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The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China

Department of Statistics, University of California, Berkeley, CA 94720, USA
Department of Industrial Engineering and Management, Peking University, Beijing 100871, China
IBM Research China, Beijing 100193, China
Shenzhen Center for Disease Control and Prevention, Shenzhen 518073, China
Medical Information Center of Shenzhen Municipality, Shenzhen 518055, China
Authors to whom correspondence should be addressed.
These authors contributed equally in this work and they are co-first authors.
Int. J. Environ. Res. Public Health 2018, 15(2), 178;
Received: 18 November 2017 / Revised: 18 December 2017 / Accepted: 17 January 2018 / Published: 23 January 2018
(This article belongs to the Special Issue Ambient Air Pollution and Health Vulnerability)
PDF [437 KB, uploaded 23 January 2018]


Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to analyze associations between six air pollutants (namely SO2, CO, NO2, O3, PM10, and PM2.5) and daily outpatient and inpatient visits after adjusting confounding meteorological factors, time and day of the week effects. Significant associations between air pollutants and two types of hospital visits were observed. The estimated increase in overall outpatient visits associated with each 10 µg/m3 increase in air pollutant concentration ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average). Our results also suggested a heterogeneity of the health effects across different outcomes and in different populations. The findings in present study indicate that even in Shenzhen, a less polluted area in China, significant associations exist between air pollution and daily number of overall outpatient and inpatient visits. View Full-Text
Keywords: air pollution; health effects; time series analysis; generalized additive model air pollution; health effects; time series analysis; generalized additive model

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Liu, Y.; Chen, S.; Xu, J.; Liu, X.; Wu, Y.; Zhou, L.; Cheng, J.; Ma, H.; Zheng, J.; Lin, D.; Zhang, L.; Chen, L. The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China. Int. J. Environ. Res. Public Health 2018, 15, 178.

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