Search

Existing evidence suggested that the risk of tuberculosis (TB) infection was associated to the variations in temperature and PM2.5. A total of 9,111 cases of TB were reported in Ningxia Hui Autonomous Region, China from 2013 to 2015 on a daily basis, and 57.2% of them were male. The TB risk was more prominent for a lower temperature in males (RR of 1.724, 95% CI: 1.241, 2.394), the aged over 64 years (RR of 2.241, 95% CI: 1.554, 3.231), and the high mobility occupation subpopulation (RR of 2.758, 95% CI: 1.745, 4.359). High concentration of PM2.5 showed a short-term effect and was only associated with an increased risk in the early stages of exposure for the female, and aged 36–64 years group. There were 15.06% (1370 cases) of cases of TB may be attributable to the temperature, and 2.94% (268 cases) may be attributable to the increase of PM2.5 exposures. Low temperatures may be associated with significantly increase in the risk of TB, and high PM2.5 concentrations have a short-term association on increasing the risk of TB. Strengthening the monitoring and regular prevention and control of high risk groups will provide scientific guidance to reduce the incidence of TB. [ABSTRACT FROM AUTHOR]

Helicobacter pylori infection (HPI) is an important risk factor of gastrointestinal diseases, but factors leading to it are still not fully understood. To investigate the association between short-term exposure to air pollution and HPI during outpatient visits, we collected daily data for HPI outpatient visits and air pollutant concentrations during 2014–2021 in Hefei, Anhui Province, China. A time-stratified case-crossover design was performed to analyze the acute impacts of air pollution on HPI outpatient visits. We also explored potential effect modifiers. A total of 9072 outpatient visits were recorded. We found positive and statistically significant associations of acute exposure to nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO) with HPI outpatient visits. Threshold concentrations of the three pollutants with same-day exposure (lag 0 day) for outpatient visits were 37 μg/m3 for NO2, 8 μg/m3 for SO2, and 0.8 mg/m3 for CO. The odds ratios for HPI outpatient visits at the 95th percentile of NO2, SO2, and CO against the thresholds were 1.207 (1.120–1.302), 1.175 (1.052–1.312), and 1.110 (1.019–1.209), respectively. The associations were more evident in patients older than 45 years, females, with health insurance, and in cold seasons. Null associations of exposure to either ozone (O3) or particulate matter (PM) were observed. In summary, short-term exposure to NO2, SO2, and CO above certain concentrations, but not PM or O3, may trigger the increased risk of outpatient visits due to HP infection in Chinese population. [ABSTRACT FROM AUTHOR]

Air pollution is a major public health problem throughout the world. Although there have been several studies in this field, most of them have focused on particulate matter and only covered a few key cities. This study aimed to assess a potential association between exposure to gaseous air pollutants and outpatient visits for respiratory diseases in Baotou, China. Daily outpatient visits for respiratory diseases and daily averages of air pollutants and meteorological parameters from 2015 to 2020 were obtained. Time-stratified case-crossover design and restricted cubic splines were used to perform the analyses. Stratified analyses were performed in different hospital departments and districts. Significant association between the concentrations of air pollutants and outpatient visits for respiratory diseases was observed. The odds ratios of outpatient visits for respiratory diseases associated with per 10 μg/m3 increases in concentrations of NO2 and SO2, and per 10 mg/m3 increases in concentrations of CO were 1.033 (95% CI: 1.018 to 1.049), 0.965 (95% CI: 0.954 to 0.976), and 1.038 (95% CI: 1.006 to 1.071), respectively. Short-term exposure to NO2, SO2, and CO was positively associated with outpatient visits for respiratory diseases, with stronger effects among children. The relationship between O3 and respiratory diseases varied at different concentrations. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Primary gaseous air pollutants have been associated with death from multiple causes, however, it remains unknown if they play a role in premature mortality among individuals living with HIV/AIDS. Data on HIV/AIDS patients were collected from the Hubei Provincial Center for Disease Control and Prevention, with a total of 1,467 AIDS-related deaths (ARD) between 2013 and 2020. Daily mean sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), and carbon monoxide (CO) were generated by artificial intelligence algorithms combined with big data. We employed a time-stratified case-crossover approach and conditional logistical regression models to investigate the acute effects of primary gaseous air pollutants on ARD. Per interquartile range increase in the concentrations of SO 2 was significantly linked with ARD, with a corresponding odds ratio (OR) of 1.17 [95% confidence intervals (CIs): 1.01, 1.35] at lag 4 day. Furthermore, our findings indicated that males exhibited a heightened vulnerability to the adverse effects of SO 2 and NO 2 , for example, the ORs were 1.24 (95% CIs: 1.05, 1.47) and 1.16 (95% CIs: 1.01, 1.34), respectively. Moreover, individuals aged over 65 years were more susceptible to SO 2 and CO. Additionally, we identified the warm season as a sensitive period for mortality associated with SO 2 and NO 2 . Our study furnished fresh evidence regarding the detrimental effects of primary gaseous air pollutants on ARD., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)

