A large body of evidence suggests that an increase in atmospheric particulate matter (PM) concentrations will lead to an increase in morbidity due to adverse health conditions, such as respiratory diseases (RESD). Lanzhou is located in northwest China, central Gansu Province. Due to limited research and data, the impact of PM on human health have not been systematically acknowledged.

The aim of the study is to investigate the association between size-fractionated PM pollution and outpatients visits for RESD.

Material and methods:
Data on outpatient visits for RESD, air pollutants and meteorological indices in Lanzhou were collected from 1 February 2014 – 31 December 2017, and the associations of three types of PM (PM2.5, PMC, and PM10) with outpatient visits for RESD were evaluated using generalized additive models (GAMs).

Findings showed that PM2.5 and PMC had the most significant impact on outpatient visits for RESD at seven cumulative lag days. PM10 was not significantly associated with outpatient visits for RESD. In subgroup analysis, the impact of atmospheric PM on outpatient visits for RESD was significantly modified by gender and age; men, and children aged 0–5 years old, were more sensitive to PM2.5 pollution.

Increased atmospheric PM concentration is associated with an increase in outpatient visits for RESD, and it has a lag effect. The increase in outpatient visits for RESD appears to be driven by increased PM2.5 concentrations. The results obtained may provide reference values for formulating preventive strategies to protect the population from the adverse impact of PM pollution.

