Association between gaseous pollutants and emergency ambulance dispatches for asthma in Chengdu, China: a time-stratified case-crossover study

Short-term effects of air pollutants on hospital admissions for asthma among older adults: a multi-city time series study in Southwest, China

Background

This study aimed to explore the relationship between air pollution and hospital admissions for asthma in older adults, and to further assess the health and economic burden of asthma admissions attributable to air pollution.

Methods

We collected information on asthma cases in people over 65 years of age from nine cities in Sichuan province, as well as air pollution and meteorological data. The relationship between short-term air pollutant exposure and daily asthma hospitalizations was analyzed using the generalized additive model (GAM), and stratified by gender, age, and season. In addition, we assessed the economic burden of hospitalization for air pollution-related asthma in older adults using the cost of disease approach.

Results

The single pollutant model showed that every 1 mg/m3 increase in CO was linked with an increase in daily hospitalizations for older adults with asthma, with relative risk values of 1.327 (95% CI: 1.116-1.577) at lag7. Each 10 μg/m3 increase in NO2, O3, PM10, PM2.5 and SO2, on asthma hospitalization, with relative risk values of 1.044 (95% CI: 1.011-1.078), 1.018 (95% CI: 1.002-1.034), 1.013 (95% CI: 1.004-1.022), 1.015 (95% CI: 1.003-1.028) and 1.13 (95% CI: 1.041-1.227), respectively. Stratified analysis shows that stronger associations between air pollution and asthma HAs among older adult in females, those aged 65-69 years, and in the warm season, although all of the differences between subgroups did not reach statistical significance. During the study period, the number of asthma hospitalizations attributable to PM2.5, PM10, and NO2 pollution was 764, 581 and 95, respectively, which resulted in a total economic cost of 6.222 million CNY, 4.73 million CNY and 0.776 million CNY, respectively.

Conclusion

This study suggests that short-term exposure to air pollutants is positively associated with an increase in numbers of asthma of people over 65 years of age in Sichuan province, and short-term exposure to excessive PM and NO2 brings health and economic burden to individuals and society.

Long-Term Air Pollution Characteristics and Multi-scale Meteorological Factor Variability Analysis of Mega-mountain Cities in the Chengdu-Chongqing Economic Circle

Currently, air quality has become central to global environmental policymaking. As a typical mountain megacity in the Cheng-Yu region, the air pollution in Chongqing is unique and sensitive. This study aims to comprehensively investigate the long-term annual, seasonal, and monthly variation characteristics of six major pollutants and seven meteorological parameters. The emission distribution of major pollutants is also discussed. The relationship between pollutants and the multi-scale meteorological conditions was explored. The results indicate that particulate matter (PM), SO2 and NO2 showed a "U-shaped" variation, while O3 showed an "inverted U-shaped" seasonal variation. Industrial emissions accounted for 81.84%, 58% and 80.10% of the total SO2, NOx and dust pollution emissions, respectively. The correlation between PM2.5 and PM10 was strong (R = 0.98). In addition, PM only showed a significant negative correlation with O3. On the contrary, PM showed a significant positive correlation with other gaseous pollutants (SO2, NO2, CO). O3 is only negatively correlated with relative humidity and atmospheric pressure. These findings provide an accurate and effective countermeasure for the coordinated management of air pollution in Cheng-Yu region and the formulation of the regional carbon peaking roadmap. Furthermore, it can improve the prediction accuracy of air pollution under multi-scale meteorological factors, promote effective emission reduction paths and policies in the region, and provide references for related epidemiological research.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s11270-023-06279-8.

Ambient gaseous pollutants and emergency ambulance calls for all-cause and cause-specific diseases in China: a multicity time-series study

Much attention has been paid to the health effects of ambient particulate matter pollution; the effects of gaseous air pollutants have not been well studied. Emergency ambulance calls (EACs) may provide a better indicator of the acute health effects than the widely used health indicators, such as mortality and hospital admission. We estimated the short-term associations between gaseous air pollutants [nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and ozone (O₃)] and EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and pooled associations. Stratified analyses were conducted by age, sex, and season. A total of 1,626,017 EACs were observed for all-cause EACs, including 230,537 from cardiovascular diseases, and 96,483 from respiratory diseases. Statistically significant associations were observed between NO₂ and EACs for all-cause diseases, while the effects of SO₂ were positive, but not statistically significant in most models. No significant relationship was found between O₃ and EACs. Specifically, each 10 μg/m³ increase in the 2-day moving average concentration of NO₂ was associated with a 1.07% [95% confidence interval (CI): 0.40%, 1.76%], 0.76% (95% CI: 0.19%, 1.34%) and 0.06% (95% CI: -1.57%, 1.73%) increase in EACs due to all-cause, cardiovascular and respiratory diseases, respectively. Stratified analysis showed a larger effect of NO₂ on all-cause EACs in the cold season [excess relative risk (ERR): 0.33% (95% CI: 0.05%, 0.60%) for warm season, ERR: 0.77% (95% CI: 0.31%, 1.23%) for cold season]. Our study indicates that acute exposures to NO₂ might be an important trigger of the emergent occurrence of all-cause, cardiovascular and respiratory diseases, and this effect should be of particular concern in the cold season. Further policy development for controlling gaseous air pollution is warranted to reduce the emergent occurrence of cardiopulmonary diseases.