Background: Pneumonia is one of the principal reasons for incidence and death in the world. The former research mainly concentrated on specific sources of patients. Besides, due to the heterogeneity among regions, there are inconsistencies in the outcome of these surveys. To explore the relationship between atmospheric pollution and hospital visits for pneumonia under the climate and pollution conditions in Qingdao, we carried out this study.Methods: The medical records of pneumonia patients were gathered from the affiliated hospital of Qingdao University during Jan 1st, 2014, and Dec 31st,2018. Daily concentrations of PM2.5, PM10, SO2, NO2, as well as CO, were collected from the national air quality monitoring stations in Qingdao. Case-crossover study design and conditional logistic regression model were used to estimate the associations. Daily temperature, relative humidity, and atmospheric pressure were adjusted as the covariates in all models. A principal component analysis was used to solve the multicollinearity between atmospheric pollutants and investigate the relationship between various air pollutants and pneumonia occurs.Results: In the single pollutant model, with interquartile range increment of the density of PM2.5, PM10, NO2 and SO2 at the lag2 days, the odds ratio of hospital visits for pneumonia patients increased by 6.4% (95%CI, 2.3-10.7%), 7.7% (95%CI, 3.2-12.4%), 6.7% (95%CI, 1.0-12.7%), and 7.2% (95%CI, 1.1-13.5%). Stratified analysis showed that pollutants were more significant in the cold period. Besides, the impact of atmospheric particulates on different ages mainly occurs in the young child (0 to 3-year-old). The odds ratio was 1.042 (95%CI, 1.012-1.072) when the principal components of atmospheric pollutants were included in the conditional logistic model.Conclusions: Our study found a significant relationship between short-term uncovering to PM2.5, PM10, NO2, SO2, and hospital visits for pneumonia in Qingdao. The effect of atmospheric pollutants mainly arose in a cold period. The particulate matter might be the principal reason in inducing hospital visits for pneumonia. [ABSTRACT FROM AUTHOR]

Ambient particulate matter (PM) has been linked to adverse health outcomes, but evidence is still relatively limited for emergency department visits (EDVs). Most prior studies used daily mean PM as exposure assessment regardless of within-day variations, which might underestimate the potential acute health effects. In this study, we evaluated the hourly associations between PM and EDVs, so as to further understand the very short-term impacts of PM on EDVs. Hourly data for all-cause EDVs, air pollutants and meteorological factors were collected from Shenzhen, China, between March 1, 2015 and February 28, 2018. A time-stratified case-crossover design with conditional logistic regression analysis was performed to assess the hourly associations between PM and EDVs, adjusting for hourly mean temperature and relative humidity. Subgroup analyses stratified by gender, age and clinic department were conducted to identify vulnerable populations. We further classified the whole year into warm (April to September) and cold (October to March of the next year) months to evaluate seasonal effect modification. Hourly mean all-cause EDVs peaked at 9 a.m. and 7 p.m., while PM 2.5 and PM 10 peaked at 8 a.m. and 8 p.m. The hourly associations between PM and EDVs appeared immediately and persisted for about 10 hours. All-cause EDVs increased 0.72% (95% confidence interval (CI): 0.33, 1.12) and 0.72% (95% CI: 0.45, 0.99) associated with per 10 μg/m3 rise in PM 2.5 and PM 10 at lag 0–10 h, respectively. Stronger effects of PM 2.5 and PM 10 on EDVs were observed among younger groups (age <35 years). Significant PM-EDVs associations were only identified in cold season. A 10 μg/m3 rise in PM 2.5 along 0–10 h, for instance, was associated with increased all-cause EDVs risks of 1.13% (95% CI: 0.67, 1.60) in cold season and −0.23% (95% CI: −1.00, 0.53) in warm season, respectively. Our study provided hourly perspective for the short-term associations between PM exposure and increased EDVs. The adverse impacts of PM on EDVs were only identified in cold season, and young people suffered more from both PM 2.5 and PM 10 exposures. These findings may have valuable implications for public policy promotion on air cleaning, as well as hospital management in optimizing allocation of resources on PM-sensitive conditions. • First study to evaluate hourly associations between particulate matter (PM) and emergency department visits (EDVs) in China. • Hourly PM 2.5 and PM 10 were significantly associated with increased risks of all-cause EDVs. • Distinct seasonal pattern in PM-EDVs associations was observed, with significant results occurring mainly in cold season. • Children were more susceptible to PM exposures. [ABSTRACT FROM AUTHOR]