GAM – Generalized Additive Model; RESD – Respiratory Diseases; AIC – Akaike’s Information Criterion; ER – Excessive Risk; PM – Particulate Matter
This study was supported by National Natural Science Foundation of China (No.71861026) and the China Postdoctoral Science Foundation (No.2016M600827).
Gao Q, Xu Q, Guo X, Fan H, Zhu H. Particulate matter air pollution associated with hospital admissions for mental disorders: A time-series study in Beijing, China. Eur Psychiat. 2017; 44: 68–75.
Yang Kedi. Environmental Hygiene. Edition 7. Beijing: People’s Medical Publishing House; 2012. p. 76–77.
Ling SH, Van E, Stephan F. Particulate matter air pollution exposure: role in the development and exacerbation of chronic obstructive pulmonary disease. Int J Chronic Obstr. 2009; 4: 233–43.
Zhao YJ, Wang SY, Lang LL, Huang CY, Ma WJ, Lin HL. Ambient fine and coarse particulate matter pollution and respiratory morbidity in Dongguan, China. Environ Pollut. 2017; 222: 126–131.
Lu F, Xu DQ, Cheng YB, Dong SX, Guo C, Jiang X, Zheng XY. Systematic review and meta analysis of the adverse health effects of ambient PM 2.5 and PM 10 pollution in the Chinese population. Environ Res. 2015; 136: 196–204.
Lin HL, Tao J, Kan HD, Qian ZM, Chen AL, Du YD, Liu T, Zhang YH, Qi YQ, Ye JJ, Li SM, Li WL, Xiao JP, Zeng WL, Li X, Stamatakis KA, Chen XY, Ma WJ. Ambient particulate matter air pollution associated with acute respiratory distress syndrome in Guangzhou, China. J Expo Sci Env Epid. 2018; 28: 392–399.
Wang C, Feng L, Chen K. The impact of ambient particulate matter on hospital outpatient visits for respiratory and circulatory system disease in an urban Chinese population. Sci Total Environ. 2019; 666: 672–679.
Li R, Jiang QC, Huang XB, Liu F, Gao ZC. Impact of Air Pollutants on Outpatient Visits for Acute Respiratory Outcomes. Int J Env Res Pub He. 2017; 14(1).
Eun JJ, Woo SL, Hyun YJ, Chang HK, Jung SE, Jeong HM, Mi HK, Kwangha L, Ki UK, Hye KP. Effects of particulate matter on respiratory disease and the impact of meteorological factors in Busan, Korea. Resp Med. 2017; 124: 79–87.
Xu Q. The effects of particulate matter on emergency room visits in Beijing, based on generalized additive model. Beijing: Capital Medical University; 2017.
Ge EJ, Lai KF, Xiao X, Luo M, Fang ZF, Zeng YJ, Ju H, Zhong NS. Differential effects of size-specific particulate matter on emergency department visits for respiratory and cardiovascular diseases in Guangzhou, China. Environ Pollut. 2018; 243(Pt A): 336–345.
Zhang ZY, Chai PF, Wang JB, Ye ZH, Peng Shen, Lu HC, Jin MJ, Gu MJ, Li D, Lin HB, Chen K. Association of particulate matter air pollution and hospital visits for respiratory diseases: a time-series study from China. Environ Sci Pollut R. 2019; 26(12): 12280–12287.
Zhao JG, Wang SG, Zhang TY, Yu SW, Hu YL, Zhu Z, Shang KZ. The analysis of meteorological factors causing heavy air pollution in Lanzhou. Acta Scientiae Circumstantiae. 2015; 35(5): 1547–1555.
Xiao ZH, Shao LY, Zhang N. Chemical Compositions and Sources of PM10 in Winter and Spring in Chengguan District of Lanzhou. Environ Sci Technol. 2011; 34(12): 164–168.
Wang YN, Jia CH, Tao J, Zhang LM, Liang XX, Ma JM, Gao H, Huang T, Zhang K. Chemical characterization and source apportionment of PM 2.5 in a semi-arid and petrochemical-industrialized city, Northwest China. Sci Total Environ. 2016; 573: 1031–1040.
Tan JH, Zhang LM, Zhou XM, Duan JC, Li Y, Hu JN, He KB. Chemical characteristics and source apportionment of PM 2.5 in Lanzhou, China. Sci Total Environ. 2017; 601–602: 1743–175.
Liao YX, Sun J, Qian ZM, Mei SJ, Li Y, Lu Y, McMillin SE, Lin HL, Lang LL. Modification by seasonal influenza and season on the association between ambient air pollution and child respiratory diseases in Shenzhen, China. Atmos Environ. 2020; 234. atmosenv.2020.117621.
Feng W, Li HB, Wang S, Van Halm-Lutterodt N, An J, Liu Y, Liu MY, Wang XN, Guo XH. Short-term PM 10 and emergency department admissions for selective cardiovascular and respiratory diseases in Beijing, China. Sci Total Environ. 2019; 657: 213–221.
Zhang P, Zhou XY. Health and economic impacts of particulate matter pollution on hospital admissions for mental disorders in Chengdu, Southwestern China. Sci Total Environ. 2020; 733: 139114.
Malig BJ, Green S, Basu R, Broadwin R. Coarse Particles and Respiratory Emergency Department Visits in California. Am J Epidemiol. 2013; 178(1): 58–69.
