The Effects of Short-Term PM2.5 Exposure on Pulmonary Function among Children with Asthma-A Panel Study in Shanghai, China.

Fine particulate matter (PM2.5) has been reported to be an important risk factor for asthma. This study was designed to evaluate the relationship between PM2.5 and lung function among children with asthma in Shanghai, China. From 2016 to 2019, a total of 70 Chinese children aged 4 to 14 in Shanghai were recruited for this panel study. The questionnaire was used to collect baseline information, and the lung function covering forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) were carried out for each child more than twice during follow-up. Meanwhile, the simultaneous daily air atmospheric pollutants and meteorological data were collected. The linear mixed effect (LME) model was used to assess the relationship between air pollutants and lung function. A significantly negative association was found between PM2.5 and lung function in children with asthma. In the single-pollutant model, the largest effects of PM2.5 on lung function were found for lag 0-2, with FVC and FEV1 decreasing by 0.91% [95% confidence interval (CI): -1.75, -0.07] and 1.05% (95% CI: -2.09, 0.00), respectively, for each 10 µg/m3 increase in PM2.5. In the multi-pollution model (adjusted PM2.5 + SO2 + O3), the maximum effects of PM2.5 on FVC and FEV1 also appeared for lag 0-2, with FVC and FEV1 decreasing by 1.57% (95% CI: -2.69, -0.44) and 1.67% (95% CI: -3.05, -0.26), respectively, for each 10 µg/m3 increase in PM2.5. In the subgroup analysis, boys, preschoolers (<6 years old) and hot seasons (May to September) were more sensitive to changes. Our findings may contribute to a better understanding of the short-term exposure effects of PM2.5 on lung function in children with asthma.

The Impact of a Health Forecasting Service on the Visits and Costs in Outpatient and Emergency Departments for COPD Patients - Shanghai Municipality, China, October 2019-April 2020.

WHAT IS ALREADY KNOWN ON THIS TOPIC?: The morbidity and mortality of chronic obstructive pulmonary disease (COPD) is associated with adverse weather and air pollution. However, COPD patients are not able to be alerted in advance of high risk environments. WHAT IS ADDED BY THIS REPORT?: This prospective controlled trial conducted in Pudong New Area of Shanghai from October 2019 to April 2020 provided evidence of COPD risk forecasting service on the reductions in visits and costs of COPD patients in outpatient and emergency departments in China for the first time. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: This study suggests that COPD risk forecasting service could be integrated into existing COPD management in public health to improve the health and economic outcomes.

Effect of diurnal temperature range on outpatient visits for common cold in Shanghai, China.

To evaluate the correlations between diurnal temperature range (DTR) and the number of outpatient visits for common cold from Jan. 1, 2008, to Dec. 31, 2010, in the Shanghai metro area; we used a distributed lag non-linear model together with a Poisson regression model. The controlling factors included long-term trends and day of the week in outpatient visits for common cold and the selected weather elements. The entire study group was divided into three different age subgroups, including ≤ 15, 15-65, and ≥ 65 years old. We found some non-linear J-patterns between DTR and daily outpatient visits for common cold. At lag 0 day, the number of outpatient visits for common cold would increase by 11.1% per 1 °C increase in DTR. The greater the DTR, the more it affects outpatient visits for common cold, especially for the ≥ 65 years age group. In addition, DTR plays a more important role in outpatient visits for common cold in spring and winter compared with other seasons of the year. Our study showed that DTR is a risk factor that contributes to common cold. Results in this study can provide scientific evidence for the local authorities in improving preventive measures of the healthcare system.

Effects of extreme temperatures on hospital emergency room visits for respiratory diseases in Beijing, China.

Extreme temperature is closely associated with human health, but limited evidence is available for the effects of extreme temperatures on respiratory diseases in China. The goal of this study is to evaluate the effects of extreme temperatures on hospital emergency room (ER) visits for respiratory diseases in Beijing, China. We used a distributed lag non-linear model (DLNM) coupled with a generalized additive model (GAM) to estimate the association between extreme temperatures and hospital ER visits for different age and gender subgroups in Beijing from 2009 to 2012. The results showed that the exposure-response curve between temperature and hospital ER visits was almost W-shaped, with increasing relative risks (RRs) at extremely low temperature. In the whole year period, strong acute hot effects were observed, especially for the elders (age > 65 years). The highest RR associated with the extremely high temperature was 1.36 (95% CI, 0.96-1.92) at lag 0-27. The longer-lasting cold effects were found the strongest at lag 0-27 for children (age ≤ 15 years) and the relative risk was 1.96 (95% CI, 1.70-2.26). We also found that females were more susceptible to extreme temperatures than males.

[Effect of Air Pollution on the Cold Disease in Shanghai].