Background: Climate change, characterized by the steady ascent of global temperatures and the escalating unpredictability of climate patterns, poses multifaceted challenges to public health worldwide. However, vulnerable groups, particularly the population affected by HIV/AIDS, have received little attention., Objectives: We aimed to examine the impacts of temperature variations on AIDS-related mortality., Methods: Data on individuals with HIV/AIDS were collected from the HIV/AIDS Comprehensive Response Information Management System between 2013 and 2019. Temperature variation metrics were constructed by diurnal temperature range (DTR), temperature changes between neighboring days (TCN), and temperature variability (TV 0-t ). Time-stratified case-crossover design with conditional logistic regression models was used to investigate the associations between ambient temperature variations and AIDS-related mortality., Results: Each 1 °C elevated in DTR was linked with a 5.28 % [95 % confidence intervals (CIs): 1.61, 9.08] increment in AIDS-related mortality at a lag of 0-6 days. Stronger associations between DTR and AIDS-related mortality were observed in the married than in single, with corresponding excess ORs (%) of 5.33 (95 % CIs: 0.29, 10.62) versus 4.79 (95 % CIs: -0.50, 10.36) for 1 °C increased in DTR at lag 0-6 days. Additionally, we noticed the impact of DTR was more pronounced in the warm season, leading to a 7.32 % (95 % CIs: 0.57, 14.51) elevation in the risks of AIDS-related mortality for 1 °C increase in DTR at lag 0-6 days, while the effect value decreased to 5.16 % (95 % CIs: 0.71, 9.81) in the cold season., Conclusions: Our findings indicated that DTR might be a significant risk factor for AIDS-related deaths among ambient temperature variation indicators, and underscored the importance of considering temperature variability in public health interventions aimed at mitigating this risk of AIDS-related mortality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Previous investigations have predominantly concentrated on the influence of ozone (O 3) on general population mortality. However, a noticeable gap exists regarding the attention directed towards susceptible demographics, specifically individuals afflicted by human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). A dataset comprising 1467 AIDS-related fatalities from 2013 to 2020 was amassed from the Hubei Provincial Center for Disease Control and Prevention. Daily maximum 8-h average O 3 levels and meteorological parameters were extracted from the ChinaHighAirPollutants dataset and the National Meteorological Science Data Center, respectively. A time-stratified case-crossover methodology was employed to scrutinize the connection between short-term exposure to O 3 and AIDS-related deaths. A rise of one interquartile (IQR) in O 3 concentration, lagged by 4 days, was associated with a 15% [95% confidence intervals (CIs): 2, 31] increase in AIDS-related deaths. Notably, males demonstrated heightened susceptibility to the adverse consequences of O 3 , marked by an odds ratio of 1.20 (95% CIs: 1.05, 1.37) at lag 4 day. Additionally, patients aged over 65 years exhibited escalated vulnerability to brief O 3 exposure. Marriage status and educational attainment emerged as influential factors modifying the interplay between O 3 and AIDS-related mortality. Our study presents novel evidence spotlighting the deleterious repercussions of O 3 on mortality in the HIV/AIDS population. • First study focusing the effects of O 3 on HIV/AIDS patients in China. • Short-term O 3 exposure may increase the risks of AIDS-related deaths. • Males, the elderly, and married patients showed susceptibility to O 3 exposure. • First year after the diagnosis and the warm season were sensitive exposure windows. [ABSTRACT FROM AUTHOR]

Studies suggested that greenness could reduce death risks related to ambient exposure to particulate matter (PM), while the available evidence was mixed across the globe and substantially exiguous in low- and middle-income countries. By conceiving an individual-level case-crossover study in central China, this analysis primarily aimed to quantify PM-mortality associations and examined the modification effect of greenness on the relationship. We investigated a total of 177,058 nonaccidental death cases from 12 counties in central China, 2008–2012. Daily residential exposures to PM 2.5 (aerodynamic diameter <2.5 µm), PM c (aerodynamic diameter between 2.5 and 10 µm), and PM 10 (aerodynamic diameter <10 µm) were assessed at a 1 × 1-km resolution through satellite-derived machine-learning models. Residential surrounding greenness was assessed using satellite-derived enhanced vegetation index (EVI) and normalized difference vegetation index (NDVI) at multiple buffer sizes (250, 500, and 1000 m). To quantify the acute mortality risks associated with short-term exposure to PM 2.5 , PM c , and PM 10 , a time-stratified case-crossover design was utilized in conjunction with a conditional logistic regression model in our main analyses. To investigate the effect modification of greenness on PM-mortality associations, we grouped death cases into low, medium, and high greenness levels using cutoffs of 25th and 75th percentiles of NDVI or EVI exposure, and examined potential effect heterogeneity in PM-related mortality risks among these groups. Mean concentrations (standard deviation) on the day of death were 73.8 (33.4) μg/m3 for PM 2.5 , 43.9 (17.3) μg/m3 for PM c , and 117.5 (44.9) μg/m3 for PM 10. Size-fractional PM exposures were consistently exhibited significant associations with elevated risks of nonaccidental and circulatory mortality. For every increase of 10-μg/m3 in PM exposure, percent excess risks of nonaccidental and circulatory mortality were 0.271 (95% confidence interval [CI]: 0.010, 0.533) and 0.487 (95% CI: 0.125, 0.851) for PM 2.5 at lag-01 day, 0.731 (95% CI: 0.108, 1.359) and 1.140 (95% CI: 0.267, 2.019) for PM c at lag-02 day, and 0.271 (95% CI: 0.010, 0.533) and 0.386 (95% CI: 0.111, 0.662) for PM 10 at lag-01 day, respectively. Compared to participants in the low-level greenness areas, those being exposed to higher greenness were found to be at lower PM-associated risks of nonaccidental and circulatory mortality. Consistent evidence for alleviated risks in medium or high greenness group was observed in subpopulations of female and younger groups (age <75). Short-term exposure to particulate air pollution was associated with elevated risks of nonaccidental and circulatory death, and individuals residing in higher neighborhood greenness possessed lower risk of PM-related mortality. These findings emphasized the potential public health advantages through incorporating green spaces into urban design and planning. • Impact of greenness on PM-mortality association was explored in central China. • Elevated risks of acute mortality associated with PM 2.5 , PM c , and PM 10 exposure. • Exposure to higher residential greenness could lower risks of PM-related mortality. • Same effect modification of greenness was observed in female and adults aged <75. [ABSTRACT FROM AUTHOR]

