Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study

Abstract Background Ozone (O3) and nitrogen dioxide (NO2) are the two main gaseous pollutants in the atmosphere that act as oxidants. Their short-term effects and interaction on emergency room visits (ERVs) for respiratory diseases remain unclear. Methods We conducted a time-series study based on 14...

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Main Authors: Yuanwei Fu, Wenlou Zhang, Yan Li, Hongyu Li, Furong Deng, Qingbian Ma
Format: Article
Language:English
Published: BMC 2022-12-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-022-14473-2
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author Yuanwei Fu
Wenlou Zhang
Yan Li
Hongyu Li
Furong Deng
Qingbian Ma
author_facet Yuanwei Fu
Wenlou Zhang
Yan Li
Hongyu Li
Furong Deng
Qingbian Ma
author_sort Yuanwei Fu
collection DOAJ
description Abstract Background Ozone (O3) and nitrogen dioxide (NO2) are the two main gaseous pollutants in the atmosphere that act as oxidants. Their short-term effects and interaction on emergency room visits (ERVs) for respiratory diseases remain unclear. Methods We conducted a time-series study based on 144,326 ERVs for respiratory diseases of Peking University Third Hospital from 2014 to 2019 in Beijing, China. Generalized additive models with quasi-Poisson regression were performed to analyze the association of O3, NO2 and their composite indicators (Ox and Ox wt) with ERVs for respiratory diseases. An interaction model was further performed to evaluate the interaction between O3 and NO2. Results Exposure to O3, NO2, Ox and Ox wt was positively associated with ERVs for total respiratory diseases and acute upper respiratory infection (AURI). For instance, a 10 μg/m3 increase in O3 and NO2 were associated with 0.93% (95%CI: 0.05%, 1.81%) and 5.87% (95%CI: 3.92%, 7.85%) increase in AURI at lag0-5 days, respectively. Significant linear exposure–response relationships were observed in Ox and Ox wt over the entire concentration range. In stratification analysis, stronger associations were observed in the group aged < 18 years for both O3 and NO2, in the warm season for O3, but in the cold season for NO2. In interaction analysis, the effect of O3 on total respiratory emergency room visits and AURI visits was the strongest at high levels (> 75% quantile) of NO2 in the < 18 years group. Conclusions Short-term exposure to O3 and NO2 was positively associated with ERVs for respiratory diseases, particularly in younger people (< 18 years). This study for the first time demonstrated the synergistic effect of O3 and NO2 on respiratory ERVs, and Ox and Ox wt may be potential proxies.
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spelling doaj.art-53206fb47420428bbeb72e3940e409f42022-12-22T04:40:08ZengBMCBMC Public Health1471-24582022-12-0122111110.1186/s12889-022-14473-2Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series studyYuanwei Fu0Wenlou Zhang1Yan Li2Hongyu Li3Furong Deng4Qingbian Ma5Emergency Department, Peking University Third HospitalDepartment of Occupational and Environmental Health Sciences, School of Public Health, Peking UniversityEmergency Department, Peking University Third HospitalDepartment of Occupational and Environmental Health Sciences, School of Public Health, Peking UniversityDepartment of Occupational and Environmental Health Sciences, School of Public Health, Peking UniversityEmergency Department, Peking University Third HospitalAbstract Background Ozone (O3) and nitrogen dioxide (NO2) are the two main gaseous pollutants in the atmosphere that act as oxidants. Their short-term effects and interaction on emergency room visits (ERVs) for respiratory diseases remain unclear. Methods We conducted a time-series study based on 144,326 ERVs for respiratory diseases of Peking University Third Hospital from 2014 to 2019 in Beijing, China. Generalized additive models with quasi-Poisson regression were performed to analyze the association of O3, NO2 and their composite indicators (Ox and Ox wt) with ERVs for respiratory diseases. An interaction model was further performed to evaluate the interaction between O3 and NO2. Results Exposure to O3, NO2, Ox and Ox wt was positively associated with ERVs for total respiratory diseases and acute upper respiratory infection (AURI). For instance, a 10 μg/m3 increase in O3 and NO2 were associated with 0.93% (95%CI: 0.05%, 1.81%) and 5.87% (95%CI: 3.92%, 7.85%) increase in AURI at lag0-5 days, respectively. Significant linear exposure–response relationships were observed in Ox and Ox wt over the entire concentration range. In stratification analysis, stronger associations were observed in the group aged < 18 years for both O3 and NO2, in the warm season for O3, but in the cold season for NO2. In interaction analysis, the effect of O3 on total respiratory emergency room visits and AURI visits was the strongest at high levels (> 75% quantile) of NO2 in the < 18 years group. Conclusions Short-term exposure to O3 and NO2 was positively associated with ERVs for respiratory diseases, particularly in younger people (< 18 years). This study for the first time demonstrated the synergistic effect of O3 and NO2 on respiratory ERVs, and Ox and Ox wt may be potential proxies.https://doi.org/10.1186/s12889-022-14473-2Air pollutionOzoneNitrogen dioxideEmergency room visitsRespiratory diseasesInteraction
spellingShingle Yuanwei Fu
Wenlou Zhang
Yan Li
Hongyu Li
Furong Deng
Qingbian Ma
Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study
BMC Public Health
Air pollution
Ozone
Nitrogen dioxide
Emergency room visits
Respiratory diseases
Interaction
title Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study
title_full Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study
title_fullStr Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study
title_full_unstemmed Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study
title_short Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study
title_sort association and interaction of o3 and no2 with emergency room visits for respiratory diseases in beijing china a time series study
topic Air pollution
Ozone
Nitrogen dioxide
Emergency room visits
Respiratory diseases
Interaction
url https://doi.org/10.1186/s12889-022-14473-2
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