Assessing PM2.5-associated risk of hospitalization for COPD: an application of daily excessive concentration hours
2021
Zhang, Faxue | Zhang, Yuanyuan | Liu, Linjiong | Jiao, Anqi | Chen, Dieyi | Xiang, Qianqian | Fang, Jiaying | Ding, Zan | Zhang, Yunquan
Existing PM₂.₅-morbidity studies using daily mean concentration as exposure metric may fail to capture intra-day variations of PM₂.₅ concentrations, resulting in underestimated health impacts to some extent. This study introduced a novel indicator, daily excessive concentration hours (DECH), defined as sums of per-hourly excessive concentrations of PM₂.₅ against a specific threshold within a day. PM₂.₅ DECHs were separately calculated as daily concentration-hours >8, 10, 15, 20, and 25 μg/m³ (abbreviations: DECH-8, DECH-10, DECH-15, DECH-20, and DECH-25). We adopted a time-stratified case-crossover design with conditional logistic regression models to compare risks of hospitalizations for chronic obstructive pulmonary disease (COPD) associated with PM₂.₅ mean and DECHs in Shenzhen, China. We observed highly comparable PM₂.₅-COPD associations using exposure metrics of daily mean and DECHs with above-defined thresholds. For instance, PM₂.₅ mean and DECHs showed similar increases in risks of COPD hospitalization for an interquartile range rise in exposure, with odds ratio estimates of 1.26 (95% confidence interval: 1.06–1.50) for PM₂.₅ mean, 1.24 (1.05–1.46) for DECH-10 and 1.21 (1.06–1.39) for DECH-25, respectively. Findings remained robust after further adjusting for gaseous pollutants (e.g., SO₂, NO₂, CO, and O₃) and meteorologic factors (e.g., wind speed and air pressure). Our study strengthened the evidence that DECHs could come be as a novel exposure metric in health risk assessments associated with short-term exposure to ambient PM₂.₅.
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