Case-crossover study for the association between increased hospital admissions for respiratory diseases and the increase in atmospheric PM2.5 and PM2.5-bound trace elements in Pretoria, South Africa

Int J Environ Health Res. 2024 Mar;34(3):1551-1565. doi: 10.1080/09603123.2023.2229256. Epub 2023 Jun 29.

Abstract

Outdoor PM2.5 was sampled in Pretoria, 18 April 2017 to 28 February 2020. A case-crossover epidemiology study was associated for increased PM2.5 and trace elements with increased hospital admissions for respiratory disorders (J00-J99). The results included a significant increase in hospital admissions, with total PM2.5 of 2.7% (95% CI: 0.6, 4.9) per 10 µg·m-3 increase. For the trace elements, Ca of 4.0% (95% CI: 1.4%-6.8%), Cl of 0.7% (95% CI: 0.0%-1.4%), Fe of 3.3% (95% CI: 0.5%-6.1%), K of 1.8% (95% CI: 0.2-3.5) and Si of 1.3% (95% CI: 0.1%-2.5%). When controlling for PM2.5, only Ca of 3.2% (95% CI: 0.3, 6.1) and within the 0-14 age group by 5.2% (95% CI: 1.5, 9.1). Controlling for a co-pollutant that is highly correlated with PM2.5 does reduce overestimation, but further studies should include deposition rates and parallel sampling analysis.

Keywords:

MeSH terms

  • Air Pollutants* / analysis
  • Air Pollution* / analysis
  • Cross-Over Studies
  • Hospitalization
  • Hospitals
  • Humans
  • Particulate Matter / analysis
  • Respiratory Tract Diseases* / epidemiology
  • South Africa / epidemiology
  • Trace Elements* / analysis

Substances

  • Trace Elements
  • Particulate Matter
  • Air Pollutants