Short-term exposure to air pollution increases the risk of hospital admissions for neurological disorders, particularly during the cold season, with PM2.5 contributing the largest disease burden.
Abstract
Background
Air pollution is an important environmental factor influencing respiratory and cardiovascular diseases, and growing experimental evidence suggests that exposure to air pollutants can also cause neuroinflammation and neuronal damage. However, epidemiological evidence on the impact of air pollution exposure on neurological disorders remains limited. This study aims to evaluate the impact of short-term air pollution exposure on hospital admissions for neurological disorders.
Methods
A total of 249,717 hospital admissions for neurological disorders in Harbin, China, from 2014 to 2023, were collected in this registry-based cohort study. Distributed lag nonlinear model (DLNM) was used to evaluate the effects of PM2.5, PM10, NO2, CO, and a composite pollution index on overall neurological disorders, specific ICD disease modules and categories. Stratified analyses by sex, age, pandemic period, and season were further performed to identify high-risk subpopulations and examine variations in susceptibility to air pollution. Attributable risk estimations were further performed to assess the disease burden attributable to air pollution.
Results
Exposure to PM2.5 (RR = 1.23, 95% CI: 1.14-1.32), NO2 (RR = 1.18, 95% CI: 1.10-1.27), PM10 (RR = 1.12, 95% CI: 1.06-1.19), and CO (RR = 1.10, 95% CI: 1.03-1.19) was associated with increased hospital admissions for overall neurological disorders. These associations were stronger in the cold season than in the warm season. Attributable risk analysis suggested that PM2.5 contributed the largest burden, accounting for 8.46% (95% CI: 5.46%-10.76%) of admissions. Different ICD disease modules and categories exhibited varying associations with different air pollutants.
Conclusions
Short-term exposure to air pollution increases the risk of hospital admissions for neurological disorders, particularly during the cold season, with PM2.5 contributing the largest disease burden.
Stroke is a leading cause of death and disability worldwide. Exposure to ambient air pollutants and the risk of stroke have been reported in many studies, but the results vary greatly among different regions. This study aims to investigate the association between short-term exposure to air pollution and the admission of total stroke and its subtypes in the Luohu District, Shenzhen. A time-stratified case-crossover study was conducted among 21,973 newly diagnosed stroke cases in Luohu, Shenzhen from 2014 to 2022. Residential exposure to air pollution was assessed using validated grid datasets. A distributed lag model (DLM) and conditional logistic regression model were implemented to evaluate the relationship between ambient air pollution and the admission of stroke and its subtypes. We found that a 10 µg/m3 increase in exposure to NO2 and SO2 was positively associated with a 2.73% increase (95% confidence interval [CI]: 2.21%, 3.25%) and a 24.89% increase (20.87%, 29.06%) in the odds of total stroke admission, respectively. Statistical significance has also been found in subtypes. Stronger associations were observed in females (SO2), the elderly (NO2 and SO2), and the cold season (NO2 and SO2). Our findings indicate that exposure to NO2 and SO2 exacerbates the risk of stroke admission, especially in the elderly, females, and the cold season.
Short-term exposure to PM2.5, PM10, SO2, NO2, and CO was associated with increased AECOPD hospitalization risk, with nonlinear, lagged, and cumulative effects, and older adults and females may be more susceptible to ambient air pollution.
Huixia Shi, Jiajun Li, Bo-Yan Li et al.· Medicine· 0 citations
The health hazards caused by air pollution vary significantly depending on factors such as the composition of pollutants in the region, climate, and the susceptibility of the population. Although numerous studies have explored the relationship between air quality and pneumonia, specific research evidence from a particular inland energy city like Qingyang in China is still scarce. This study aims to quantify the short-term impact of air pollution in this under-researched region on pneumonia hospitalizations. We collected the medical records of patients with pneumonia from January 1, 2015, to December 31, 2019, and also obtained data on 6 types of common air pollutants and meteorological conditions. We performed a time series analysis using a generalized additive model and a distributed nonlinear lag model. All measured data exhibited pronounced seasonality: particulate matter less than 2.5 μm in diameter, particulate matter less than 10 μm in diameter, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) concentrations and pneumonia admissions were higher in the cold season and lower in the warm season, a pattern conversely mirrored by ozone (O3) concentrations, average temperature, and relative humidity. In the single pollutant model, for every 10 μg/m3 increase in exposure levels of particulate matter less than 2.5 μm in diameter, particulate matter less than 10 μm in diameter, SO2, NO2, and O3 8 hours and for every 1 mg/m3 increase in CO exposure level, the risk of pneumonia admission was 1.004 (0.991, 1.017), 1.004 (0.999, 1.010), 1.035 (1.022, 1.048), 1.221 (1.174, 1.271), 0.999 (0.981, 1.017), and 1.382 (1.230, 1.552), respectively. The strongest effects occur in lag 1, lag 7, lag 07, lag 07, lag 3, and lag 05, respectively. Our study identifies significant gender- and age-specific susceptibilities to air pollution in Qingyang. Men were more vulnerable to SO2, whereas women were more affected by CO. Children aged ≤14 years constituted a high-risk group. Furthermore, we observed a distinct seasonal pattern: SO2, NO2, and CO were key drivers of pneumonia admissions with stronger effects in the cold season, in contrast to O3, which exhibited adverse effects only during the warm season.
Lisha Zhu, Jiyuan Dong, Jianhua You et al.· Medicine· 0 citations
BACKGROUND
The association between air pollutants and mortality from chronic kidney disease (CKD) remains to be further investigated. This study aims to examine the impact of air pollutant exposure on CKD mortality in individuals.
