Ambient air pollutants relate to hospital admissions for chronic obstructive pulmonary disease in Ganzhou, China
DOI:
https://doi.org/10.11606/s1518-8787.2022056004324Palavras-chave:
Pulmonary Disease, Chronic Obstructive, epidemiology, Hospitalization, Air Pollution, adverse effects, Air Quality Standards, Models, StatisticalResumo
OBJECTIVE To evaluate the relationship between ambient air pollutants and chronic obstructive pulmonary disease in relatively low-polluted areas in China. METHODS Atmospheric pollutants levels and meteorological data were obtained from January 2016 to December 2020. The medical database including daily hospital admissions for chronic obstructive pulmonary disease (ICD10: J44) was derived from the First Affiliated Hospital of Gannan Medical University. The generalized additive model was used to analyze the percentage change with 95% confidence interval in daily hospital admissions for chronic obstructive pulmonary disease associated with a 10 µg/m3 increase in atmospheric pollutants levels. RESULTS In total, occurred 4,980 chronic obstructive pulmonary disease hospital admissions (not including emergency department visits) during 2016–2020. The mean concentrations of daily PM2.5, PM10, SO2, NO2, O3, and CO were 37.5 μg/m3, 60.1 μg/m3, 18.7 μg/m3, 23.5 μg/m3, 70.0 μg/m3, and 1.2 mg/m3 in Ganzhou. Each 10 µg/m3 increment of PM2.5, PM10, NO2, and O3 were significantly associated with 2.8% (95%CI: 1.0–4.7), 1.3% (95%CI: 0.3–2.4), 2.8% (95%CI: 0.4–5.4), and 1.5% (95%CI: 0.2–2.7) elevation in daily chronic obstructive pulmonary disease hospital admissions. The estimates of delayed effects of PM2.5, PM10, NO2, and O3 were observed at lag6, lag6, lag8, lag1, respectively. The health effects of particulate pollutants (PM2.5 and PM10) may be independent of other pollutants. The adverse effects of air pollutants were more evident in the warm season (May–Oct) than in the cold season (Nov–Apr). CONCLUSION Our study demonstrated that elevated concentrations of atmospheric pollutant (PM2.5, PM10, NO2, and O3), especially particulate pollutants, can be associated with increased daily count of hospital admissions for chronic obstructive pulmonary disease , which may promote further understanding of the potential hazards of relatively low levels of air pollution on chronic obstructive pulmonary disease and other respiratory disorders.
Referências
Burney PGJ, Patel J, Newson R, Minelli C, Naghavi M. Global and regional trends in COPD mortality, 1990-2010. Eur Respir J. 2015;45:1239-1247. https://doi.org/10.1183/09031936.00142414
Chapman KR, Mannino DM, Soriano JB, Vemeire PA, Buist AS, Thun MJ, et al. Epidemiology and costs of chronic obstructive pulmonary disease. Eur Respir J. 2006;27:188-207. https://doi.org/10.1183/09031936.06.00024505
Hogg JC. Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet. 2004;364(9435):709-721. https://doi.org/10.1016/S0140-6736(04)16900-6
Mannino DM, Braman S. The epidemiology and economics of chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2007;4(7):502-506. https://doi.org/10.1513/pats.200701-001FM
Hwang SL, Lin YC, Guo SE, Chou CT, Lin CM, Chi MC. Fine particulate matter on hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in southwestern Taiwan during 2006-2012. Int J Environ Health Res. 2017;27(2):95-105. https://doi.org/10.1080/09603123.2017.1278748
Gao N, Li C, Ji J, Yang Y, Wang S, Tian X, et al. Short-term effects of ambient air pollution on chronic obstructive pulmonary disease admissions in Beijing, China (2013-2017). Int J Chron Obstruct Pulmon Dis. 2019;14:297-309. https://doi.org/10.2147/COPD.S188900
Liu C, Liu Y, Zhou Y, Feng A, Wang C, Shi T. Short-term effect of relatively low level air pollution on outpatient visit in Shennongjia, China. Environ Pollut. 2019;245:419-426. https://doi.org/10.1016/j.envpol.2018.10.120
Liu Y, Xie S, Yu Q, Huo X, Ming X, Wang J, et al. Short-term effects of ambient air pollution on pediatric outpatient visits for respiratory diseases in Yichang city, China. Environ Pollut. 2017;227:116-124. https://doi.org/10.1016/j.envpol.2017.04.029
The People’s Republic of China, Ministry of Ecology and Environment. Report on the State of the Ecology and Environment in China. Beijing (CN); 2019 [cited 2021 Dec 14]. Available from: https://english.mee.gov.cn/Resources/Reports/soe/
Nascimento AP, Santos JM, Mill JG, Albuquerque TTA, Reis Júnior NC, Reisen VA, et al. Association between the incidence of acute respiratory diseases in children and ambient concentrations of SO2, PM10 and chemical elements in fine particles. Environ Res. 2020;188:109619. https://doi.org/10.1016/j.envres.2020.109619
Raji H, Riahi A, Borsi SH, Masoumi K, Khanjani N, AhmadiAngali K, et al. Acute effects of air pollution on hospital admissions for asthma, COPD, and bronchiectasis in Ahvaz, Iran. Int J Chron Obstruct Pulmon Dis. 2020;15:501-514.
