Impacts of short-term air pollution exposure on appendicitis admissions: Evidence from one of the most polluted cities in mainland China

BACKGROUND: Emerging evidence indicates that air pollutants contribute to the development and progression of gastrointestinal diseases. However, there is scarce evidence of an association with appendicitis in mainland China. METHODS: In this study, Linfen city, one of the most polluted cities in mainland China, was selected as the study site to explore whether air pollutants could affect appendicitis admissions and to identify susceptible populations. Daily data on appendicitis admissions and three principal air pollutants, including inhalable particulate matter (PM(10)), nitrogen dioxide (NO(2)), and sulfur dioxide (SO(2)) were collected in Linfen, China. The impacts of air pollutants on appendicitis were studied by using a generalized additive model (GAM) combined with the quasi-Poisson function. Stratified analyses were also performed by sex, age, and season. RESULTS: We observed a positive association between air pollution and appendicitis admissions. For a 10 μg/m(3) increase in pollutants at lag01, the corresponding relative risks (RRs) and 95% confidence intervals (95% CIs) were 1.0179 (1.0129–1.0230) for PM(10), 1.0236 (1.0184–1.0288) for SO(2), and 1.0979 (1.0704–1.1262) for NO(2). Males and people aged 21–39 years were more susceptible to air pollutants. Regarding seasons, the effects seemed to be stronger during the cold season, but there was no statistically significant difference between the seasonal groups. CONCLUSIONS: Our findings indicated that short-term air pollution exposure was significantly correlated with appendicitis admissions, and active air pollution interventions should be implemented to reduce appendicitis hospitalizations, especially for males and people aged 21–39 years.