Introduction: There is limited evidence regarding particulate matter (PM)'s short-term effects on pulmonary tuberculosis (PTB) hospital admission. Our study aimed to determine the short-term associations of the exposure to ambient PM with aerodynamic diameters <2.5 μm (PM 2.5 ) and < 10 μm (PM 10 ) with hospital admission for PTB in Hainan, a tropical province in China., Methods: We collected individual data on patients hospitalized with PTB, PM 2.5 , PM 10 , and meteorological data from 2016 to 2019 in Hainan Province, China. Conditional logistic regression models with a time-stratified case-crossover design were used to assess the short-term effects of PM 2.5 and PM 10 on hospital admission for PTB at a spatial resolution of 1 km  ×  1 km. Stratified analyses were performed according to age at admission, sex, marital status, administrative division, and season of admission., Results: Each interquartile range (IQR) increases in the concentrations of PM 2.5 and PM 10 were associated with 1.155 (95% confidence interval [CI]: 1.041-1.282) and 1.142 (95% CI: 1.033-1.263) hospital admission risks for PTB at lag 0-8 days, respectively. The stratified analyses showed that the effects of PM 2.5 and PM 10 were statistically significant for patients aged ≥65 years, males, married, and those residing in prefecture-level cities. Regarding seasonal differences, the associations between PM and hospital admission for PTB were statistically significant in the warm season but not in the cold season. The effect of PM 2.5 was consistently stronger than that of PM 10 in most subgroups., Conclusion: Short-term exposure to PM increases the risk of hospital admission for PTB. The potential impact of PM with smaller aerodynamic diameter is more detrimental. Our findings highlight the importance of reducing ambient PM level to alleviate the burden of PTB., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhu, Gao, Zhou, Liu, Li, Fu, Fu, Lin, Zhou and Li.)