The association between air pollution parameters and emergency department visits and hospitalizations due to cardiovascular and respiratory diseases: a time-series analysis

OBJECTIVE

In this study, the association between cardiovascular and respiratory Emergency Department (ED) visits and hospitalizations and Sulfur Dioxide (SO₂) and particulate matter with an aerodynamic diameter ≤ 10 µm (PM₁₀) was determined.

METHODS

The records of a total of 632,223 people diagnosed with cardiovascular diseases (ICD-10 code I00-I99) and respiratory diseases (ICD-10 code J00-J99) at and over the age of 18 between 2012 and 2018 in three hospitals in Karaman in Turkey were examined in the present study. The daily 24-h averages for SO₂ and PM₁₀ concentrations were acquired in National Air Quality Monitoring. A time-series analysis with Poisson Generalized Linear Model was used.

RESULTS

Among the air pollution parameters, the mean ± standard deviation of SO₂ and PM₁₀ were 16.2 ± 22.1 and 75.8 ± 48.2 μg/m³, respectively. An increase of 10 μg/m³ in SO₂ was associated with a 3% [Relative Risk (RR), 95% Confidence Interval (CI): 2-4)] increase in cardiovascular ED visit and 2% (RR, 95% CI 2-3) increase in respiratory ED visit, and 1% (RR, 95% CI 1-3) increase in respiratory hospitalizations. An increase of 10 μg/m³ in PM₁₀ was associated with a 1% (RR, 95% CI 1-2) increase in cardiovascular hospitalizations.

CONCLUSIONS

Increases in SO₂ are a risk factor for cardiovascular and respiratory ED visits, and respiratory hospitalizations. Increases in PM₁₀ are a risk factor for cardiovascular hospitalizations.

Characteristics of Particulate Matter at Different Pollution Levels in Chengdu, Southwest of China

Air pollution is becoming increasingly serious along with social and economic development in the southwest of China. The distribution characteristics of particle matter (PM) were studied in Chengdu from 2016 to 2017, and the changes of PM bearing water-soluble ions and heavy metals and the distribution of secondary ions were analyzed during the haze episode. The results showed that at different pollution levels, heavy metals were more likely to be enriched in fine particles and may be used as a tracer of primary pollution sources. The water-soluble ions in PM2.5 were mainly Sulfate-Nitrate-Ammonium (SNA) accounting for 43.02%, 24.23%, 23.50%, respectively. SO42−, NO3−, NH4+ in PM10 accounted for 34.56%, 27.43%, 19.18%, respectively. It was mainly SO42− in PM at Clean levels (PM2.5 = 0~75 μg/m3, PM10 = 0~150 μg/m3), and mainly NH4+ and NO3− at Light-Medium levels (PM2.5 = 75~150 μg/m3, PM10 = 150~350 μg/m3). At Heavy levels (PM2.5 = 150~250 μg/m3, PM10 = 350~420 μg/m3), it is mainly SO42− in PM2.5, and mainly NH4+ and NO3− in PM10. The contribution of mobile sources to the formation of haze in the study area was significant. SNA had significant contributions to the PM during the haze episode, and more attention should be paid to them in order to improve air quality.

Overviewing the air quality models on air pollution in Sichuan Basin, China

Most developing countries in the world face the common challenges of reducing air pollution and advancing the process of sustainable development, especially in China. Air pollution research is a complex system and one of the main methods is through numerical simulation. The air quality model is an important technical method, it allows researchers to better analyze air pollutants in different regions. In addition, the SCB is a high-humidity and foggy area, and the concentration of atmospheric pollutants is always high. However, research on this region, one of the four most polluted regions in China, is still lacking. Reviewing the application of air quality models in the SCB air pollution has not been reported thoroughly. To fill these gaps, this review provides a comprehensive narration about i) The status of air pollution in SCB; ii) The application of air quality models in SCB; iii) The problems and application prospects of air quality models in the research of air pollution. This paper may provide a theoretical reference for the prevention and control of air pollution in the SCB and other heavily polluted areas in China and give some¹inspirations for air pollution forecast in other countries with complex terrain.

Sulfur dioxide and exacerbation of allergic respiratory diseases: A time-stratified case-crossover study

Background:

Strong epidemiological evidence suggests that air pollution plays a significant role in the exacerbation of allergic respiratory diseases. This study aimed to assess the potential relationship between daily levels of sulfur dioxide (SO₂) and emergency department (ED) visits for allergic diseases.