This study discusses the changes in the daily average concentrations of the main air pollutants, such as PM10, PM2.5, O3, and NO2, in Shanghai, and the effects of air pollution on cold in Shanghai. For this study, data on air pollutants, meteorological factors, and the number of daily hospital visits from cold in Shanghai were collected from January 1, 2008 to December 31, 2010. Using the time series Poisson semi-parametric generalized additive model, and controlling for the long-term trend, "week" effect, and meteorological factors by smoothing the spline function, the exposure-response relationship between air pollution and human health in Shanghai was analyzed. The study sets up the model according to age, evaluating the impact and the lag effect of air pollution on the number of daily hospital visits. Results show that when PM10, NO2, O3, and PM2.5 increase by an IQR, the relative risk of cold disease is 1.0240 (1.0233-1.0246), 1.0206 (1.0201-1.0212), 0.9393 (0.9384-0.9402), and 1.0080 (1.0069-1.0086), and when PM10, NO2, O3, and PM2.5 increase by 10 µg·m-3, the daily hospital visits increase by 0.5%, 1.0%, -2.0%, and 0.2%. In the multi-polluted model, the results of NO2 and PM2.5 are basically lower compared to the results of the single-pollutant model, the results of PM10 and O3are higher. Air pollution in Shanghai has an impact on the incidence of cold disease.

The relationship between diurnal temperature range and COPD hospital admissions in Changchun, China.

Diurnal temperature range (DTR) has been suggested to be an adverse health factor especially related to respiratory and cardiovascular diseases. In the current study, we investigated the association between DTR and chronic obstructive pulmonary disease (COPD) hospital admissions during 2009 to 2012 in northeast city of Changchun, China. Based on generalized additive model (GAM), the effects were expressed as relative risk (RR) values of COPD with 95% confidence intervals (CIs) with each 1 °C increase in DTR. And they were significantly increased with an increment of 1 °C in DTR, modified by season, age, and sex. The elderly were more vulnerable, with relative risk values of 1.048 (1.029, 1.066) in cold season and 1.037 (1.021, 1.053) in warm season. Regarding the gender, the DTR effect on females was greater during cold season and the RR value was 1.051 (1.033, 1.069) on the current day (lag 0). The greater estimates for males appeared at lag 7 days, with RR of 1.019 (0.998, 1.040). A season-specific effect was detected that the relative risk values with per 1 °C increase in DTR were greater in cold season than in warm season. These findings support the hypothesis of significant relationship between DTR and COPD in Changchun, one northeast city of China.

Short-term effects of ambient air pollution on emergency room admissions due to cardiovascular causes in Beijing, China.

Ambient air pollution has been a major global public health issue. A number of studies have shown various adverse effects of ambient air pollution on cardiovascular diseases. In the current study, we investigated the short-term effects of ambient air pollution on emergency room (ER) admissions due to cardiovascular causes in Beijing from 2009 to 2012 using a time-series analysis. A total of 82430 ER cardiovascular admissions were recorded. Different gender (male and female) and age groups (15yrs ≤ age <65 yrs and age ≥ 65 yrs) were also examined by single model and multiple-pollutant model. Three major pollutants (SO2, NO2 and PM10) had lag effects of 0-2 days on cardiovascular ER admissions. The relative risks (95% CI) of per 10 µg/m3 increase in PM10, SO2 and NO2 were 1.008 (0.997-1.020), 1.008(0.999-1.018) and 1.014(1.003-1.024), respectively. The effect was more pronounced in age ≥65 and males in Beijing. We also found the stronger acute effects on the elderly and females at lag 0 than on the younger people and males at lag 2.

Short-term effects of air pollution on daily hospital admissions for cardiovascular diseases in western China.

Controlling the confounding factors on cardiovascular diseases, such as long-time trend, calendar effect, and meteorological factors, a generalized additive model (GAM) was used to investigate the short-term effects of air pollutants (PM10, SO2, and NO2) on daily cardiovascular admissions from March 1st to May 31st during 2007 to 2011 in Lanzhou, a heavily polluted city in western China. The influences of air pollutants were examined with different lag structures, and the potential effect modification by dust storm in spring was also investigated. Significant associations were found between air pollutants and hospital admissions for cardiovascular diseases both on dust event days and non-dust event days in spring. Air pollutants had lag effects on different age and gender groups. Relative risks (RRs) and their 95% confidence intervals (CIs) associated with a 10 µg/m3 increase were 1.14 (1.04~1.26) on lag1 for PM10, 1.31 (1.21~1.51) on lag01 for SO2, and 1.96 (1.49~2.57) on lag02 for NO2 on dust days. Stronger effects of air pollutants were observed for females and the elderly (≥60 years). Our analysis concluded that the effects of air pollutants on cardiovascular admissions on dust days were significantly stronger than non-dust days. The current study strengthens the evidence of effects of air pollution on health and dust-exacerbated cardiovascular admissions in Lanzhou.