Some studies have investigated the effects of PM 2.5 on cardiovascular diseases based on the population-average exposure data from several monitoring stations. No one has explored the short-term effect of PM 2.5 on cardiovascular hospitalizations using individual-level exposure data. We assessed the short-term effects of individual exposure to PM 2.5 on hospitalizations for myocardial infarction (MI) and stroke in Guangzhou, China, during 2014-2019. The population-based data on cardio-cerebrovascular events were provided by Guangzhou Center for Disease Control and Prevention. Average annual percent changes (AAPCs) were used to describe trends in the hospitalization rates of MI and stroke. The conditional logistic regression model with a time-stratified case-crossover design was applied to estimate the effects of satellite-retrieved PM 2.5 with 1-km resolution as individual-level exposure. Furthermore, we performed stratified analyses by demographic characteristics and season. There were 28,346 cases of MI, 188,611, and 36,850 cases of ischemic stroke (IS) and hemorrhagic stroke (HS), respectively, with an annual average hospitalization rate of 37.2, 247, and 48.4 per 100,000 people. Over the six-year study period, significant increasing trends in the hospitalization rates were observed with AAPCs of 12.3% (95% confidence interval [CI]: 7.24%, 17.6%), 13.1% (95% CI: 9.54%, 16.7%), and 9.57% (95% CI: 6.27%, 13.0%) for MI, IS, and HS, respectively. A 10 μg/m 3 increase in PM 2.5 was associated with an increase of 1.15% (95% CI: 0.308%, 1.99%) in MI hospitalization and 1.29% (95% CI: 0.882%, 1.70%) in IS hospitalization. A PM 2.5 -associated reduction of 1.17% (95% CI: 0.298%, 2.03%) was found for HS hospitalization. The impact of PM 2.5 was greater in males than in females for MI hospitalization, and greater effects were observed in the elderly (≥ 65 years) and in cold seasons for IS hospitalization. Our study added important evidence on the adverse effect of PM 2.5 based on satellite-retrieved individual-level exposure data., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Most existing studies have investigated short-term associations between ozone exposure and acute disease events among children at a daily timescale, which might neglect risk effects happening within several hours after ozone exposure. In this research, we aimed to depict intraday associations between pediatric emergency department visits (PEDVs) and exposure to ozone in order to better detect ultra-short-term effects of ozone exposure on children. We obtained hourly data of all-cause PEDVs, air pollutants, and meteorological factors in Shenzhen and Guangzhou, China, 2015-2018. We applied time-stratified case-crossover design and conditional logistic regression models to estimate odds ratios per 10-μg/m 3 rise of ozone concentrations at various exposure periods (e.g., 0-3, 4-6, 7-12, 13-24, 25-48, and 49-72 h) prior to PEDVs, controlling for hourly relative humidity and temperature. Subgroup analyses divided by gender, age, and season were undertaken to identify the potential susceptible population and period. A total of 358,285 cases of PEDVs were included in two cities, and hourly average concentration of ozone was 45.5 μg/m 3 in Guangzhou and 58.9 μg/m 3 in Shenzhen, respectively. Increased risks of PEDVs occurred within a few hours (0-3 h) after exposure to ozone and remained up to 48 h. Population risks for PEDVs increased by 0.8% (95% confidence interval, 0.6 to 1.0) in Shenzhen and 0.7% (0.5 to 0.9) in Guangzhou for a 10-μg/m 3 increase in ozone concentrations at lag 4-6 h and lag 7-12 h, respectively. These findings were robust to co-exposure adjustments in our sensitivity analyses. Significantly greater ozone-associated risks were consistently observed during cold months (October to March of the following year) in both cities, while we did not identify evidence for effect modification of children's age and gender. This study provided novel evidence for increased risks of acute disease events among children within several hours after ozone exposure, highlighting the significant implications for policymakers to establish hourly air quality standards for better protecting children's health., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been a worrisome public health problem in the world. However, evidence for associations between short-term exposure to particulate matter (PM) and mortality among HIV/AIDS patients is scarce., Methods: We collected daily death records in people with HIV/AIDS from all counties (N = 103) of Hubei province, China from 2018 to 2019. The county-level daily concentrations of PM 1 , PM 2.5 and PM 10 in the same period were extracted from ChinaHighAirPollutants dataset. A time-stratified case-crossover design with conditional logistic regression analysis was performed to assess the associations between PM and mortality., Results: Each 1 μg/m 3 increased in PM 1 corresponded with 0.89 % elevated in all-cause deaths (ACD) at lag 0-4 days. The largest effects of PM 1 , PM 2.5 and PM 10 on AIDS-related deaths (ARD) were detected at lag 0-4 days, and PM 1 [percent changes in odds ratio: 2.51 % (95 % CIs: 0.82, 4.22)] appeared greater health hazards than PM 2.5 [1.24 % (95 % CIs: 0.33, 2.15)] as well as PM 10 [0.65 % (95 % CIs: 0.01, 1.30)]. In subgroup analyses, the significant associations of PM 1 /PM 2.5 and ACD were only found in male and the cold season. We also observed the effects of PM 1 and PM 10 on ARD were significantly stronger (P for interaction <0.05) in males than females. In addition, we caught sight of HIV/AIDS patients aged over 60 years old were more susceptible to ARD caused by PM than younger population., Conclusions: Our study suggested PM 1 was positively linked with the risk of ACD and ARD. Male patients with HIV/AIDS were more significantly susceptible to PM 1 , PM 2.5 and PM 10 . PM 1 /PM 2.5 appeared stronger associations with ARD in HIV/AIDS patients aged over 60 years old and in the cold season., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Methadone maintenance treatment (MMT) is a key risk reduction measure for controlling HIV transmission among drug users. Studies using traditional methods exist to distinguish between drop outs and nondrop outs. However, many nondrop outs use MMT discontinuously and no study has identified situation-specific factors predicting their showing or not showing up. This study used a case-crossover design comparing situation-specific factors appearing on the last episode of attendance versus those of the last episode of nonattendance. A total of 133 participants were recruited from two MMT clinics in Guangzhou, China. Participants were asked separately whether various situation-specific factors existed in the last episodes of nonattendance and attendance of MMT. Matched odds ratios (ORs) based on conditional logistic regression analysis were presented. The results showed that the participants attended the MMT clinics on average for 25 days in the last month. Situation-specific factors significantly predicting nonattendance included: (1) physical and mental health status: in illness (OR = 33.0,P< 0.001), in a bad mood (OR = 7.5,P< 0.001), and occurrence of an unhappy event (OR = 18.0,P< 0.001); (2) other engagement: work engagement (OR = 40.0,P< 0.001), trip to other places (OR = 83.0,P< 0.001), and social activities (OR = 10.0,P= 0.012); (3) interpersonal relationship: conflicts with family (OR = 19.0,P= 0.004); and (4) structural situational factors: financial difficulty (OR = 19.0,P= 0.004) and worrying about police arrest (OR = 12.0,P= 0.003). Other factors such as interaction with drug users and heroin use were marginally significant, while reduced methadone dosage was nonsignificant. Interventions to improve MMT adherence need to consider situation-specific factors. Ancillary psychosocial services should be integrated with current MMT; MMT should also provide more flexible services to the clients. Furthermore, efforts should be taken to build up interdisciplinary teams and to connect with MMT in order to provide holistic harm reduction, rehabilitation, and health care. [ABSTRACT FROM PUBLISHER]

