Air pollution and respiratory hospital admissions in Shiraz, Iran, 2009 to 2015

Abstract Air pollution has been identified as one of the most challenging health issues in urban areas worldwide. The aim of this study was to investigate the association between short-term exposure to ambient air pollution and respiratory disease over a long-term period in Shiraz, one of the largest cities in Iran. Methods: hospital admissions due to respiratory diseases (asthma, pneumonia, chronic obstructive pulmonary disease (COPD) and pleural effusion) in residents of Shiraz between March 21, 2009 and March 20, 2015 were included. Demographics for each patient and meta data to include principal meteorological variables (temperature and relative humidity) and five ambient pollutants (CO, O 3 , SO 2 , NO 2 , and PM 10 ) were also included. Statistical analysis was performed by Poisson regression in single-pollutant generalized linear model with principal component analysis (GLPCA) to analyze the relationship between pollutants and hospital admissions at the 0–9 cumulative lag day period. Pearson correlation test was used to determine the relationship between different pollutants, temperature and humidity. Results It was found that the highest increase in asthma admission was related to PM 10 (relative risk (RR) = 1.31, 95% CI = 1.17, 1.47). For COPD, the rate of hospital visits significantly increased with the increase in NO 2 concentration (RR = 1.17, 95% CI = 1.09.1.27). In the children's hospital, O 3 (RR = 1.25, 95% CI = 1.06, 1.47) and SO 2 (RR = 1.17, 95% CI = 1.07, 1.28) affected the asthma admissions and all contaminants (highest RR observed was for NO 2 (RR = 1.28 95% CI = 1.18, 1.40) affected pneumonia admissions on cumulative lag days of 0–9. Conclusions: These data confirm an association between ambient air pollutants and hospital admissions due to respiratory disease.