METHODS
This study utilized an individual-level, time-stratified case-crossover design to evaluate the association between short-term exposure to air pollutants (PM2.5, SO2, O3, and NO2) and mortality from CKD. The deceased population was identified from the mortality surveillance data of the Zhejiang Provincial Center for Disease Control and Prevention. For each decedent, we collected air pollutant concentrations on the day of death (case day) and on matched control days within the same month. This design inherently controls confounding factors such as age, place of residence, and seasonality.
RESULTS
The study found that short-term exposure to all four air pollutants was associated with an increased risk of CKD mortality. The excess risk (ER) per interquartile range (IQR) increase in pollutant concentrations was evaluated across different lag periods. Using multi-day moving average lags (calculated as the mean exposure from the current day up to the specified preceding day), the most prominent ERs were observed for PM2.5 at lag02 (ER: 15.16%, 95% CI: 12.69-17.68), SO2 at lag03 (ER: 8.80%, 95% CI: 5.95-11.72), O3 at lag01 (ER: 5.67%, 95% CI: 2.07-9.39), and NO2 at lag03 (ER: 13.66%, 95% CI: 9.12-18.39). After adjusting for interactions with other pollutants, the associations for SO2 and PM2.5 remained significant. Additionally, the study found that this association was influenced by factors such as marriage, and season (cold vs. warm).
CONCLUSIONS
This study revealed a significant association between short-term exposure to air pollutants and CKD mortality in the population of Zhejiang Province. These findings provide novel evidence for understanding the impact of environmental factors on kidney disease and suggest a need for governmental authorities to enhance the monitoring and control of air pollution to mitigate the health burden on the elderly.
P. Dai, Xiaoyan Zhou, Weiwei Gong et al.· BMC Nephrology· 0 citations
Short-term absolute changes in ambient air pollution levels may result in disease events such as depression, whereas evidence from large-scale epidemiological studies has been insufficient. A time-stratified case-crossover study was performed to investigate the associations between air pollution increases between neighboring days (APINs, generated as the differences in absolute air pollution concentrations on the current days minus those on the previous days) and morbidity risks of depression based on hospital admission and outpatient visit data from 239 Chinese cities of prefecture-level or above during 2013-2017. Daily absolute concentrations of particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (8 h O3) were obtained, and conditional logistic regression models were used to evaluate the associations between absolute concentrations and APINs of major air pollutants with morbidity risks of depression. A total of 330,610 hospital admissions and 3,726,390 outpatient visits for depression were included. Per interquartile range (IQR) increase in APINs of major air pollutants at lag 0-3 were associated with increases ranging from 0.59% (0.06%, 1.13%) (8 h O3) to 1.66% (1.09%, 2.22%) (NO2) in hospital admissions for depression; and with increases ranging from 0.42% (0.15%, 0.68%) (8 h O3) to 0.85% (0.56%, 1.14%) (NO2) in outpatient visits for depression, which were robust to adjustments for absolute concentrations of major air pollutants (with the exception of 8 h O3). This study provides novel evidence that short-term absolute increases in air pollution levels are associated with elevated risks of depression, which is worth consideration in future disease prevention practices.
Yating Ma, Chenlu Yang, Lijun Bai et al.· Ecotoxicology and Environmen...· 0 citations
Background Short-term exposure to ambient air pollution has been associated with cardiovascular disease (CVD) mortality, but localized evidence from subtropical cities in southwestern China remains limited. This 11-year time-series study aimed to evaluate the short-term associations between six criteria air pollutants and daily CVD mortality in Nanning, China. Methods We conducted a time-series analysis using daily data on CVD mortality, air pollutant concentrations, and meteorological variables from 2014 to 2024 in Nanning. Generalized additive quasi-Poisson models were used to estimate associations across single-day lags (lag0-lag7) and cumulative lag windows (lag0-1 to lag0-7), adjusting for long-term trends, temperature, relative humidity, and day of the week. Exposure-response relationships were assessed using natural cubic splines. Stratified analyses were conducted by season and age group, and two-pollutant models and sensitivity analyses were performed to evaluate robustness. Results A total of 87,913 CVD deaths were recorded during the study period, of which 57.5% occurred in males and 77.9% occurred among individuals aged ≥65 years. In single-day lag models, PM2.5, PM10, SO2, NO2, and O3-8h showed significant positive associations with CVD mortality at early lag days. At lag0, the RRs were 1.014 (95% CI: 1.008–1.020) for PM2.5, 1.009 (95% CI: 1.006–1.013) for PM10, and 1.018 (95% CI: 1.011–1.026) for NO2, while SO2 showed its largest estimate at lag1 [RR = 1.044 (95% CI: 1.018–1.069)]. In cumulative lag models, PM2.5, PM10, SO2, NO2, and O3-8h showed significant cumulative associations, whereas CO was significant mainly in shorter lag windows. Season-stratified analyses suggested pollutant-specific variation between cold and warm seasons, although formal pollutant-by-season interaction tests were not statistically significant. Age-stratified analyses indicated broader susceptibility among older adults. The main associations were generally robust in sensitivity analyses, distributed lag models, and two-pollutant models, particularly for PM2.5, PM10, and NO2. Conclusion Short-term exposure to ambient air pollution was associated with increased CVD mortality, particularly for PM2.5, PM10, and NO2, with consistent effects across single-day and cumulative lag structures. The results highlight the cardiovascular risks of particulate and traffic-related pollution and support pollutant-specific air quality management and targeted protection for older adults during high-pollution periods.
Xia Luo, Linhan Liang, Yang Yu et al.· Frontiers in Public Health· 0 citations