Our results suggested that short-term exposure to particulate matter (PM) might increase the risks of hospitalizations for osteoporotic fractures. Government should protect its citizens by putting in place policies to reduce unhealthy emissions and air pollution., Introduction: Osteoporotic fractures are accompanied by high rates of disability and mortality. PM has been linked with many health outcomes. However, few studies focus on the association of short-term exposure to ambient PM and osteoporotic fractures., Methods: Data on daily mean air pollution, meteorological factors, and hospitalizations for osteoporotic fractures were collected from Hangzhou, China, 2020-2021. A time-stratified case-crossover design with extended Cox proportional hazards regression was applied to assess the associations between PM and osteoporotic fractures., Results: Short-term exposure to PM significantly increased the risks of hospitalizations for osteoporotic fractures at cumulative lag days. Per 10 μg/m 3 increased in PM 2.5 (PM with an aerodynamic diameter ≤ 2.5 μm), PM C (PM with an aerodynamic diameter between 2.5 μm and 10 μm), and PM 10 (PM with an aerodynamic diameter ≤ 10 μm) were associated with 5.65% (95% confidence intervals (CIs): 1.29, 10.19), 3.19% (0.11, 6.36), and 2.45% (0.57, 4.37) increase in hospitalizations for osteoporotic fractures, respectively. Significant PM-osteoporotic fracture associations were only observed in females and people aged over 65 years old. For the season, the estimates of PM on hospitalizations for osteoporotic fractures were 6.30% (95% CIs: 1.62, 11.20) in the cold season vs. 2.16% (95% CIs: - 4.62, 9.42) in the warm season for per 10 μg/m 3 increase of PM 2.5 , and 0.99 (95% CIs: - 2.69, 4.80) vs. 6.72% (95% CIs: 0.68, 13.13) for PM C ., Conclusions: Our study showed PM was positively linked with the risk of osteoporotic fractures. Females and people aged over 65 years old were more susceptible to PM. The adverse impacts of PM 2.5 in the cold season and PM C in the warm season were worthy of special attention., (© 2022. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)

A growing number of studies associated increased mortality with exposures to specific fine particulate (PM 2.5 ) constituents, while great heterogeneity exists between locations. In China, evidence linking PM 2.5 constituents and mortality was extensively sparse. This study primarily aimed to quantify short-term associations between PM 2.5 constituents and non-accidental mortality among the Chinese population. We collected daily mortality records from 32 counties in China between January 1, 2011, and December 31, 2013. Daily concentrations of main PM 2.5 constituents (organic carbon (OC), elemental carbon (EC), nitrate (NO 3 - ), sulfate (SO 4 )) were estimated using the modified Community Multiscale Air Quality model. Time-stratified case-crossover design with conditional logistic regression models was adopted to estimate mortality risks associated with short-term exposures to PM 2- ), and ammonium (NH 4 + )) were estimated using the modified Community Multiscale Air Quality model. Time-stratified case-crossover design with conditional logistic regression models was adopted to estimate mortality risks associated with short-term exposures to PM 2.5 mass and its constituents. Stratification analyses were done by sex, age, and season. A total of 116,959 non-accidental deaths were investigated. PM 2.5 concentrations on the day of death were averaged at 75.7 µg m -3 (control day: 75.6 µg m -3 ), with an interquartile range (IQR) of 65.2 µg m -3 . Per IQR rise in PM 2.5 , EC, OC, NO 3 - , SO 4 2- , and NH 4 + at lag-04 day was associated with an increase in non-accidental mortality of 2.4% (95% confidence interval, (1.0-3.7), 1.7% (0.8-2.7), 2.9% (1.6-4.3), 2.1% (0.4-3.9), 1.0% (0.2-1.9), and 1.6% (0.3-2.9), respectively. Both PM 2.5 mass and its constituents were strongly associated with elevated cardiovascular mortality risks, but only PM 2.5 , EC, and OC were positively associated with respiratory mortality at lag-3 day. PM 2.5 mass and its constituents associated effects on mortality varied among sex- and age-specific subpopulations. Differences in the seasonal pattern of associations exist among PM 2.5 constituents, with stronger effects related to EC and NO 3 - in warm months but SO 4 2- and NH 4 + in cold months. Short-term exposures to PM 2.5 compositions were positively associated with increased risks of mortality, particularly those constituents from combustion-related sources., (© 2022. Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Aims: To study the association between short-term exposure to air pollutants and mortality of Chronic Ischemic Heart Disease (CIHD)., Methods: Using a case-crossover design, we investigated 148,443 CIHD deaths from 2015 to 2020 in Jiangsu Province, China. Exposure to six ambient pollutants, including PM 10 , PM 2.5 , NO 2 , CO, SO 2 , and O 3, was assessed by extracting daily concentrations from validated 10 km × 10 km pollutant grids at each subject's residential address. A conditional logistic regression approach was used to explore the exposure-response relationship with adjustment for temperature and relative humidity. We calculated the Population Attributable Fractions (PAFs) and the attributable deaths number of CIHD., Results: An increase of 10 μg/m 3 in PM 10 and PM 2.5 exposure was associated with a 1.16% (95% CI: 0.85-1.48%) and 1.80% (1.36-2.24%) increase in CIHD mortality, respectively. A threshold value of 123 µg/m 3 was identified for the association between O 3 exposure and CIHD mortality. Controlling for PM 2.5 , each increase of 10 µg/m 3 in O 3 (>threshold) was statistically significantly associated with a 0.94% (0.19-1.71%) increase in CIHD mortality, however there was no association between NO 2 , SO 2 , CO exposure and CIHD mortality. Reducing PM 2.5 , PM 10 and O 3 to the WHO air quality guidelines would prevent 6.16% (95% CI: 4.70-7.58%), 4.30% (3.18-5.43%) and 1.29% (0.48-4.20%) of CIHD deaths, respectively. During the warm season, mortality and PAFs of CIHD associated with PM 2.5 , PM 10 , and O 3 were significantly higher., Conclusions: Short-term exposure to ambient PM 2.5 , PM 10, and O 3 might trigger deaths from CIHD. These findings indicate that the premature deaths of CIHD patients can be alleviated by reducing exposure to polluted air., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Abstract: Background: Because epidemiological studies have yielded different results, the association between exposure to fine particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5) and acute events of cardiovascular diseases (CVD) is unknown. Additionally, no research has been conducted to explore the association between PM2.5 and hospital emergency room (ER) visits of cardiovascular diseases in Beijing, China. Objective: To explore the association between PM2.5 and the hospital ER visits in Beijing, China for CVD {(International Classification of Diseases, 10th vision (ICD-10): I00~I99)}. Methods: We collected data for daily hospital ER visits for CVD from the Peking University Third Hospital, daily ambient PM2.5 data from a fixed monitor site at Peking University, and data on the daily level of gaseous air pollutants {sulfur dioxide (SO2) and nitrogen dioxide (NO2)} from the Beijing Municipal Environmental Monitoring Center between June 1, 2004 and December 31, 2006. A time-stratified case–crossover design was used to evaluate associations between CVD health outcomes and ambient air pollutants. Results: 8377 hospital ER visits of CVD were collected in our study. After adjusting the temperature and the relative humidity, the associations for 10 μg/m3 increases in levels of PM2.5, SO2, or NO2 and hospital ER visits for cardiovascular diseases were statistically significant with odds ratios (ORs) of 1.005{95% confidence interval (CI): 1.001–1.009}, 1.014(95% CI: 1.004–1.024), and 1.016(95% CI: 1.003–1.029), respectively. Conclusion: These findings suggest that elevated levels of ambient air pollutants are associated with the increase in hospital ER visits for CVD in Beijing, China. [Copyright &y& Elsevier]

