Impacts of event-specific air quality improvements on total hospital admissions and reduced systemic inflammation in COPD patients

PLoS One. 2019 Mar 20;14(3):e0208687. doi: 10.1371/journal.pone.0208687. eCollection 2019.

Abstract

There is limited evidence linking the impacts of reduced air pollution on hospital admissions. The potential biological mechanisms are still not completely understood. This study examined the effects of mitigated ambient pollution on hospital admissions and inflammatory biomarker levels in chronic obstructive pulmonary disease (COPD) COPD patients. Daily hospital admissions were compared over 51 days associated with the Asian Games period (Nov 1-Dec 21, 2010) with the identical calendar dates of baseline years (2004-2009 and 2011-2013). A three-year cohort study was conducted with 36 COPD patient participants. The daily particulate matter (PM10) decreased from 65.86 μg/m3 during the baseline period to 62.63 μg/m3 during the Asian Games period; the daily NO2 level decreased from 51.33 μg/m3 to 42.63 μg/m3. Between the baseline period and the Asian Games, daily hospital admissions from non-accidental diseases decreased from 116 to 93, respectively; respiratory diseases decreased from 20 to 17, respectively; and cardiovascular diseases decreased from 11 to 9 during the Asian Games period, respectively. No statistically significant reductions were seen in the remaining months of 2010 in Guangzhou, during the the Asian Games period in the control city, and two other control diseases. Furthermore, we identified significant improvement in CRP and fibrinogen by -20.4% and -15.4% from a pre-Asian game period to a during-Asian game period, respectively. For CRP, we found significant increases in NO2 at lag1-3 days after-Asian game period and significant increases in PM10 at lag1-2 days. Similar effects were also seen with fibrinogen. This discovery provides support for efforts to diminish air pollution and improve public health through human air pollutants intervention. Improved air pollution during the 2010 Asian games was correlated with decreases in biomarkers associated with systemic inflammation in COPD patient participants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Air Pollutants / analysis
  • Air Pollution / analysis*
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cohort Studies
  • Environmental Biomarkers
  • Female
  • Humans
  • Male
  • Middle Aged
  • Particulate Matter / analysis
  • Patient Admission / statistics & numerical data*
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Young Adult

Substances

  • Air Pollutants
  • Environmental Biomarkers
  • Particulate Matter

Grants and funding

This work was supported by grants from National Natural Science Foundation of China (81700043, 81520108001, 81770043), the 973 Key Scheme of China (2015CB553406), Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2014, W Lu), Guangzhou Department of Education for Innovative Team (13C08), and Guangdong Natural Science Foundation (2016A030313593), and State Key Laboratory of Respiratory Disease Foundation (SKLRD-QN-201719). The funding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.