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The association between fine particulate matter (PM2.5) and rheumatoid arthritis (RA) is currently unclear, especially in Beijing, a city with severe air pollution. Our study aimed to explore the relationship between short-term outdoor exposure to PM2.5 and RA outpatient visits using a time-series analysis in Beijing. We used the Beijing's Medical Claims for Employees database to identify patients with RA in 2010–2012. A generalized additive model with a Poisson link was used to estimate the percentage change in RA outpatient visits after the PM2.5 concentration increased by 10 μg/m3. From January 1, 2010, to June 30, 2012, a total of 541,061 RA outpatient visits were identified. During the study period, the average daily (standard deviation) concentration of PM2.5 was 99.5 (75.3) µg/m3. A 10 µg/m3 increase in PM2.5 concentration was correlated with a 0.21% (95% CI, 0.18–0.23%) increase in outpatient visits for RA on the same day. A significant association for the cumulative effect of PM2.5 was found, and the largest significant association was observed for a lag of 0–3 days (0.26%; 95% CI, 0.23–0.29%). Stratified analyses revealed that females (0.29%, 95% CI: 0.26–0.33%) and 18–65 years old patients (0.29%, 95% CI: 0.25–0.32%) were most susceptible to the effects of PM2.5 exposure. The current findings showed that short-term exposure to PM2.5 was followed by an increase in the number of outpatient visits for RA in Beijing. Future studies should investigate the mechanisms underlying this association. [ABSTRACT FROM AUTHOR]

Introduction: Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. The 2015 Beijing tobacco control policy package incorporating all six components of MPOWER has been implemented since Jun 2015. The present study aimed to evaluate the impact of a comprehensive tobacco control policy package on hospital admissions for chronic obstructive pulmonary disease (COPD) in Beijing, China.Aims and Methods: An interrupted time-series study was conducted based on the hospital admission information for about 18 million residents, who were covered by the Beijing Medical Claim Data for Employees from January 2013 to June 2017. The average percentage change of COPD hospital admission rates and reductions in hospital admission numbers were estimated by segmented Poisson regression models.Results: There were 54 040 COPD hospital admissions with a crude rate of 67.2 per 100 000 residents during the observational period. After the implementation of the policy package, the hospital admission rates of COPD were reduced by -14.7% (95%CI: -17.8%, -11.5%) immediately. The secular trend was slowed down by -3.0% (95% CI: -5.6%, -0.4%) annually. A total of 5 581 reductions in COPD hospital admissions were estimated during the 25 months post-law period, accounting for 17.5% (95% CI: 12.5%, 22.5%) of overall COPD hospital admissions. More reductions were shown in males and those aged over 65 years old.Conclusions: The results indicated significant protections against hospitalization of COPD after the 2015 Beijing comprehensive tobacco control policy package. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures.Implications: Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. Based on medical records for about 18 million residents, this study showed an association between comprehensive tobacco control policies and significant reductions of hospital admissions for chronic obstructive pulmonary disease. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures. [ABSTRACT FROM AUTHOR]

Little is known about the influence of ambient fine particulate matter (PM2.5) on the incidence of venous thromboembolism in areas with heavy air pollution. We examined seasonal associations between airborne concentrations of fine particulate matter and outpatient visits for venous thromboembolism in Beijing using a city-wide time-series design that covered a period of 30 months (January 1, 2010 to June 30, 2012). Generalized additive models were used to investigate the associations with adjustment of temperature for various time lags (lag 0 for the warm season and lag 0–10 for the cold season). Overall, 92,435 outpatient visits were recorded by the Beijing Medical Claim Data for Employees database during the study period. We found a significant association between PM2.5 levels and outpatient visits for venous thromboembolism. A 10-μg/m3 increase in PM2.5 concentrations on lag days 0–2 corresponded to a 0.64% (95% confidence interval: 0.55–0.73%; P < 0.001) increase in outpatient visits for venous thromboembolism during the cold season, and a 10-μg/m3 increase in PM2.5 concentrations on lag days 0–3 corresponded to a 0.82% (95% confidence interval: 0.67–0.96%; P < 0.001) increase in outpatient visits for venous thromboembolism during the warm season. Our findings suggest that PM2.5 exposure is associated with outpatient visits for venous thromboembolism in Beijing, and a more pronounced association was observed during the warm season. We propose that various temperature-adjustment strategies should be used when investigating seasonal associations. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence showed metformin may have pleiotropic effects on ameliorating depression. However, whether metformin was associated with decreased risk of depression remains unclear.Methods: A historical cohort study was conducted based on a medical claim database from 2010 to 2017 in Beijing, China. Patients newly diagnosed with T2D were classified into the metformin and non-metformin groups according to their initial antidiabetic prescription. The incidences of depression between the groups were compared using Cox proportional regression model.Results: There were 193,624 (37.4 %) and 323,930 (62.6 %) T2D patients in the metformin and non-metformin groups. The mean age was 54.9 (SD: 13.1) years and 53.9% were females. With a median follow-up of 3.2 years, 64,963 patients developed depression. The adjusted incidence of depression in the metformin group (30.6, 95 % CI: 30.1, 31.0 per 1000 person-years) was significantly lower than in the non-metformin group (39.6, 95 % CI: 39.3, 40.0 per 1000 person-years, P < 0.001). The metformin group was significantly associated with a lower risk of depression compared with the overall non-metformin group (HR: 0.77, 95% CI: 0.75, 0.78), as well as compared with α-glucosidase inhibitors (HR: 0.73, 95 % CI: 0.71, 0.74), sulfonylureas (HR: 0.84, 95 % CI: 0.82, 0.86), and glinides (HR: 0.85, 95 % CI: 0.82, 0.88), except for thiazolidinediones (HR: 0.96, 95 % CI: 0.91, 1.01). The association between metformin and lower depression risk was significant in all the age and sex subgroups.Conclusions: Metformin was associated with a lower risk of depression compared with other oral hypoglycemic agents, indicating a potential pleiotropic effect on depression. [ABSTRACT FROM AUTHOR]

