title: Fine Particulate Air Pollution and Hospital Emergency Room Visits for Respiratory Disease in Urban Areas in Beijing, China, in 2013.
abstract: BACKGROUND
  Heavy fine particulate matter (PM2.5) air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing.
  
  
  METHODS
  Daily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender.
  
  
  RESULTS
  A total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM2.5 concentration was 102.1±73.6 μg/m3. Every 10 μg/m3 increase in PM2.5 concentration at lag0 was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%). The strongest association was identified between AECOPD and PM2.5 concentration at lag0-3 (3.15%, 95%CI: 1.39%-4.91%). The estimated effects were robust after adjusting for SO2, O3, CO and NO2. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM2.5 exposure.
  
  
  CONCLUSIONS
  PM2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM2.5 pollution varied by gender and age.
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.|Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.affiliation: Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Huang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Tao
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.|School of Medical Sciences, Edith Cowan University, Perth, WA, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.|Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000068476:Beijing; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis*; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology*; D012737:Sex Factors; D014506:Urban Renewal; D055815:Young Adult
chemical_list: D052638:Particulate Matter