The effect of nitrogen dioxide and atmospheric pressure on hospitalization risk for Chronic Obstructive Pulmonary Disease in Guangzhou, China

Background The relationship between air pollution and meteorological factors on diseases has become a research hotspot recently. Nevertheless, few studies have touched the inferences of nitrogen dioxide (NO2) and atmospheric pressure (AP) on hospitalization risk for chronic obstructive pulmonary disease (COPD). Objectives To investigate the short-term impact of particulate air pollutants and meteorology factors on hospitalizations for COPD and quantify the corresponding risk burden of hospital admission. Methods In our study, COPD cases were collected from Guangzhou Panyu Central Hospital (n = 11,979) from Dec of 2013 to Jun 2019. The 24-hour average temperature, relative humidity (RH), wind speed (V), AP and other meteorological data were obtained from Guangzhou Meteorological Bureau. Air pollution data were collected from Guangzhou Air Monitoring Station. The influence of different NO2 and AP values on COPD risk was quantified by a distributed lag nonlinear model (DLNM) combined with Poisson Regression and Time Series analysis. Results We found that NO2 had a non-linear relationship with the incidence of COPD, with an approximate "M" type, appearing at the peaks of 126μg/m³ (RR=1.32, 95%CI, 1.07 to 1.64) and 168μg/m³ (RR=1.21, 95%CI, 0.94 to 1.55), respectively. And the association between AP and COPD incidence exhibited an approximate J-shape with a peak occurring at 1035pa (RR=1.16, 95% CI, 1.02 to 1.31). Conclusions The nonlinear relationship of NO2 and AP on COPD admission risk in different periods of lag can be used to establish an early warning system for diseases and reduce the possible outbreaks and burdens of COPD in a sensitive population.