Effect of Short-Term Exposure to Air Pollutants on Hospital Admissions for End-Stage Renal Disease Patients Undergoing Hemodialysis

CHEN Yilong; HU Yao; ZHAN Yu; SUN Yajing; LI Chunyang; GU Yonghong; ZENG Xiaoxi

doi:10.12182/20231160504

Volume 54 Issue 6

Dec. 2023

Turn off MathJax

Article Contents

Abstract

References

JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES) > 2023 > 54(6): 1176-1183. > DOI: 10.12182/20231160504

CHEN Yilong, HU Yao, ZHAN Yu, et al. Effect of Short-Term Exposure to Air Pollutants on Hospital Admissions for End-Stage Renal Disease Patients Undergoing Hemodialysis[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(6): 1176-1183. DOI: 10.12182/20231160504

Citation:

PDF (1054 KB)

Effect of Short-Term Exposure to Air Pollutants on Hospital Admissions for End-Stage Renal Disease Patients Undergoing Hemodialysis

CHEN Yilong^{1, 2,},
HU Yao^{1, 2},
ZHAN Yu³,
SUN Yajing^{1, 2},
LI Chunyang^{1, 2},
GU Yonghong^{1, 2},
ZENG Xiaoxi^{1, 2, ,}

1.
Department of Nephrology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
2.
Med-X Center for Informatics, Sichuan University, Chengdu 610041, China
3.
Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu 610065, China

More Information

Corresponding author:
ZENG Xiaoxi, E-mail: zengxiaoxi@wchscu.cn
Received Date: June 12, 2023
Revised Date: November 07, 2023
Available Online: December 19, 2023
Published Date: December 24, 2023

Abstract

Abstract

Objective To evaluate the association between short-term exposure to air pollutants of end-stage renal disease (ESRD) patients on maintenance hemodialysis and the number of daily hospital admissions.
Methods The data on hospitalizations were obtained from the database of the municipal Urban Employees' Basic Medical Insurance and Urban Residents' Basic Medical Insurance of a city in Southwest China. Single and multiple pollutant generalized additive models were utilized to estimate the effect of air pollutants (CO, NO₂, O₃, PM₁₀, PM_2.5, and SO₂) on patient admissions after the lag time of different numbers of days. In addition, subgroup analyses stratified by sex, age, PM_2.5 and PM₁₀ concentration thresholds, seasonality, and comorbidity status for cardiovascular diseases and hypertension were conducted.
Results In the single pollutant models, the pollutants significantly associated with patient admissions and the corresponding lag time of the strongest association were as follows, every time CO increased by 0.1 mg/m³, there was a 2.39% increase (95% confidence interval [CI]: 0.96%-3.83%) in patient admissions after 7 days of lag time; every time NO₂, O₃, PM_2.5, PM₁₀, and SO₂ increased by 10 μg/m³, patient admissions increased by 4.02% (95% CI: 1.21%-6.91%) after 7 days of lag time, 3.57% (95% CI: 0.78%-6.44%) after 0-4 days of lag time, 2.00% (95% CI: 1.07%-2.93%) after 6 days of lag time, 1.19% (95% CI: 0.51%-1.88%) after 7 days of lag time, and 8.37% (95% CI: 3.08%-13.93%) after 7 days of lag time, respectively. In the multiple pollutant model, every time O₃ and PM_2.5 increased by 10 μg/m³, there was an increase of 3.18% (95% CI: 0.34%-6.09%) in daily patient admissions after 0-4 days of lag time and an increase of 1.85% (95% CI: 0.44%-3.28%) after 7 days of lag time. Furthermore, subgroup analyses showed that seasonality, the severity of air pollution, and patients' comorbidities might be the effect modifiers for the association between ambient air pollution and hospital admissions in ESRD patients receiving maintenance hemodialysis.
Conclusion Air pollution is closely associated with hospital admissions in ESRD patients undergoing maintenance hemodialysis and the strength of this association varies according to seasonality, the severity of air pollution, and patients’ status of comorbidities.
- Air pollution,
- Admission,
- Hemodialysis,
- End-stage renal disease,
- Association

