This study aims to analyze the acute effects of PM2.5, PM10, SO2, NO2, and O3 on hospitalizations for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), stroke, and myocardial infarction (MI) from 2014 to 2017 in Shenyang, China. Hospitalization records for AECOPD (17,655), stroke (276,736) and MI (26,235) and air pollutions concentration data (PM2.5, PM10, SO2, NO2, and O3) were collected. A generalized additive model (GAM) was utilized to determine the impact of air pollutants on the relative risk (RR) of hospitalization for AECOPD, stroke, and MI. Stratified analysis for AECOPD was based on gender and age. It was based on gender, age, hypertension, and diabetes for stroke, and for MI it was based on gender, age, and coronary atherosclerosis. The lag effect for AECOPD in terms of gender analysis occurred at lag3-lag5. The hospitalization risk for stroke with hypertension due to SO2 and NO2 was greater than that of stroke without hypertension. The risk of hospitalization for stroke with hypertension as a comorbidity due to O3 was lower than without hypertension. The risk of hospitalization for MI combined with coronary atherosclerosis due to PM2.5, PM10, or NO2 was higher than that of hospitalizations for MI without coronary atherosclerosis. Air pollution increased the rate of hospitalization for AECOPD. SO2 and O3 appeared protective for stroke patients with coronary atherosclerosis. PM2.5, PM10, and NO2 had no influence on total hospitalization for myocardial infarction.
Keywords: Acute exacerbation of chronic obstructive pulmonary disease; Air pollution; Coronary atherosclerosis; Generalized additive model; Hospitalization; Hypertension; Myocardial infarction; Stroke.