Apart from concentrations of particulate mass, PM2.5-associated effects on health may largely depend on its chemical components. However, little is known regarding the underlying effects of specific PM2.5 constituents. The study included nearly 1 million hospital admissions from five Chinese cities during 2015-2017. Based on the modified Community Multiscale Air Quality model, our study simulated daily concentrations of PM2.5 and five main components. We used a time-stratified case-crossover design with conditional logistic regression models to estimate short-term effects of PM2.5 constituents on cause-specific hospital admissions. Per interquartile range increase in exposure to PM2.5, elemental carbon, organic carbon, nitrate, sulfate and ammonium at lag 04-day was related to an excess risk (ER%) for non-accidental admissions of 1.6% [95% confidence interval: 1.1-2.0], 1.9% [1.3-2.4], 1.0% [0.5-1.6], 1.2% [0.4-2.0], 1.2% [0.9-1.5] and 1.4% [0.9-1.9], respectively. Great heterogeneities of constituents-admission associations existed in diverse causes and constituents. This study provided multi-center high-quality evidence that hospital admissions, particularly those for ischemic heart disease (ER% ranging from 2.3 to 5.4% at lag 04-day) and pneumonia (1.9-5.1% at lag 4-day), could be triggered by short-term exposures to ambient PM2.5 constituents. Relatively stronger constituents-admission associations were found among females for respiratory causes and the elderly for cardiovascular causes. [ABSTRACT FROM AUTHOR]

Few studies have evaluated the short-term association between hospital admissions and individual exposure to ambient particulate matter (PM 2.5 ). Particularly, no studies focused on hospital admissions for chronic obstructive pulmonary disease (COPD) at the individual level. We assessed the short-term effects of PM 2.5 on hospitalization admissions for COPD in Guangzhou, China, during 2014-2015, based on satellite-derived estimates of ambient PM 2.5 concentrations at a 1-km resolution near the residential address as individual-level exposure for each patient. Around 40,002 patients with COPD admitted to 110 hospitals were included in this study. A time-stratified case-crossover design with conditional logistic regression models was applied to assess the effects of PM 2.5 based on a 1-km grid data of aerosol optical depth provided by the National Aeronautics and Space Administration on hospital admissions for COPD. Further, we performed stratified analyses by individual demographic characteristics and season of hospital admission. Around 10 μg/m 3 increase in individual-level PM 2.5 was associated with an increase of 1.6% (95% confidence interval [CI]: 0.6%, 2.7%) in hospitalization for COPD at a lag of 0-5 days. The impact of PM 2.5 on hospitalization for COPD was greater significantly in males and patients admitted in summer. Our study strengthened the evidence for the adverse effect of PM 2.5 based on satellite-based individual-level exposure data., (© 2021. The Author(s).)

