TY - JOUR
T1 - Ambient sulfur dioxide and hospital expenditures and length of hospital stay for respiratory diseases
T2 - A multicity study in China
AU - Cao, Dawei
AU - Zheng, Dashan
AU - Qian, Zhengmin (Min)
AU - Shen, Huiqing
AU - Liu, Yi
AU - Liu, Qiyong
AU - Sun, Jimin
AU - Zhang, Shiyu
AU - Jiao, Guangyuan
AU - Yang, Xiaoran
AU - Vaughn, Michael G.
AU - Wang, Chongjian
AU - Zhang, Xinri
AU - Lin, Hualiang
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Background: Ambient sulfur dioxide (SO2) has been associated with morbidity and mortality of respiratory diseases, however, its effect on length of hospital stays (LOS) and cost for these diagnoses remain unclear. Methods: We collected hospital admission information for respiratory diseases from all 11 cities in the Shanxi Province of China during 2017–2019. We assessed individual-level exposure by using an inverse distance weighting approach based on geocoded residential addresses. A generalized additive model was built to delineate city-specific effects of SO2 on hospitalization, hospital expenditure, and length of hospital stay for respiratory diseases. The overall effects were obtained by random-effects meta-analysis. We further estimated the respiratory burden attributable to SO2 by comparing different reference concentrations. Results: We observed significant effects of SO2 exposure on respiratory diseases. At the provincial level, each 10 μg/m3 increase in SO2 on lag03 was associated with a 0.63% (95% CI: 0.14–0.11) increase in hospital admission, an increase of 4.56 days (95% CI: 1.16–7.95) of hospital stay, and 3647.97 renminbi (RMB, Chinese money) (95% CI: 1091.05–6204.90) in hospital cost. We estimated about 6.13 (95% CI: 1.33–11.10) thousand hospital admissions, 65.77 million RMB (95% CI: 19.67–111.87) in hospital expenditure, and 82.13 (95% CI: 20.87–143.40) thousand days of hospital stay could have potentially been avoided had the daily SO2 concentrations been reduced to WHO's reference concentration (40 µg/m3). Variable values in correspondence with this reference concentration could reduce the hospital cost and LOS of each case by 52.67 RMB (95% CI: 15.75–89.59) and 0.07 days (95% CI: 0.02–0.117). Conclusion: This study provides evidence that short-term ambient SO2 exposure is an important risk factor of respiratory diseases, indicating that continually tightening policies to reduce SO2 levels could effectively reduce respiratory disease burden in Shanxi Province.
AB - Background: Ambient sulfur dioxide (SO2) has been associated with morbidity and mortality of respiratory diseases, however, its effect on length of hospital stays (LOS) and cost for these diagnoses remain unclear. Methods: We collected hospital admission information for respiratory diseases from all 11 cities in the Shanxi Province of China during 2017–2019. We assessed individual-level exposure by using an inverse distance weighting approach based on geocoded residential addresses. A generalized additive model was built to delineate city-specific effects of SO2 on hospitalization, hospital expenditure, and length of hospital stay for respiratory diseases. The overall effects were obtained by random-effects meta-analysis. We further estimated the respiratory burden attributable to SO2 by comparing different reference concentrations. Results: We observed significant effects of SO2 exposure on respiratory diseases. At the provincial level, each 10 μg/m3 increase in SO2 on lag03 was associated with a 0.63% (95% CI: 0.14–0.11) increase in hospital admission, an increase of 4.56 days (95% CI: 1.16–7.95) of hospital stay, and 3647.97 renminbi (RMB, Chinese money) (95% CI: 1091.05–6204.90) in hospital cost. We estimated about 6.13 (95% CI: 1.33–11.10) thousand hospital admissions, 65.77 million RMB (95% CI: 19.67–111.87) in hospital expenditure, and 82.13 (95% CI: 20.87–143.40) thousand days of hospital stay could have potentially been avoided had the daily SO2 concentrations been reduced to WHO's reference concentration (40 µg/m3). Variable values in correspondence with this reference concentration could reduce the hospital cost and LOS of each case by 52.67 RMB (95% CI: 15.75–89.59) and 0.07 days (95% CI: 0.02–0.117). Conclusion: This study provides evidence that short-term ambient SO2 exposure is an important risk factor of respiratory diseases, indicating that continually tightening policies to reduce SO2 levels could effectively reduce respiratory disease burden in Shanxi Province.
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U2 - 10.1016/j.ecoenv.2021.113082
DO - 10.1016/j.ecoenv.2021.113082
M3 - Article
C2 - 34929503
AN - SCOPUS:85121218047
SN - 0147-6513
VL - 229
JO - Ecotoxicology and Environmental Safety
JF - Ecotoxicology and Environmental Safety
M1 - 113082
ER -