Association Between Short‐Term Exposure to Air Pollutants and Emergency Attendance for Upper Gastrointestinal Bleeding in Hong Kong: A Time‐Series Study

• Published in: Geohealth 2024-11, Vol.8 (11), p.e2024GH001086-n/a
• Main Authors: Li, Yun hao, Tong Tan, Jing, Hwa Ooi, Poh, Jiang, Fang, Kan, Haidong, Leung, Wai K.
• Format: Article
• Language: English
• Subjects: Abrupt/Rapid Climate Change; Aerosols; Aerosols and Particles; Air pollution; Air/Sea Constituent Fluxes; Air/Sea Interactions; ambient air pollution; Atmosphere; Atmospheric; Atmospheric Composition and Structure; Atmospheric Effects; Atmospheric Processes; Avalanches; Benefit‐cost Analysis; Biogeosciences; Biosphere/Atmosphere Interactions; Climate and Interannual Variability; Climate Change and Variability; Climate Dynamics; Climate Impact; Climate Impacts; Climate Variability; Climatology; Cold season; Computational Geophysics; Coronaviruses; COVID-19; Cryosphere; Decadal Ocean Variability; Disaster Risk Analysis and Assessment; Disease; Earth System Modeling; Earthquake Ground Motions and Engineering Seismology; Effusive Volcanism; Emergency medical care; Evolution of the Atmosphere; Evolution of the Earth; Explosive Volcanism; Exposure; General Circulation; Geodesy and Gravity; Geological; Global Change; Global Change from Geodesy; Gravity and Isostasy; Holidays & special occasions; Humidity; Hydrological Cycles and Budgets; Hydrology; Impacts of Global Change; Inflammatory bowel disease; Informatics; Land/Atmosphere Interactions; Marine Geology and Geophysics; Marine Pollution; Mass Balance; Megacities and Urban Environment; Modeling; Monte Carlo simulation; Mud Volcanism; Natural Hazards; Nitrogen dioxide; Numerical Modeling; Numerical Solutions; Observatories; Ocean influence of Earth rotation; Ocean Monitoring with Geodetic Techniques; Ocean/Atmosphere Interactions; Ocean/Earth/atmosphere/hydrosphere/cryosphere interactions; Oceanic; Oceanography: Biological and Chemical; Oceanography: General; Oceanography: Physical; Oceans; Older people; Outdoor air quality; Paleoceanography; Pandemics; Particulate matter; Patients; Physical Modeling; Policy Sciences; Pollutants; Pollution: Urban and Regional; Pollution: Urban, Regional and Global; Radio Oceanography; Radio Science; Regional Climate Change; Regional Modeling; Review boards; Risk; Sea Level Change; Sea Level: Variations and Mean; Seasons; Seismology; Solid Earth; Surface Waves and Tides; Tectonophysics; Theoretical Modeling; time‐series study; Tsunamis and Storm Surges; Ulcers; upper gastrointestinal bleeding; Urban Systems; Volcanic Effects; Volcanic Hazards and Risks; Volcano Monitoring; Volcano Seismology; Volcano/Climate Interactions; Volcanology; Water Cycles; Wind
• ISSN: 2471-1403; 2471-1403
• DOI: 10.1029/2024GH001086

The relationship between exposure to ambient air pollutants and emergency attendance for upper gastrointestinal bleeding (UGIB) remains inconclusive. This study examines the association between short‐term exposure to various ambient pollutants and the risk of UGIB emergency attendance. Data on daily UGIB emergency attendance, ambient pollutants, and meteorological conditions in Hong Kong were collected from 2017 to 2022. A time‐series study using a distributed lag non‐linear model to analyze the data, considering lag days. Stratified analysis was performed based on sex, seasons, and the COVID‐19 pandemic period. The burden was quantified using attributable fraction (AF) and number (AN). The study included 31,577 UGIB emergency records. Exposure to high levels of PM2.5 significantly increased the risk of UGIB emergency attendance from lag day 3 (RR: 1.012) to day 6 (RR: 1.008). High NO2 exposure also posed a significant risk from lag day 0 (RR: 1.026) to day 2 (RR: 1.014), and from lag day 5 (RR: 1.013) to day 7 (RR: 1.024). However, there was no association between UGIB and high O3 levels. The attributable burden of high‐concentration NO2 exposure was higher compared to those of PM2.5. Males and elderly individuals (≥65 years) faced a higher risk of UGIB emergencies, particularly during cold seasons. Our study suggests that both PM2.5 and NO2 exposure are associated with an increased risk of emergency attendance for UGIB. Ambient pollutant exposure has a stronger effect on UGIB in males and the elderly, particularly during cold seasons. Plain Language Summary Our research in Hong Kong from 2017 to 2022 investigated the impact of brief exposure to air pollution on emergency visits for upper gastrointestinal bleeding (UGIB). We examined various types of air pollutants, including fine particulate matter (PM) and ozone, with a specific focus on identifying the most harmful pollutants and their temporal patterns. Our findings demonstrate that even a slight increase in levels of fine PM and nitrogen dioxide can significantly contribute to an upsurge in emergency cases of UGIB. Notably, these effects are more pronounced during colder months and in the elderly. The burden was more severe before the COVID‐19 pandemic. This study underscores the direct influence of air pollution on public health and emphasizes the imperative need to enhance air quality, particularly in densely populated urban areas. Our finding could help to inform public health policies and to prom