Short-term PM10 and emergency department admissions for selective cardiovascular and respiratory diseases in Beijing, China

• Published in: The Science of the total environment Vol. 657; pp. 213 - 221
• Main Authors: Feng, Wei, Li, Haibin, Wang, Shuo, Van Halm-Lutterodt, Nicholas, An, Ji, Liu, Yue, Liu, Mengyang, Wang, Xiaonan, Guo, Xiuhua
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 20.03.2019
• Subjects: Air pollution; arrhythmia; Cardiovascular disease; China; cold; confidence interval; elderly; Generalized-additive model; heart failure; Hospital admissions; hospitals; males; myocardial ischemia; particulates; PM10; Respiratory disease; respiratory tract diseases; warm season; China; Hospital admissions; Air pollution; PM10; Cardiovascular disease; Respiratory disease; Generalized-additive model
• ISSN: 0048-9697; 1879-1026; 1879-1026
• DOI: 10.1016/j.scitotenv.2018.12.066

Few studies have explored PM10's connection with specific respiratory and cardiovascular emergency department admissions (EDAs). This study aimed to examine the overall effects of PM10 on EDAs for cardiovascular and respiratory diseases, including specifically, cerebrovascular events (CVE), ischemic heart disease (IHD), arrhythmia, heart failure (HF), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), chronic obstructive pulmonary disease (COPD) and asthma. We collected daily data for EDAs from the 10 largest hospitals in Beijing, between January 2013 and December 2013 as well as daily measurements of PM10 from 17 stations in Beijing. The generalized-additive model was utilized to evaluate the associations between daily PM10 and cardio-pulmonary disease admissions. Differences in gender, age, and season groups were also examined by models. Relative risks (RR) with 95% confidence interval (CI) were calculated based on subtype, age, gender and seasonal groups. In all, there were approximately 56,212 cardiovascular and 92,464 respiratory emergency admissions presented in this study. The largest estimate effects in EDAs of total cardiovascular disease, CVE, IHD, total respiratory diseases, URTI, LRTI and COPD were found for PM10 at day 4 (accumulative) moving average, were 0.29% (95% CI:0.12%, 0.46%), 0.36% (95% CI:0.11%, 0.61%), 0.68% (95% CI:0.25%, 1.10%), 0.34% (95% CI:0.22%, 0.47%), 0.35% (95% CI:0.18%, 0.51%), 0.34% (95% CI:0.14%, 0.55%), 2.75% (95% CI:1.38%, 4.12%) respectively. In two-pollutant models and full-pollutant model modified confounding factors, the positive correlation remained unchanged. The elderly (age ≥ 65 years) and male subjects were more susceptible to specific respiratory diseases. PM10's impact on EDAs for HF was found higher during the hot season however, EDAs for COPD peaked during the cold season. The study markedly informed that PM10 pollution was strongly associated with EDAs for cardio-pulmonary diseases. The effects of PM10 pollution on COPD and heart failure EDAs were clearly determined by seasonal-temperatures. [Display omitted] •Patients with cardiopulmonary diseases are vulnerable to PM10.•Subjects ≥65 years old and male gender tend to be more vulnerable to respiratory illnesses owing to PM10.•PM10 is a significant health hazard greatly impacting cardio-pulmonary emergency admissions.•Polluted areas can greatly curb the health care burden associated with costs of needlessly increased emergency admissions.