Study On The Effect Of Air Pollution On The Hospitalization Of Respiratory And Cardiovascular System Disease In Ji'nan

Objective:Air pollution has become one of the primary risk factors for the morbidity and mortality of respiratory system diseases and cardiovascular system diseases.Most of the research is carried out in developed countries such as Europe and America The research concerning the effects of air pollution on these three types of acute diseases in developing countries is still insufficiency.In addition,none of the studies or researches take inclusion of all three types of acute diseases at the same time.Therefore,this study selected Ji'nan,a seriously polluted city in Shandong Province,as a typical area to explore the associations and diversities between the hospitalization rate of acute exacerbation of chronic obstructive pulmonary disease(AECOPD),stroke and myocardial infarction(MI)with air pollution in Ji'nan city during 2013 to 2015.Aiming to provide pertinent advice and guidance for prevention of respiratory and cardiovascular system diseases,and provide basis for the formulation of corresponding policies.Material and Methods:Selected the hospitalizations information of patients from the main class 3-A hospitals due to AECOPD,stroke and MI from 2013 to 2015 and determined the data screening criteria.Collected the daily average concentration of air pollution data at 14 national air quality-monitoring points in Ji'nan during 2013 to 2015.Collected the meteorological data during 2013 to 2015 and used the method of expectation maximization(Expectation-maximization;EM)to compensate for the missing value.The descriptive statistics was conducted to analyze the temporal distribution characteristics of air pollutants and meteorological data.The correlation analysis between air pollutants and meteorological data was carried out.The generalized additive model(GAM)with the link function of Poisson distribution was used to analyze the association between the hospitalization risk of AECOPD,stroke and MI with air pollution and assesse the risk of concentration of air pollution on three types of disease.O3 was included in the single pollutant model for sensitivity analysis to verify the stability of the adverse effects of air pollutants on the three types of diseases.Finally,the stratification analysis regarding gender and age were conducted to further analyze the association of air pollution exposure in the best lag days on hospitalization of three types of diseases.Result:The result of the descriptive analysis of air pollutants and meteorological indicators indicated that daily average temperature,daily concentrations of PM2.5,PM10,SO2,NO2 and O3 showed a periodic variation with the year and season.The temperature and daily average concentration of O3 was negatively correlated with the daily average concentration of PM2.5,PM10,SO2 and NO2.The correlation analysis between air pollutants and meteorological indicators showed a positive correlation between PM2.5,PM10,SO2 and NO2,while a negative correlation with O3,daily average temperature and relative humidity,the results were statistically significant(p<0.01).The results of generalized additive model analysis showed:a)the increment of concentrations of PM2.5,PM10 and O3 would aggravate the risk of hospitalization for patients with AECOPD and the impact of pollutants on patients aging above 65 or male were more severe.While the daily concentrations of SO2 and NO2 have no significant impact on the risk of hospitalization.b)The increment of concentrations of all air pollutants would aggravate the risk of hospitalization for patients with stroke.The impact of particulates pollutants including PM2.5 and PM10 on patients aging below 65 or male were more severe.While the impact of gaseous pollutants including SO2,NO2 and O3 on patients aging above 65 or female were more severe.c)The increment of concentrations of PM2.5,PM10,SO2 and O3 would aggravate the risk of hospitalization for patients with MI and the impact of pollutants on patients aging above 65 or female were more severe.While the daily concentrations of NO2 have no significant impact on the risk of hospitalization.Conclusion:The increment of concentration of particulates pollutants including PM2 5 and PM10 can significantly aggravate the risk of hospitalization for patients with AECOPD,stroke and MI,and the adverse effects of PM2.5 on acute severe disease are generally stronger than that of PM10.The increment of concentration of gaseous pollutants including SO2,NO2 and O3 can significantly aggravate the risk of hospitalization for patients with cardiovascular disease such as stroke and MI.The impact of O3 on respiratory diseases(AECOPD)was significantly higher than that of cardiovascular diseases(stroke and MI).