FullText(HTML)

References (30)

References

[1]	HEMMELGARN B R, MANNS B J, LLOYD A, et al. Relation between kidney function, proteinuria, and adverse outcomes. JAMA,2010,303(5): 423–429. DOI: 10.1001/jama.2010.39
[2]	VANHOLDER R, ANNEMANS L, BROWN E, et al. Reducing the costs of chronic kidney disease while delivering quality health care: a call to action. Nat Rev Nephrol,2017,13(7): 393–409. DOI: 10.1038/nrneph.2017.63
[3]	SARAN R, ROBINSON B, ABBOTT K. US Renal Data System 2018 Annual Data Report: epidemiology of kidney disease in the United States. Am J Kidney Dis,2019,73(3 Suppl 1): A7–A8. DOI: 10.1053/j.ajkd.2019.01.001
[4]	LI P K, LUI S L, NG J K, et al. Addressing the burden of dialysis around the world: a summary of the roundtable discussion on dialysis economics at the First International Congress of Chinese Nephrologists 2015. Nephrology,2017,22(Suppl 4): 3–8. DOI: 10.1111/nep.13143
[5]	LIU X, KONG D, LIU Y, et al. Effects of the short-term exposure to ambient air pollution on atrial fibrillation. Pacing Clin Electrophysiol,2018,41(11): 1441–1446. DOI: 10.1111/pace.13500
[6]	SUN S, STEWART J D, ELIOT M N, et al. Short-term exposure to air pollution and incidence of stroke in the Women's Health Initiative. Enviro Int,2019,132: 105065. DOI: 10.1016/j.envint.2019.105065
[7]	ZHANG W, LIN S, HOPKE P K, et al. Triggering of cardiovascular hospital admissions by fine particle concentrations in New York state: Before, during, and after implementation of multiple environmental policies and a recession. Environ Pollut,2018,242(Pt B): 1404–1416. DOI: 10.1016/j.envpol.2018.08.030
[8]	DOMINICI F, PENG R D, BELL M L, et al. Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA,2006,295(10): 1127–1134. DOI: 10.1001/jama.295.10.1127
[9]	CULQUI D R, LINARES C, ORTIZ C, et al. Association between environmental factors and emergency hospital admissions due to Alzheimer's disease in Madrid. Sci Total Environ,2017,592: 451–457. DOI: 10.1016/j.scitotenv.2017.03.089
[10]	WYATT L H, XI Y, KSHIRSAGAR A, et al. Association of short-term exposure to ambient PM2.5 with hospital admissions and 30-day readmissions in end-stage renal disease patients: population-based retrospective cohort study. BMJ Open,2020,10(12): e041177. DOI: 10.1136/bmjopen-2020-041177
[11]	WHO Regional Office for Europe. Review of evidence on health aspects of air pollution--REVIHAAP Project: technical report. Copenhagen: WHO Regional Office for Europe; 2013: 301.
[12]	YONG Z, LUO L, GU Y, et al. Bayesian comorbidity network and cost analysis for asthma. IEEE J Biomed Health Inform,2022,26(9): 4714–4724. DOI: 10.1109/JBHI.2022.3182368
[13]	ZENG S, LUO L, CHEN F, et al. Association of outdoor air pollution with the medical expense of ischemic stroke: the case study of an industrial city in western China. Int J Health Plann Manage,2021,36(3): 715–728. DOI: 10.1002/hpm.3115
[14]	YONG Z, LUO L, GU Y, et al. Implication of excessive length of stay of asthma patient with heterogenous status attributed to air pollution. J Environ Health Sci Eng,2021,19(1): 95–106. DOI: 10.1007/s40201-020-00584-8
[15]	KO F W, TAM W, WONG T W, et al. Effects of air pollution on asthma hospitalization rates in different age groups in Hong Kong. Clin Exp Allergy,2007,37(9): 1312–1319. DOI: 10.1111/j.1365-2222.2007.02791.x
[16]	CAI J, ZHAO A, ZHAO J, et al. Acute effects of air pollution on asthma hospitalization in Shanghai, China. Environ Pollut,2014,191: 139–144. DOI: 10.1016/j.envpol.2014.04.028