Materials and Methods:

Data regarding ED visits for allergic respiratory diseases were routinely collected from the EDs in the Zlatibor district, and the General Hospital, Užice. The daily average concentrations of SO₂ were obtained from the regional automatic air quality monitoring stations. All data were collected from June 2012 to July 2014. A time-stratified case-crossover design was used. Crude odds ratios (ORs) and ORs adjusted for weather conditions were calculated using conditional logistic regression.

Results:

Statistically significant associations were seen between 0-day lagged exposure to SO₂ and ED visits for all allergic diseases (OR = 1.62; 95% confidence interval [CI]: 1.05–2.48; P = 0.028) and between 2-day lagged exposure to SO₂ and ED visits for asthma with allergic rhinitis (OR = 2.00; 95% CI: 1.03–3.88; P = 0.042). These results were adjusted for temperature, temperature², and humidity.

Conclusion:

Our results suggest that short-term exposure to SO₂ conferred an increased risk of ED visits for allergic respiratory diseases, particularly for asthma with concomitant allergic rhinitis.

Short-term effect of particular matter and sulfur dioxide exposure on asthma and/or chronic obstructive pulmonary disease hospital admissions in Center of Anatolia

We investigated the associations between the daily variations of coarse particulate matter (PM₁₀) and/or sulfur dioxide (SO₂) and hospital admissions for asthma and/or chronic obstructive pulmonary disease (COPD) diseases in Kirsehir, Center of Anatolia of Turkey. We analyzed the poison generalized linear model (GLM) to analyze the association between ambient air pollutants such as PM₁₀ and SO₂ and asthma and/or COPD admissions. We investigated single-lag days and multi-lag days for the risk increase in asthma, COPD, asthma, and/or COPD hospital admissions PM₁₀, SO₂, and PM₁₀ with SO₂ per 10 μg/m³. In single-lag day model a 10 μg/m³ increase in the current day (lag 0) concentrations of PM₁₀ and SO₂ corresponded to increase of 1.027 (95% CI:1.022-1.033) and 1.069 (95% CI:1.062, 1.077) for asthma. A 10 μg/m³ increase in the current day (lag 0) concentrations of PM₁₀ and SO₂ corresponded to increase of 1.029 (95% CI:1.022-1.035) and 1.065 (95% CI:1.056, 1.075) for COPD. A 10 μg/m³ increase in the current day (lag 0) concentrations of PM₁₀ and SO₂ corresponded to increase of 1.028 (95% CI:1.024-1.032) and 1.068 (95% CI:1.062, 1.074) for asthma and/or COPD. It was found that some lag structures were related with PM₁₀ and SO₂. Significant lags were detected in some lag structures from the previous first day until the previous eighth day (lag 1 to lag 7) in the asthma, COPD, and asthma and/or COPD hospital admissions in the model created with PM₁₀ with SO₂ both in the single-lag day model and in the multi-lag day model. Our study that used GLM in time series analysis showed that PM₁₀ and/or SO₂ short-term exposure in single-lag day and multi-lag day models was related with increased asthma, COPD, and asthma and/or COPD hospital admissions in the city between 2016 and 2019 until the previous-eighth day.

Prevalence and risk factors of pre-sick building syndrome: characteristics of indoor environmental and individual factors

BACKGROUND

With the aim to prevent sick building syndrome and worsening of allergic symptoms, primarily resulting from the indoor environment, the relationships among people's residential environment in recent years, their lifestyle habits, their awareness, and their symptoms were investigated using an online survey.

METHODS

In the survey, respondents experiencing symptoms specific to sick building syndrome, although they were not diagnosed with sick building syndrome, were categorized in the pre-sick building syndrome group. The relationships among individual characteristics, residential environment, and individual awareness were analyzed.

RESULTS

Results showed that the prevalence of pre-sick building syndrome was high among young (aged 20-29 years) population of both sexes. In addition, "condensation," "moisture," "musty odors" in the house, and the "use of deodorant and fragrance" were all significantly associated with pre-sick building syndrome. Conversely, there was no significant association with recently built "wooden" houses that are highly airtight and have thermal insulation.

CONCLUSIONS

Efficient "ventilation" plans and "ventilation" improvement and air conditioning systems to prevent mold and condensation in rooms are necessary to maintain a good, indoor environment that is beneficial for health. Efforts should also be made to encourage individuals to regularly clean and effectively ventilate their homes.

Hourly associations between ambient air pollution and emergency ambulance calls in one central Chinese city: Implications for hourly air quality standards

BACKGROUND

Most studies on the short-term health effects of air pollution have been conducted on a daily time scale, while hourly associations remain unclear.

