AUTHOR=Ju Xu , Yimaer Wumitijiang , Du Zhicheng , Wang Xinran , Cai Huanle , Chen Shirui , Zhang Yuqin , Wu Gonghua , Wu Wenjing , Lin Xiao , Wang Ying , Jiang Jie , Hu Weihua , Zhang Wangjian , Hao Yuantao 

TITLE=The impact of monthly air pollution exposure and its interaction with individual factors: Insight from a large cohort study of comprehensive hospitalizations in Guangzhou area

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1137196

DOI=10.3389/fpubh.2023.1137196

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p>Although the association between short-term air pollution exposure and certain hospitalizations has been well documented, evidence on the effect of longer-term (e. g., monthly) air pollution on a comprehensive set of outcomes is still limited.</p></sec><sec><title>Method</title><p>A total of 68,416 people in South China were enrolled and followed up during 2019–2020. Monthly air pollution level was estimated using a validated ordinary Kriging method and assigned to individuals. Time-dependent Cox models were developed to estimate the relationship between monthly PM<sub>10</sub> and O<sub>3</sub> exposures and the all-cause and cause-specific hospitalizations after adjusting for confounders. The interaction between air pollution and individual factors was also investigated.</p></sec><sec><title>Results</title><p>Overall, each 10 μg/m<sup>3</sup> increase in PM<sub>10</sub> concentration was associated with a 3.1% (95%<italic>CI</italic>: 1.3%−4.9%) increment in the risk of all-cause hospitalization. The estimate was even greater following O<sub>3</sub> exposure (6.8%, 5.5%−8.2%). Furthermore, each 10 μg/m<sup>3</sup> increase in PM<sub>10</sub> was associated with a 2.3%-9.1% elevation in all the cause-specific hospitalizations except for those related to respiratory and digestive diseases. The same increment in O<sub>3</sub> was relevant to a 4.7%−22.8% elevation in the risk except for respiratory diseases. Additionally, the older individuals tended to be more vulnerable to PM<sub>10</sub> exposure (<italic>P</italic><sub>interaction</sub>: 0.002), while the alcohol abused and those with an abnormal BMI were more vulnerable to the impact of O<sub>3</sub> (<italic>P</italic><sub>interaction</sub>: 0.052 and 0.011). However, the heavy smokers were less vulnerable to O<sub>3</sub> exposure (<italic>P</italic><sub>interaction</sub>: 0.032).</p></sec><sec><title>Conclusion</title><p>We provide comprehensive evidence on the hospitalization hazard of monthly PM<sub>10</sub> and O<sub>3</sub> exposure and their interaction with individual factors.</p></sec>