Existing PM 2.5 -morbidity studies using daily mean concentration as exposure metric may fail to capture intra-day variations of PM 2.5 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 PM 2.5 against a specific threshold within a day. PM 2.5 DECHs were separately calculated as daily concentration-hours >8, 10, 15, 20, and 25 μg/m 3 (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 PM 2.5 mean and DECHs in Shenzhen, China. We observed highly comparable PM 2.5 -COPD associations using exposure metrics of daily mean and DECHs with above-defined thresholds. For instance, PM 2.5 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 PM 2.5 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., SO 2 , NO 2 , CO, and O 3 ) 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 PM 2.5 .

Background: Short-term exposure to PM 2.5 has been widely associated with human morbidity and mortality. However, most up-to-date research was conducted at a daily timescale, neglecting the intra-day variations in both exposure and outcome. As an important fraction in PM 2.5 , PM 1 has not been investigated about the very acute effects within a few hours., Methods: Hourly data for size-specific PMs (i.e., PM 1 , PM 2.5 , and PM 10 ), all-cause emergency department (ED) visits and meteorological factors were collected from Guangzhou, China, 2015-2016. A time-stratified case-crossover design with conditional logistic regression analysis was performed to evaluate the hourly association between size-specific PMs and ED visits, adjusting for hourly mean temperature and relative humidity. Subgroup analyses stratified by age, sex and season were conducted to identify potential effect modifiers., Results: A total of 292,743 cases of ED visits were included. The effects of size-specific PMs exhibited highly similar lag patterns, wherein estimated odds ratio (OR) experienced a slight rise from lag 0-3 to 4-6 h and subsequently attenuated to null along with the extension of lag periods. In comparison with PM 2.5 and PM 10 , PM 1 induced slightly larger effects on ED visits. At lag 0-3 h, for instance, ED visits increased by 1.49% (95% confidence interval: 1.18-1.79%), 1.39% (1.12-1.66%) and 1.18% (0.97-1.40%) associated with a 10-μg/m 3 rise, respectively, in PM 1 , PM 2.5 and PM 10 . We have detected a significant effect modification by season, with larger PM 1 -associated OR during the cold months (1.017, 1.013 to 1.021) compared with the warm months (1.010, 1.005 to 1.015)., Conclusions: Our study provided brand-new evidence regarding the adverse impact of PM 1 exposure on human health within several hours. PM-associated effects were significantly more potent during the cold months. These findings may aid health policy-makers in establishing hourly air quality standards and optimizing the allocation of emergency medical resources., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Stroke, especially ischemic stroke (IS), has been a severe public health problem around the world. However, the association between air pollution and ischemic stroke remains ambiguous., Methods: A total of 63, 997 IS cases aged 18 years or above in Shenzhen were collected from 2008 to 2014. We used the time-stratified case-crossover design combining with distributed lag nonlinear model (DLNM) to estimate the association between air pollution and IS onset. Furthermore, this study explored the variability across gender and age groups., Results: The cumulative exposure-response curves were J-shaped for SO 2 , NO 2 and PM 10 , and V-shaped for O 3 , and crossed over the relative risk (RR) of one. The 99th, 50th (median) and 1st percentiles of concentration (μg/m 3 ) respectively were 37.86, 10.06, 3.71 for SO 2 , 116.26, 41.29, 18.51 for NO 2 , 145.94, 48.29, 16.14 for PM 10 , and 111.57, 49.82, 16.00 for O 3 . Extreme high-SO 2 , high-NO 2 , high-PM 10 , high-O 3 , and low-O 3 concentration increased the risk of IS, with the maximum RR values and 95% CIs: 1.50(1.22, 1.84) (99th vs median) at 0-12 lag days, 1.37(1.13, 1.67) (99th vs median) at 0-10 lag days, 1.26(1.04, 1.53) (99th vs median) at 0-12 lag days, 1.25(1.04, 1.49) (99th vs median) at 0-14 lag days, and 1.29(1.03, 1.61) (1st vs median) at 0-14 lag days, respectively. The statistically significant minimal RR value and 95% CI was 0.79(0.66,0.94) at 0-10 lag days for extreme low-PM 10 . The elderly aged over 65 years were susceptible to extreme pollution conditions. Difference from the vulnerability of males to extreme high-SO 2 , high-NO 2 and low-O 3 , females were vulnerable to extreme high-PM 10 and high-O 3 . Comparing with the elderly, adults aged 18-64 year were immune to extreme low-NO 2 and low-PM 10 . However, no association between CO and IS onset was found., Conclusions: SO 2 , NO 2 , PM 10 and O 3 exerted non-linear and delayed influence on IS, and such influence varied with gender and age. These findings may have significant public health implications for the prevention of IS.