalizations during the COVID-19 pandemic to test result robustness. Results A total of 68,482 patients were included. The strongest significant association between particulate matter (PM10) and COPD hospitalization was identified at lag day 4, particulate matter (PM2.5), PM10, nitrogen dioxide (NO2) and carbon monoxide (CO) exposures generally had relationships of COPD hospitalization [OR (95% CI): 1.015 (1.002–1.032), 1.008 (1.002–1.016), 1.034 (1.008–1.067), and 1.034 (1.005–1.065), respectively]. Individuals who are young, patients with a history of severe acute exacerbations, farmers, smokers, and individuals admitted in cooler seasons may be particularly susceptible. Sensitivity analyses omitting COVID-19 cases showed barely significant associations for PM2.5, PM10 and NO2, with CO displaying only a faint, non-significant relationship. Conclusion PM2.5, PM10, NO2, and CO exposures were associated with COPD hospitalization in Kashi, precautionary measures should be taken with a focus on vulnerable subgroups, to control hospitalization for COPD associated with air pollutants.
Li Li, Ayiguli Alimu, Jingran Xu et al.· International Journal of COP...· 0 citations
Air pollution is a major public health concern, particularly for children who are more susceptible to its harmful respiratory effects. Makkah experiences elevated levels of air pollution due to the influx of religious visitors, vehicular emissions, and traffic during the annual Hajj. The resulting increase in air pollutants raises concerns about respiratory health risks among children, yet local research has focused little on this vulnerable group. This study investigated the association between air pollutants (PM10 and NO2) and pediatric admissions from acute lower respiratory infections (ALRI) among children aged 5-14 years in Makkah, Saudi Arabia, from January 2021 to December 2022. The study period overlapped with the COVID-19 pandemic, which was considered when interpreting the findings. Daily time-series log-linear Poisson regression models were used, adjusting for temporal trends using natural cubic splines, meteorological variables, and sociodemographic factors. Relative risks were estimated per interquartile range increase in pollutant concentrations across lag days 0-2. Hajj-specific associations were assessed using interaction terms for the Hajj and non-Hajj periods. Exposure to NO2 was significantly associated with an increased risk of same-day ALRI admissions in children during the Hajj events (RR = 1.033; 95% CI: 1.003-1.063 per IQR rise) but not outside the Hajj events. In contrast, PM10 effects were non-significant. The findings suggest that NO2, but not PM10, was associated with ALRI admissions during Hajj, highlighting the need for Hajj-focused traffic-emission control and child health protection strategies in Makkah.Implications: Increased NO2 levels during Hajj are associated with higher pediatric ALRI admissions, highlighting the need for targeted air quality management during mass gatherings. Strengthening emission controls, traffic regulation, and monitoring can reduce exposure and protect vulnerable children.
Albaraa A. Milibari, I. Hanigan, H. Badri et al.· Journal of the Air and Waste...· 0 citations
Short-term exposure to traffic-related gaseous pollutants [nitrogen dioxide (NO2) and sulfur dioxide (SO2)] may increase childhood bronchopneumonia risk, but evidence from megacities with high pollution levels remains limited. This study aimed to evaluate the association between short-term exposure to NO2 and SO2 and pediatric bronchopneumonia hospitalization in Guangzhou. We collected all pediatric inpatient records with a primary discharge diagnosis of bronchopneumonia (International Classification of Diseases, Tenth Revision: J18) among children aged 0 to 14 years from a tertiary hospital in the Huadu District, between 1 January 2014 and 31 December 2023. Daily air pollutant and meteorological data were integrated with admission records and analyzed using a generalized additive model with quasi-Poisson distribution. A total of 20,623 hospitalisations were included, of which 60.6% were male and 68.4% were aged <6 years. Both NO2 and SO2 were positively associated with bronchopneumonia hospitalization. Per 5 μg/m3 increase in pollutant concentration, for single-day exposure, the peak excess risks (ERs) occurred at lag 4 (NO2: 2.74% [95% confidence interval (CI): 1.73–3.75]; SO2: 8.81% [95% CI: 4.94–12.82]); For the 0-7 day moving average, the ERs increased to 6.83% (95% CI 4.93–8.77) for NO2 and 17.21% (95% CI 10.18–24.70) for SO2. Children aged 6–14 years and boys showed consistently higher susceptibility. These findings provide the first long-term evidence from Guangzhou that short-term NO2 and SO2 exposure is positively associated with childhood bronchopneumonia hospitalization, with older children and boys being the susceptible subgroups. Public health authorities should consider developing targeted air pollution alert thresholds and intervention strategies for school-aged children and boys.
Qi Yue, Qian Nie, Weiling Liu et al.· Frontiers in Public Health· 0 citations
This study investigated the impacts and interactive effects of apparent temperature and air pollutants on rural pneumonia hospitalizations in Jiuquan, China (2015-2020), utilizing NRCMS surveillance data, distributed lag non-linear models (DLNM), and stratified analyses. The findings revealed an inverted U-shaped relationship between apparent temperature and pneumonia hospitalizations, peaking at a relative risk (RR) of 1.50 (95% CI: 1.41-1.60). Per interquartile range (IQR) increases in CO, SO2, O3, NO2, PM2.5, and PM10 were associated with RR values of 1.11 (95% CI: 1.01-1.21), 1.04 (95% CI: 0.97-1.12), 1.08 (95% CI: 0.93-1.24), 1.02 (95% CI: 0.93-1.12), 1.04 (95% CI: 0.97-1.12), and 1.05 (95% CI: 1.00-1.12), respectively. Furthermore, synergistic interactive effects occurred between low apparent temperature and high air pollution, and among distinct air pollutants. Subgroup analyses showed higher risks for children under 7 years old, minimal gender disparities, and more pronounced risks during autumn and winter. The study underscores the critical need for targeted interventions in rural areas during concurrent periods of low apparent temperature and high air pollution to reduce public health risks.
Guangyu Zhai, Dexin Meng· International Journal of Env...· 0 citations