Environmental factors play an important role in the development of ulcerative colitis (UC). However, only few studies have examined the effects of air pollution on UC occurrence. We conducted a time–series analysis to explore the association between short-term exposure to fine particulate matter (PM 2.5) and outpatient visits for UC in Beijing, China. In total, 84,000 outpatient visits for UC were retrieved from the Beijing Medical Claim Data for Employees between January 1, 2010 and June 30, 2012. Measurements of daily PM 2.5 concentrations were obtained from the United States Embassy air-monitoring station. A generalized additive model with quasi-Poisson link was applied to examine the association between PM 2.5 concentrations and outpatient visits for UC stratified by sex, age, and season. We found that short-term exposure to PM 2.5 was significantly associated with increased daily outpatient visits for UC at lag 0 day. A 10 μg/m3 increase in PM 2.5 concentration at lag 0 day corresponded to a 0.32% increase in outpatient visits for UC (95% confidence interval (CI), 0.05–0.58%; P = 0.019). There was a clear concentration–response association between daily outpatient visits for UC and PM 2.5 concentrations. The PM 2.5 effects were significant across all sex and season subgroups, without evidence of effect modification by sex (P = 0.942) or season (P = 0.399). The association was positive in patients younger than 65 years old but negative in those 65 years old or older, although the difference was not significant (P = 0.883). In conclusion, our study demonstrated that short-term exposure to ambient PM 2.5 was significantly associated with an increased risk of daily outpatient visits for UC, especially in younger people. Additional studies are warranted to confirm our findings. • Significant associations were found between PM 2.5 and outpatient visits for UC. • There was a clear concentration–response association between the above two. • The PM 2.5 effect was positive in the cool season but negative in the warm season. [ABSTRACT FROM AUTHOR]

Previous studies have reported conflicting results on the relationship between ambient fine particulate matter (PM 2.5) and pneumonia in adults. This study was designed to conduct a time-series study to investigate the short-term association between ambient PM 2.5 concentrations and hospitalization for pneumonia in Beijing adults. Hospitalization data were obtained from the Beijing Medical Claim Data for Employees database. A generalized additive model with a Poisson link was applied to assess the relationship between PM 2.5 and pneumonia. In total, 37,552 adult hospital admissions for pneumonia were identified between January 1, 2010, and June 30, 2012. High levels of PM 2.5 were significantly associated with increased hospitalizations for pneumonia. A 10-μg/m3 increase in PM 2.5 concentrations on lag days 0–2 was associated with a 0.79% (95% confidence interval: 0.69%–0.90%) increase in hospitalizations for pneumonia. Patients aged ≥65 years were more sensitive to the adverse effects (0.89%, 95% confidence interval: 0.80%–0.98% in patients ≥65 years old; 0.52%, 95% confidence interval: 0.34%–0.70% in patients 18–64 years old; P = 0.033). But the difference of estimates was not significant between sex (0.92%, 95% confidence interval: 0.85%–0.99% in female; 0.76%, 95% confidence interval: 0.62%–0.89% in male; P = 0.781) and season (0.98%, 95% confidence interval: 0.85%–1.10% in cool season; 0.44%, 95% confidence interval: 0.22%–0.67% in warm season; P = 0.529). Short-term exposure to PM 2.5 was associated with increased risk of hospitalization for pneumonia in adults. Our findings add new evidence on the effect of air pollution on pneumonia and may promote prevention and intervention strategies. • Significant associations were found between air pollution and hospitalization for pneumonia. • There was a clear concentration-response association between PM 2.5 and pneumonia risk. • The PM 2.5 effect estimates were greater in people aged ≥65 years. • This study provides evidence in areas with higher levels of PM 2.5. [ABSTRACT FROM AUTHOR]