Short-term associations between particulate matter air pollution and hospital admissions through the emergency room for urinary system disease in Beijing, China: A time-series study.

Evidence on the relationship between particulate matter air pollution and urinary system disease (UD) is scarce. This study aims to evaluate the associations between short-term exposures to PM _2.5 and PM ₁₀ and risk of daily UD inpatient hospital admissions through the emergency room (ER-admissions) in Beijing. We obtained 41,203 weekday UD ER-admissions for secondary and tertiary hospitals in all 16 districts in Beijing during 2013-2018 from the Beijing Municipal Health Commission Information Center and obtained district-level air pollution concentrations based on 35 fixed monitoring stations in Beijing. We conducted a two-stage time-series analysis, with district-specific generalized linear models for each of Beijing's 16 districts, followed by random effects meta-analysis to obtain pooled risk estimates. We evaluated lagged and cumulative associations up to 30 days. In single-pollutant models, for both PM _2.5 and PM ₁₀ , cumulative exposure averaged over the day of admission and the previous 10 days (lag 0-10 days) showed the strongest association, with per interquartile range increases of PM _2.5 or PM ₁₀ concentrations associated with a 7.5 % (95 % confidence interval [CI]: 3.0 %-12.2 %) or 6.0 % (95 % CI: 1.1 %-11.2 %) increased risk of daily UD hospital admissions, respectively. The risk estimates were robust to adjustment for co-pollutants and to a variety of sensitivity analyses. However, due to the strong correlation between PM _2.5 and PM ₁₀ concentrations, we were unable to disentangle the respective relationships between these two exposures and UD risk. In this study, we found that short-term exposures to PM _2.5 and PM ₁₀ are risk factors for UD morbidity and that cumulative exposure to PM pollution over a period of one to two weeks (i.e., 11 days) could be more important for UD risk than transient exposure during each of the respective single days.
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