Ambient Particulate Matter Concentrations and Hospital Admissions in 26 of China's Largest Cities: A Case-Crossover Study

作者:Liu, Hui; Tian, Yaohua; Xiang, Xiao; Juan, Juan; Song, Jing; Cao, Yaying; Huang, Chao; Li, Man; Hu, Yonghua*
来源:Epidemiology, 2018, 29(5): 649-657.
DOI:10.1097/EDE.0000000000000869

摘要

Background: Few studies have evaluated the short-term impacts of ambient particulate matter (PM) pollution on morbidity in China. The aims of this study were to examine the short-term association between hospital admissions and ambient PM and also to explore whether PM2.5 at levels below current regulatory limits also increases the risk of hospitalizations in 26 Chinese cities. @@@ Methods: We identified 14,569,622 all-cause, 2,008,786 cardiovascular, and 916,388 respiratory admissions during 2014-2015. We employed conditional logistic regression to estimate the association between hospital admissions and ambient PM. @@@ Results: A 10 g/m(3) increase in PM2.5 at lag 0 day corresponded to increases of 0.19% (95% confidence interval [CI] = 0.18%, 0.20%) in all-cause, 0.23% (95% CI = 0.20%, 0.26%) in cardiovascular, and 0.26% (95% CI = 0.22%, 0.31%) in respiratory admissions. For PM10, the values were 0.12% (95% CI = 0.11%, 0.13%) for all-cause, 0.15% (95% CI = 0.13%, 0.17%) for cardiovascular, and 0.21% (95% CI = 0.17%, 0.24%) for respiratory admissions. The associations held at PM2.5 levels below the current Chinese and European/WHO standards. Among individuals with exposure levels below 25 g/m(3), increasing PM2.5 levels from below 15 g/m(3) to above 15 g/m(3) was associated with increases of 1.8% (odds ratio, 1.018; 95% CI = 1.015, 1.022) in all-cause admissions and 2.5% (odds ratio, 1.025; 95% CI = 1.017, 1.034) in cardiovascular admissions. @@@ Conclusions: Short-term PM exposures were associated with increased hospitalizations, even for exposure levels not exceeding the current regulatory limits.