Acute impact of persistent high ambient fine particulate matter exposures on hospital visits for respiratory diseases from 2013 to 2018 in the Beijing-Tianjin-Hebei region and surrounding areas
10.3760/cma.j.cn112338-20250208-00073
- VernacularTitle:2013-2018年京津冀及周边地区大气细颗粒物持续高暴露对呼吸系统疾病因病就诊的急性影响
- Author:
Yiqi QIU
1
;
Chen CHEN
;
Jianan LI
;
Yue LIANG
;
Changzhen XIANG
;
Huiting LING
;
Jinxia YANG
;
Yu WANG
;
Jianlong FANG
;
Jiaonan WANG
;
Chen MAO
;
Xiaoming SHI
Author Information
1. 南方医科大学公共卫生学院流行病学系，广州 510515
- Publication Type:Journal Article
- Keywords:
Heavy pollution;
Fine particulate matter;
Nitrogen dioxide;
Respiratory diseases;
Risk of morbidity
- From:
Chinese Journal of Epidemiology
2025;46(6):979-985
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the acute effects of persistent high exposure to atmospheric fine particulate matter (PM 2.5) on residents' outpatient visits for respiratory diseases. Methods:We collected daily outpatient records from 92 hospitals in 13 cities across the Beijing-Tianjin-Hebei region, along with daily PM 2.5, nitrogen dioxide (NO 2), and meteorological data from 2013 to 2018. Five persistent high PM 2.5 exposure scenarios were defined in terms of daily mean PM 2.5 concentrations (>75 μg/m 3 and >150 μg/m 3), duration (≥2 days and ≥3 days), and whether or not there was concurrent exposure to high levels of NO 2 (daily mean NO 2 concentration >50 μg/m 3). A two-stage statistical analysis strategy based on a generalized linear model was applied to conduct a time-series analysis to assess the exposure-response relationship between persistent high PM 2.5 exposure scenarios and residents' outpatient visits for a variety of respiratory diseases, and to estimate excess outpatient visits. Results:During the period, M ( Q1, Q3) PM 2.5 and NO 2 concentrations were 61.2 (42.3, 95.1) μg/m 3 and 40.2 (31.4, 54.4) μg/m 3, respectively, and the daily respiratory disease outpatient visits were 57 (52, 66) cases. When compared with non-permanent high PM 2.5 exposure periods, exposure scenarios with PM 2.5 >75 μg/m 3 and lasting for ≥2 days caused an increased risk of outpatient visits for respiratory diseases by 2.10% (95% CI: 1.44%-2.77%), and resulted in 43 787 (95% CI: 30 025-57 757) excess visits; in this scenario, the concurrent exposure to high levels of NO 2 had a greater acute effect on respiratory disease visits than the absence of exposure to high levels of NO 2 ( P<0.001). The risk of respiratory disease visits increased substantially by 4.41% (95% CI: 3.15%-5.68%) when the daily mean PM 2.5 concentration exceeded 150 μg/m 3 for ≥2 days. Subgroup disease analyses showed that scenarios with daily mean PM 2.5 concentrations exceeding 75 μg/m 3 for ≥3 days caused a significant increase in the risk of lower respiratory tract infections, chronic lower respiratory disease, and asthma visits. Conclusions:Sustained persistent high PM 2.5 exposure increases the risk of outpatient visits for various respiratory diseases; concurrent exposure to high concentrations of NO 2 leads to a greater risk of visiting the clinic, suggesting that the prevention and control of PM 2.5 pollution should be synchronized with the control of mobile source emissions, to synergistically manage the compound pollution of PM 2.5 and NO 2 in the atmosphere.
