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Open AccessArticle

The Burden of COPD Morbidity Attributable to the Interaction between Ambient Air Pollution and Temperature in Chengdu, China

1
Health Big Data Research Institute, Big Data Research Center, University of Electronic Science and Technology of China, Chengdu 611731, China
2
Health and Family Planning Information Center of Sichuan Province, Chengdu 610041, China
3
Sichuan Health Information Association, Chengdu 610041, China
4
School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing 100044, China
5
School of Economics and Management, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
6
Department of Statistics, The Pennsylvania State University, University Park, PA 16802-2111, USA
7
Chengdu Shulianyikang Technology Co., Ltd., Chengdu 610041, China
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2018, 15(3), 492; https://doi.org/10.3390/ijerph15030492
Received: 24 January 2018 / Revised: 2 March 2018 / Accepted: 8 March 2018 / Published: 11 March 2018
(This article belongs to the Special Issue Climate Change, Extreme Temperatures, Air Pollution, and Health)
Evidence on the burden of chronic obstructive pulmonary disease (COPD) morbidity attributable to the interaction between ambient air pollution and temperature has been limited. This study aimed to examine the modification effect of temperature on the association of ambient air pollutants (including particulate matter (PM) with aerodynamic diameter <10 μm (PM10) and <2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3)) with risk of hospital admissions (HAs) for COPD, as well as the associated morbidity burden in urban areas of Chengdu, China, from 2015 to 2016. Based on the generalized additive model (GAM) with quasi-Poisson link, bivariate response surface model and stratification parametric model were developed to investigate the potential interactions between ambient air pollution and temperature on COPD HAs. We found consistent interactions between ambient air pollutants (PM2.5, PM10 and SO2) and low temperature on COPD HAs, demonstrated by the stronger associations between ambient air pollutants and COPD HAs at low temperatures than at moderate temperatures. Subgroup analyses showed that the elderly (≥80 years) and males were more vulnerable to this interaction. The joint effect of PM and low temperature had the greatest impact on COPD morbidity burden. Using WHO air quality guidelines as reference concentration, about 17.30% (95% CI: 12.39%, 22.19%) and 14.72% (95% CI: 10.38%, 19.06%) of COPD HAs were attributable to PM2.5 and PM10 exposures on low temperature days, respectively. Our findings suggested that low temperature significantly enhanced the effects of PM and SO2 on COPD HAs in urban Chengdu, resulting in increased morbidity burden. This evidence has important implications for developing interventions to reduce the risk effect of COPD morbidity. View Full-Text
Keywords: air pollution; temperature; COPD; interaction; hospital admissions air pollution; temperature; COPD; interaction; hospital admissions
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MDPI and ACS Style

Qiu, H.; Tan, K.; Long, F.; Wang, L.; Yu, H.; Deng, R.; Long, H.; Zhang, Y.; Pan, J. The Burden of COPD Morbidity Attributable to the Interaction between Ambient Air Pollution and Temperature in Chengdu, China. Int. J. Environ. Res. Public Health 2018, 15, 492.

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