Yao CY, Wang Y, Christopher W, Xu CZ, Christiana K, Lin Y, Zhang P, Yin P, Kin BHL. The association between high particulate matter pollution and daily cause-specific hospital admissions: a time-series study in Yichang, China. Environ Sci Pollut R. 2020; 27: 5240–5250.
Wang AX, Cheng X, Song CB, Ying SM, Li Q, Wu L, Mao HJ. Association between fine particulate matter and asthma hospital outpatient visits in Hangzhou. Environ Sci. 2018; 39(10): 4457–4462 (2018).
Yin GJ, Liu C, Hao LP, Chen YC, Wang WD, Huo JT, Zhao QB, Zhang YH, Duan YS, Fu QY, Chen RJ, Kan HD. Associations between size-fractionated particle number concentrations and COPD mortality in Shanghai, China. Atmos Environ. 2019; 214.
Meng X, Ma YJ, Chen RJ, Zhou ZJ, Chen BH, Kan HD. Size-Fractionated Particle Number Concentrations and Daily Mortality in a Chinese City. Environ Health Persp. 2013; 121(10): 1174–8.
Chen GB, Li SS, Zhang YM, Zhang WY, Li DW, Wei XM, He Y, Bell ML, Williams G, Marks GB, Jalaudin B, Abramson MJ, Guo YM. Effects of ambient PM1 air pollution on daily emergency hospital visits in China: an epidemiological study. The Lancet Planetary Health. 2017; 1(6): e221-e229.
Lin M, Chen Y, Burnett RT, Villeneuve PJ, Krewski D. The Influence of Ambient Coarse Particulate Matter on Asthma Hospitalization in Children: Case-Crossover and Time-Series Analyses. Environ Health Persp. 2002; 110(6): 575–581.
Qiu H, Yu ITS, Tian LW, Wang XR, Tse LA, Tam W, Wong TW. Effects of Coarse Particulate Matter on Emergency Hospital Admissions for Respiratory Diseases: A Time-Series Analysis in Hong Kong. Environ Health Persp. 2012; 120(4): 572–6.
Li T, Hu R, Chen, Z, Li QY, Huang SX, Zhou LF. Fine particulate matter (PM 2.5 ): The culprit for chronic lung diseases in China. Chronic diseases and translational medicine. 2018; 4(3): 176–186.
Han YQ, Zhu T. Health effects of fine particles (PM 2.5 ) in ambient air. Science China (Life Sciences). 2015; 58(06): 624–626.
Zhang YQ, Ding Z, Xiang QQ, Wang W, Huang L, Mao FY. Short-term effects of ambient PM1 and PM2.5 air pollution on hospital admission for respiratory diseases: Case-crossover evidence from Shenzhen, China. Int J Hyg Envir Heal. 2020; 224.
Kim SY, Peel JL, Hannigan MP, Dutton SJ, Sheppard L, Clark ML, Vedal S. The temporal lag structure of short-term associations of fine particulate matter chemical constituents and cardiovascular and respiratory hospitalizations. Environ Health Pers. 2020; 120(8): 1094–1099.
Jiang JJ, Niu Y, Liu C, Chen RJ, Cao JY, Kan HD, Cheng YX. Short-term exposure to coarse particulate matter and outpatient visits for cardiopulmonary disease in a Chinese city. 199110686. Ecotox Environ Safe. 2020; 199: 110686.
Li YH. Chemical characteristics and source apportionment of atmospheric fine particles in Lanzhou city. Lanzhou: Lanzhou University; 2015.
Zuo BQ, Liu C, Chen RJ, Kan HD, Sun J, Zhao J, Wang C, Sun Q, Bai HJ. Associations between short-term exposure to fine particulate matter and acute exacerbation of asthma in Yancheng, China. Chemosphere. 2019; 237.
Xu Q, Li X, Wang S, Wang C, Huang FF, Gao Q, Wu LJ, Tao LX, Guo J, Wang W, Guo XH. Fine particulate air pollution and hospital emergency room visits for respiratory disease in urban areas in Beijing, China, in 2013. Plos One.2016; 11(4).
Faustini A, Stafoggia M, Berti G, Bisanti L, Chiusolo M, Cernigliaro A, Mallone S, Primerano R, Scarnato C, Simonato L, Vigotti MA, Forastiere F. The relationship between ambient particulate matter and respiratory mortality: a multi-city study in Italy. Eur Respir J. 2011; 38(3): 538–547.
Cordova JED, Aguirre VT, Apestegui VV, Ibarguen LO, Vu BN, Steenland K, Rengifo GGF. Association of PM2.5 concentration with health center outpatient visits for respiratory diseases of children under 5 years old in Lima, Peru. Environ Health. 2020; 19(S2): 1–32.
Nascimento AP, Santos JM, Mill JG, de Souza JB, Reis NC, Reisen VA. Association between the concentration of fine particles in the atmosphere and acute respiratory diseases in children. Rev Saude Publ. 2017; 51.
Wang MZ, Zheng S, Wang SG, Tao Y, Shang KZ. The weather temperature and air pollution interaction and its effect on hospital admissions due to respiratory system diseases in western China. Biomed Environ Sci. 2013; 26(5): 403–407.
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