Investigating the impact of air pollution on AMI and COPD hospital admissions in the coastal city of Qingdao, China

Air pollution has been widely associated with adverse effects on the respiratory and cardiovascular systems. We investigated the relationship between acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD) and air pollution exposure in the coastal city of Qingdao, China. Air pollution in this region is characterized by inland and oceanic transportation sources in addition to local emission. We examined the influence of PM2.5, PM10, NO2, SO2, CO and O-3 concentrations on hospital admissions for AMI and COPD from October 1, 2014, to September 30, 2018, in Qingdao using a Poisson generalized additive model (GAM). We found that PM2.5, PM10, NO2, SO2 and CO exhibited a significant short-term (lag 1 day) association with AMI in the single-pollutant model among older adults (>65 years old) and females, especially during the cold season (October to March). In contrast, only NO2 and SO2 had clear cumulative lag associations with COPD admission for females and those over 65 years old at lag 01 and lag 03, respectively. In the two-pollutant model, the exposure-response relationship fitted by the two-pollutant model did not change significantly. Our findings indicated that there is an inflection point between the concentration of certain air pollutants and the hospital admissions of AMI and COPD even under the linear assumption, indicative of the benefits of reducing air pollution vary with pollution levels. This study has important implications for the development of policy for air pollution control in Qingdao and the public health benefits of reducing air pollution levels.