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

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          Abstract

          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/m 3 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/m 3 increase in NO 2, O 3, PM 10, PM 2.5 and SO 2, 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 PM 2.5, PM 10, and NO 2 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 NO 2 brings health and economic burden to individuals and society.

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          Most cited references72

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          Marilena Kampa, Elias Castanas (2008)
          Hazardous chemicals escape to the environment by a number of natural and/or anthropogenic activities and may cause adverse effects on human health and the environment. Increased combustion of fossil fuels in the last century is responsible for the progressive change in the atmospheric composition. Air pollutants, such as carbon monoxide (CO), sulfur dioxide (SO(2)), nitrogen oxides (NOx), volatile organic compounds (VOCs), ozone (O(3)), heavy metals, and respirable particulate matter (PM2.5 and PM10), differ in their chemical composition, reaction properties, emission, time of disintegration and ability to diffuse in long or short distances. Air pollution has both acute and chronic effects on human health, affecting a number of different systems and organs. It ranges from minor upper respiratory irritation to chronic respiratory and heart disease, lung cancer, acute respiratory infections in children and chronic bronchitis in adults, aggravating pre-existing heart and lung disease, or asthmatic attacks. In addition, short- and long-term exposures have also been linked with premature mortality and reduced life expectancy. These effects of air pollutants on human health and their mechanism of action are briefly discussed.
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            Outdoor air pollution and asthma

            Michael Guarnieri, John R. Balmes (2014)
            The Lancet, 383(9928), 1581-1592
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              Long-Term Ozone Exposure and Mortality in a Large Prospective Study.

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              Tropospheric ozone (O3) is potentially associated with cardiovascular disease risk and premature death. Results from long-term epidemiological studies on O3 are scarce and inconclusive.
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                Author and article information

                Contributors
                Yuqin Zhang: URI : https://loop.frontiersin.org/people/2635562/overviewRole: Role: Role: Role: Role:
                Xi Yang: Role:
                Wanyanhan Jiang: Role: Role:
                Xi Gao: Role: Role:
                Biao Yang: Role: Role:
                Xing Lin Feng: URI : https://loop.frontiersin.org/people/838378/overviewRole: Role:
                Lian Yang: URI : https://loop.frontiersin.org/people/1601709/overviewRole: Role: Role: Role: Role: Role:
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 29 January 2024
                Publication date Collection: 2024
                Volume: 12
                Electronic Location Identifier: 1346914
                Affiliations
                [1] 1School of Public Health, Chengdu University of Traditional Chinese Medicine , Chengdu, China
                [2] 2School of Public Health, Peking University , Beijing, China
                Author notes

                Edited by: Ding Li, Southwestern University of Finance and Economics, China

                Reviewed by: Mingsheng Chen, Nanjing Medical University, China

                Weidong Huang, Harbin Medical University, China

                Mohammad Javad Mohammadi, Ahvaz Jundishapur University of Medical Sciences, Iran

                *Correspondence: Xing Lin Feng, fxl@ 123456bjmu.edu.cn
                Article
                DOI: 10.3389/fpubh.2024.1346914
                PMC ID: 10859495
                PubMed ID: 38347929
                SO-VID: ff32c0ea-9b36-4bfe-afcf-7955e50fed87
                Copyright © Copyright © 2024 Zhang, Yang, Jiang, Gao, Yang, Feng and Yang.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 30 November 2023
                Date accepted : 12 January 2024
                Page count
                Figures: 3, Tables: 2, Equations: 8, References: 76, Pages: 12, Words: 8934
                Funding
                Funded by: Calculation and Research of Total Health Expenditure in Sichuan Province
                Award ID: 301021002
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Calculation and Research of Total Health Expenditure in Sichuan Province in 2021 (No. 301021002).
                Categories
                Subject: Public Health
                Subject: Original Research
                Custom metadata
                section-at-acceptance Environmental health and Exposome

                Keywords: air pollution,asthma in older adults,economic cost,generalized additive model,time-series study
                Data availability:
                Keywords: air pollution, asthma in older adults, economic cost, generalized additive model, time-series study

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