Short-Term Effect of Moderate Level Air Pollution on Outpatient Visits for Multiple Clinic Departments: A Time-Series Analysis in Xi'an China.

There is limited evidence concerning the association between air pollution and different outpatient visits in moderately polluted areas. This paper investigates the effects of moderate-level air pollution on outpatient visits associated with six categories of clinic department. We analyzed a total of 1,340,791 outpatient visits for the pediatric, respiratory, ear-nose-throat (ENT), cardiovascular, ophthalmology, and orthopedics departments from January 2016 to December 2018. A distributed lag nonlinear model was used to analyze the associations and was fitted and stratified by age and season (central heating season and nonheating season). We found SO 2 had the largest effect on pediatrics visits (RR = 1.105 (95%CI: 1.090, 1.121)). Meanwhile, PM 2.5 and SO 2 had greater effects on ENT visits for people under 50 years old. The results showed a strong association between O 3 and cardiovascular outpatient visits in the nonheating season (RR = 1.273, 95% CI: 1.189,1.358). The results showed every 10 μ g / m 3 increase in SO 2 was associated with a lower number of respiratory outpatient visits. Significant different associations were observed in PM 2.5 , NO 2 , CO, and O 3 on ophthalmology visits between the heating and nonheating seasons. Although no significant association has been found in existing studies, our findings showed PM 2.5 and NO 2 were significantly related to orthopedic outpatient visits for people under 60 (RR = 1.063 (95%CI: 1.032, 1.095), RR = 1.055 (95%CI: 1.011, 1.101)). This study also found that the effect-level concentrations of air pollutants for some clinic departments were lower than the national standards, which means that people should also pay more attention when the air quality is normal. [ABSTRACT FROM AUTHOR]