[17]	PASCAL M, FALQ G, WAGNER V, et al. Short-term impacts of particulate matter (PM10, PM10–2. 5, PM2.5) on mortality in nine French cities. Atmospheric Environment,2014,95: 175–184. DOI: 10.1016/j.atmosenv.2014.06.030
[18]	KLOT S V, ZANOBETTI A, SCHWARTZ J. Influenza epidemics, seasonality, and the effects of cold weather on cardiac mortality. Environ Health,2012,11: 74. DOI: 10.1186/1476-069X-11-74
[19]	WHO. Influenza (Seasonal). https://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal) (2018).
[20]	Ministry of Environmental Protection AoQSaIQ. Ambient air quality standards (GB3095-2012), http://english.mee.gov.cn/Resources/standards/Air_Environment/quality_standard1/201605/W020160511506615956495.pdf (2012, accessed August 28 2019).
[21]	ELIXHAUSER A, STEINER C, HARRIS D R, et al. Comorbidity measures for use with administrative data. Medical Care,1998,36(1): 8–27. DOI: 10.1097/00005650-199801000-00004
[22]	ALTMAN D G, BLAND J M. Interaction revisited: the difference between two estimates. BMJ,2003,326(7382): 219. DOI: 10.1136/bmj.326.7382.219
[23]	YANG Y R, CHEN Y M, CHEN S Y, et al. Associations between long-term particulate matter exposure and adult renal function in the Taipei metropolis. Environ Health Perspect,2017,125(4): 602–607. DOI: 10.1289/EHP302
[24]	LIN J H, YEN T H, WENG C H, et al. Environmental NO₂ level is associated with 2-year mortality in patients undergoing peritoneal dialysis. Medicine (Baltimore),2015,94(1): e368. DOI: 10.1097/MD.0000000000000368
[25]	XU X, WANG G, CHEN N, et al. Long-term exposure to air pollution and increased risk of membranous nephropathy in China. J Am Soc Nephrol,2016,27(12): 3739–3746. DOI: 10.1681/ASN.2016010093
[26]	SONG J, LU M, LU J, et al. Acute effect of ambient air pollution on hospitalization in patients with hypertension: a time-series study in Shijiazhuang, China. Ecotoxicol Environ Saf,2019,170: 286–292. DOI: 10.1016/j.ecoenv.2018.11.125
[27]	LU P, ZHANG Y, LIN J, et al. Multi-city study on air pollution and hospital outpatient visits for asthma in China. Environ Pollut,2020,257: 113638. DOI: 10.1016/j.envpol.2019.113638
[28]	RAJI H, RIAHI A, BORSI S H, et al. Acute effects of air pollution on hospital admissions for asthma, COPD, and bronchiectasis in Ahvaz, Iran. Int J Chron Obstruct Pulmon Dis,2020,15: 501–514. DOI: 10.2147/COPD.S231317
[29]	XIA Y, NIU Y, CAI J, et al. Effects of personal short-term exposure to ambient ozone on blood pressure and vascular endothelial function: a mechanistic study based on DNA methylation and metabolomics. Environ Sci Technol,2018,52(21): 12774–12782. DOI: 10.1021/acs.est.8b03044
[30]	HAMANAKA R B, MUTLU G M. Particulate matter air pollution: effects on the cardiovascular system. Front Endocrinol (Lausanne),2018,9: 680. DOI: 10.3389/fendo.2018.00680

OPEN ACCESS This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (CC BY-NC 4.0). In other words, the full-text content of the journal is made freely available for third-party users to copy and redistribute in any medium or format, and to remix, transform, and build upon the content of the journal. You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may not use the content of the journal for commercial purposes. For more information about the license, visit https://creativecommons.org/licenses/by-nc/4.0

Relative Articles

Supplements (0)

Cited By

Get Citation

PDF

XML

Article views (1162) PDF downloads (20)

Effect of Short-Term Exposure to Air Pollutants on Hospital Admissions for End-Stage Renal Disease Patients Undergoing Hemodialysis

Abstract

References

Catalog

Export File

Citation

Format

Content