The association of long-term exposure to outdoor air pollution with all-cause GP visits and hospital admissions by ethnicity and country of birth in the United Kingdom

PLoS One. 2023 Oct 11;18(10):e0275414. doi: 10.1371/journal.pone.0275414. eCollection 2023.

Abstract

Background: Air pollution is associated with poor health. Yet, more research is needed to reveal the association of long-term exposure to outdoor air pollution with less studied health outcomes like hospital admissions and general-practitioner (GP) visits and whether this association is stronger for ethnic minorities compared to the rest of population. This study investigates the association between air pollution and all-cause GP visits and hospital admissions by ethnicity in the United-Kingdom (UK).

Methods: We used individual-level longitudinal data from the "UK Household Longitudinal Study" including 46,442 adult individuals who provided 140,466 responses across five years (2015-2019). This data was linked to yearly concentrations of NO2, SO2, and particulate-matter (PM10, PM2.5) outdoor pollution using the Lower Super Output Area (LSOA) of residence for each individual. Multilevel mixed-effects ordered logistic models were used to assess the association between air pollution and all-cause GP visits and hospital admissions.

Results: We found higher odds of hospital admissions per 1 μg/m3 increase in annual concentrations of NO2 (OR = 1.008; 95%CI = 1.004-1.012), SO2 (OR = 1.048; 95%CI = 1.014-1.083), PM10 (OR = 1.011; 95%CI = 1.003-1.018), and PM2.5 (OR = 1.018; 95%CI = 1.007-1.029) pollutants. Higher odds of GP visits were also observed with increased exposure to NO2 (OR = 1.010; 95%CI = 1.006-1.014) and SO2 (OR = 1.114; 95%CI = 1.077-1.152) pollutants. The observed associations did not differ across ethnic groups, but by country of birth, they were more pronounced in individuals born outside UK than those born in UK.

Conclusion: This study supports an association between higher exposure to outdoor air pollution and increased all-cause hospital admissions and GP visits. Further longitudinal studies with longer follow-up time periods may be able to reveal more definite conclusions on the influence of ethnicity on the association between long-term outdoor air pollution and both hospital admissions and GP visits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollutants* / adverse effects
  • Air Pollutants* / analysis
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Environmental Pollutants*
  • Ethnicity
  • Hospitals
  • Humans
  • Longitudinal Studies
  • Nitrogen Dioxide / analysis
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • United Kingdom / epidemiology

Substances

  • Air Pollutants
  • Nitrogen Dioxide
  • Particulate Matter
  • Environmental Pollutants

Grants and funding

The work presented in this paper was funded by the Royal Society of Edinburgh (RSE) Saltire Early Career Fellowships grant (RSE Grant Reference Number: 1846). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.