https://doi.org/10.2147/COPD.S231317
Tian Y, Xiang X, Juan J, Song J, Cao Y, Huang C, et al. Short-term effects of ambient fine particulate matter pollution on hospital visits for chronic obstructive pulmonary disease in Beijing, China. Environ Health. 2018;17:21. https://doi.org/10.1186/s12940-018-0369-y
Li MH, Fan LC, Mao B, Yang JW, Choi AMK, Cao WJ, et al. Short-term exposure to ambient fine particulate matter increases hospitalizations and mortality in COPD: a systematic review and meta-analysis. Chest. 2016;149(2):447-458.
https://doi.org/10.1378/chest.15-0513
Shin S, Bai L, Burnett RT, Kwong JC, Hystad P, Donkellar A, et al. Air pollution as a risk factor for incident chronic obstructive pulmonary disease and asthma: a 15-year population-based cohort study. Am J Respir Crit Care Med. 2021;203(9):1138-1148.
https://doi.org/10.1164/rccm.201909-1744OC
Chen G, Li S, Zhang Y, Zhang W, Li D, Wei X, et al. Effects of ambient PM1 air pollution on daily emergency hospital visits in China: an epidemiological study. Lancet Planet Health. 2017;1(6):e221-e229.
https://doi.org/10.1016/S2542-5196(17)30100-6
Weichenthal S, Bai L, Hatzopoulou M, Van Ryswyk k, Kwong JC, Jerret M, et al. Long-term exposure to ambient ultrafine particles and respiratory disease incidence in in Toronto, Canada: a cohort study. Environ Health. 2017;16(1):64.
https://doi.org/10.1186/s12940-017-0276-7
Tian Y, Liu H, Liang T, Xiang X, Li M, Juan J, et al. Ambient air pollution and daily hospital admissions: a nationwide study in 218 Chinese cities. Environ Pollut. 2018;242(Part B):1042-1049. https://doi.org/10.1016/j.envpol.2018.07.116
Wiegman CH, Li F, Ryffel B, Togbe D, Chung KF. Oxidative stress in ozone-induced chronic lung inflammation and emphysema: a facet of chronic obstructive pulmonary disease. Front Immunol. 2020;11:1957. https://doi.org/10.3389/fimmu.2020.01957
Gao H, Wang K, Au WW, Zhao W, Xia ZL. A systematic review and meta-analysis of short-term ambient ozone exposure and COPD hospitalizations. Int J Environ Res Public Health. 2020;17(6):2130. https://doi.org/10.3390/ijerph17062130
Wang Z, Zhou Y, Zhang Y, Huang X, Duan X, Chen D, et al. Association of change in air quality with hospital admission for acute exacerbation of chronic obstructive pulmonary disease in Guangdong, China: a province-wide ecological study. Ecotoxicol Environ Saf. 2021;208:111590. https://doi.org/10.1016/j.ecoenv.2020.111590
Jiang J, Niu Y, Liu C, Chen R, Cao J, Kan H, et al. Short-term exposure to coarse particulate matter and outpatient visits for cardiopulmonary disease in a Chinese city. Ecotoxicol Environ Saf. 2020;199:110686. https://doi.org/10.1016/j.ecoenv.2020.110686
Li Y, Li G, Zeng Q, Liang F, Pan X. Projecting temperature-related years of life lost under different climate change scenarios in one temperate megacity, China. Environ Pollut. 2018;233:1068-1075. https://doi.org/10.1016/j.envpol.2017.10.008
Liu M, Xue X, Zhou B, Zhang Y, Sun B, Chen J, et al. Population susceptibility differences and effects of air pollution on cardiovascular mortality: epidemiological evidence from a time-series study. Environ Sci Pollut Res Int. 2019;26:15943-15952.
https://doi.org/10.1007/s11356-019-04960-2
Yang T, He T, Huang J, Li G. Impact of birth season on the years of life lost from respiratory diseases in the elderly related to ambient PM2.5 exposure in Ningbo, China. Environ Health Prev Med. 2021;26:74. https://doi.org/10.1186/s12199-021-00994-6
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Copyright (c) 2022 Xingye Zhou, Chenwei Li, Yanfang Gao, Chuanfei Zhou, Lei Huang, Xiaokang Zhang
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
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Gannan Medical University
Números do Financiamento Process QD201901 -
Education Department of Jiangxi Province
Números do Financiamento Process GJJ190786