Impact of Air Pollutants on Outpatient Visits for Acute Respiratory Outcomes

The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as air pollutant data including ozone (O(3)), nitrogen dioxide (NO(2)), carbon monoxide (CO), sulfur dioxide (SO(2)), and particulate matter (PM(2.5) and PM(10)). We screened six categories of acute respiratory outcomes and analyzed their associations with different air pollutant exposures, including upper respiratory tract infection (URTI), acute bronchitis (AB), community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), acute exacerbation of asthma (AE-asthma), and acute exacerbation of bronchiectasis (AEBX). A case-crossover design with a bidirectional control sampling approach was used for statistical analysis. A total of 57,144 patients were enrolled for analysis. PM(2.5), PM(10), NO(2), SO(2), and CO exposures were positively associated with outpatient visits for URTI, AB, CAP, and AEBX. PM(10), SO(2), and CO exposures were positively associated with outpatient visits for AECOPD. Exposure to O(3) was positively associated with outpatient visits for AE-asthma, but negatively associated with outpatient visits for URTI, CAP, and AEBX. In conclusion, air pollutants had acute effects on outpatient visits for acute respiratory outcomes, with specific outcomes associated with specific pollutants.