METHODS

We collected the hourly data of emergency ambulance calls (EACs), ambient air pollution, and meteorological variables from 2014 to 2016 in Luoyang, a central Chinese city in Henan Province. We used a generalized additive model to estimate the hourly effects of ambient air pollutants (PM_2.5, PM₁₀, SO₂, and NO₂) on EACs for all natural causes and cardiovascular and respiratory morbidity, with adjustment for potential confounding factors. We further examined the effect modification by temperature, relative humidity, wind speed, and atmospheric pressure using stratified analyses.

RESULTS

In the single-pollutant models, PM_2.5, PM₁₀, SO₂, and NO₂ were associated with an immediate increase in all-cause morbidity at 0, 0, 12, 10 h, separately, after exposure to these pollutants (excess risks: 0.19% (95% confidence interval (CI): 0.03%, 0.35%), 0.13% (95% CI: 0.02%, 0.24%), 0.28% (95% CI: 0.01%, 0.54%) and 0.52% (95% CI: 0.06%, 0.99%), respectively). These effects remained generally stable in two-pollutant models. SO₂ and NO₂ were significantly associated with an immediate increase in risk of cardiovascular morbidity, but the effects on respiratory morbidity were relatively more delayed. The stratified analyses suggested that temperature could modify the association between PM_2.5 and EACs, humidity and atmospheric pressure could modify the association between SO₂ and EACs.

CONCLUSIONS

Our study provides new evidence that higher concentrations of PM_2.5, PM₁₀, SO₂, and NO₂ may have transiently acute effects on all-cause morbidity and subacute effects on respiratory morbidity. SO₂ and NO₂ may also have immediate effects on cardiovascular morbidity. Findings of this study have important implications for the formation of hourly air quality standards.

Association between incidence of fatal intracerebral hemorrhagic stroke and fine particulate air pollution

Objective

Few studies investigating associations between fine particulate air pollution and hemorrhagic stroke have considered subtypes. Additionally, less is known about the modification of such association by factors measured at the individual level. We aimed to investigate the risk of fatal intracerebral hemorrhage (ICH) incidence in case of PM_2.5 (particles ≤ 2.5 μm in aerodynamic diameter) exposure.

Methods

Data on incidence of fatal ICH from 1 June 2012 to 31 May 2014 were extracted from the acute stroke mortality database in Shanghai Municipal Center for Disease Control and Prevention (SCDC). We used the time-stratified case-crossover approach to assess the association between daily concentrations of PM_2.5 and fatal ICH incidence in Shanghai, China.

Results

A total of 5286 fatal ICH cases occurred during our study period. The averaged concentration of PM_2.5 was 77.45 μg/m³. The incidence of fatal ICH was significantly associated with PM_2.5 concentration. Substantial differences were observed among subjects with diabetes compared with those without; following the increase of PM_2.5 in lag2, the OR (95% CI) for subjects with diabetes was 1.26 (1.09–1.46) versus 1.05 (0.98–1.12) for those without. We did not find evidence of effect modification by hypertension and cigarette smoking.

Conclusions

Fatal ICH incidence was associated with PM_2.5 exposure. Our results also suggested that diabetes may increase the risk for ICH incidence in relation to PM_2.5.

Electronic supplementary material

The online version of this article (10.1186/s12199-019-0793-9) contains supplementary material, which is available to authorized users.

Multi-Factor Analysis of Single-Center Asthma Control in Xiamen, China

We evaluated the effects of air pollutants, age, allergic history, family allergic history, treatment, treatment steps, and compliance on uncontrolled childhood asthma in Xiamen, China. The clinical data of children with asthma in the pediatric outpatient department of the First Affiliated Hospital of Xiamen University from January 2016 to June 2018 were analyzed retrospectively. According to the assessment of the patients' outcome including well-controlled, partly-controlled and uncontrolled, 7,211 cases of 3,268 patients were selected. Rank sum test and ordered multi-class logistic regression analysis were used. In the rank sum test, age, allergic history, family allergic history, season, treatment, treatment steps and compliance were found associated with uncontrolled rate (all P < 0.001). Logistic regression analysis showed that PM₁₀, NO₂, and SO₂ raised uncontrolled-asthma rate (aOR 1.311, aOR 1.281, aOR 1.252, respectively). Older children had lower uncontrolled rate (OR = 0.849, 95% CI: 0.758-0.950), children with higher treatment steps had higher uncontrolled rate (OR = 1.227, 95%CI: 1.040-1.448), and children with better treatment compliance have lower uncontrolled rate (OR = 0.374 95% CI: 0.331-0.424). The order of the uncontrolled rate of asthma from high to low was winter, spring, autumn, and summer. PM₁₀, NO₂, SO₂, age, season, treatment steps, and treatment compliance have significance for predicting the control rate of childhood asthma in Xiamen, China.