Cao Dawei, Li Dongyan, Wu Yinglin, Qian Zhengmin Min, Liu Yi, Liu Qiyong, Sun Jimin, Guo Yuming, Zhang Shiyu, Jiao Guangyuan, Yang Xiaoran, Wang Chongjian, McMillin Stephen Edward, Zhang Xinri, Lin Hualiang
Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Thorax. 2021 Jun 4. doi: 10.1136/thoraxjnl-2020-215838.
Few studies have examined the effects of ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM) on hospital cost and length of hospital stay for respiratory diseases in China.
We estimated ambient air pollution exposure for respiratory cases through inverse distance-weighted averages of air monitoring stations based on their residential address and averaged at the city level. We used generalised additive models to quantify city-specific associations in 11 cities in Shanxi and a meta-analysis to estimate the overall effects. We further estimated respiratory burden attributable to PM using the standards of WHO (25 µg/m) and China (75 µg/m) as reference.
Each 10 µg/m increase in lag PM corresponded to 0.53% (95% CI: 0.33% to 0.73%) increase in respiratory hospitalisation, an increment of 3.75 thousand RMB (95% CI: 1.84 to 5.670) in hospital cost and 4.13 days (95% CI: 2.51 to 5.75) in length of hospital stay. About 9.7 thousand respiratory hospitalisations, 132 million RMB in hospital cost and 145 thousand days of hospital stay could be attributable to PM exposures using WHO's guideline as reference. We estimated that 193 RMB (95% CI: 95 to 292) in hospital cost and 0.21 days (95% CI: 0.13 to 0.30) in hospital stay could be potentially avoidable for an average respiratory case.
Significant respiratory burden could be attributable to PM exposures in Shanxi Province, China. The results need to be factored into impact assessment of air pollution policies to provide a more complete indication of the burden addressed by the policies.
在中国，很少有研究探讨空气动力学直径小于或等于2.5微米的细颗粒物（PM）对呼吸系统疾病住院费用和住院时间的影响。
我们根据呼吸系统疾病患者的居住地址，通过空气监测站的反距离加权平均值来估算其周围空气污染暴露情况，并在城市层面进行平均。我们使用广义相加模型来量化山西省11个城市中特定城市的关联，并进行荟萃分析以估计总体影响。我们还以世界卫生组织（25微克/立方米）和中国（75微克/立方米）的标准为参考，进一步估算了可归因于PM的呼吸系统负担。
滞后PM每增加10微克/立方米，呼吸系统住院率相应增加0.53%（95%置信区间：0.33%至0.73%），住院费用增加3750元人民币（95%置信区间：1840至5670元），住院时间增加4.13天（95%置信区间：2.51至5.75天）。以世界卫生组织的指南为参考，约9700例呼吸系统住院病例、1.32亿元人民币的住院费用和14.5万天的住院时间可归因于PM暴露。我们估计，对于平均每例呼吸系统疾病患者，住院费用可能有193元人民币（95%置信区间：95至292元）和住院时间0.21天（95%置信区间：0.13至0.30天）是可以避免的。
在中国山西省，PM暴露可导致显著的呼吸系统负担。这些结果需要纳入空气污染政策的影响评估中，以便更全面地说明政策所应对的负担。
