The impact of monthly air pollution exposure and its interaction with individual factors: Insight from a large cohort study of comprehensive hospitalizations in Guangzhou area

Frontiers in Public Health

Public Health

Wumitijiang Yimaer¹  Gonghua Wu¹  Xinran Wang¹  Shirui Chen¹  Wangjian Zhang¹  Ying Wang¹  Yuqin Zhang¹  Zhicheng Du¹  Huanle Cai¹  Wenjing Wu¹  Xiao Lin¹  Xu Ju¹  Yuantao Hao²  Weihua Hu²  Jie Jiang² 

[1] Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China;Peking University Center for Public Health and Epidemic Preparedness and Response, Peking, China;

关键词: hospitalizations;    air pollution;    effect modification;    time-dependent Cox proportional model;    particulate matter;   

DOI  :  10.3389/fpubh.2023.1137196

 received in 2023-01-04, accepted in 2023-03-01,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundAlthough the association between short-term air pollution exposure and certain hospitalizations has been well documented, evidence on the effect of longer-term (e. g., monthly) air pollution on a comprehensive set of outcomes is still limited.MethodA total of 68,416 people in South China were enrolled and followed up during 2019–2020. Monthly air pollution level was estimated using a validated ordinary Kriging method and assigned to individuals. Time-dependent Cox models were developed to estimate the relationship between monthly PM10 and O3 exposures and the all-cause and cause-specific hospitalizations after adjusting for confounders. The interaction between air pollution and individual factors was also investigated.ResultsOverall, each 10 μg/m3 increase in PM10 concentration was associated with a 3.1% (95%CI: 1.3%−4.9%) increment in the risk of all-cause hospitalization. The estimate was even greater following O3 exposure (6.8%, 5.5%−8.2%). Furthermore, each 10 μg/m3 increase in PM10 was associated with a 2.3%-9.1% elevation in all the cause-specific hospitalizations except for those related to respiratory and digestive diseases. The same increment in O3 was relevant to a 4.7%−22.8% elevation in the risk except for respiratory diseases. Additionally, the older individuals tended to be more vulnerable to PM10 exposure (Pinteraction: 0.002), while the alcohol abused and those with an abnormal BMI were more vulnerable to the impact of O3 (Pinteraction: 0.052 and 0.011). However, the heavy smokers were less vulnerable to O3 exposure (Pinteraction: 0.032).ConclusionWe provide comprehensive evidence on the hospitalization hazard of monthly PM10 and O3 exposure and their interaction with individual factors.

【 授权许可】

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Copyright © 2023 Ju, Yimaer, Du, Wang, Cai, Chen, Zhang, Wu, Wu, Lin, Wang, Jiang, Hu, Zhang and Hao.