Abstract
Background
Air pollutants have an impact on the occurrence of spine fractures, hip fractures,
proximal humerus fractures and forearm fractures. This study aimed at evaluating the
short-term impact of particulate matter with aerodynamic diameters of less than 2.5 µm
(PM2.5) on the occurrence of those fractures in Shijiazhuang, Hebei, China.
Methods
The daily meteorological, pollution, and fracture data of Shijiazhuang from 2014 to
2019 were collected. Distribution characteristics of fractures were described using
descriptive epidemiological methods. The distributed lag nonlinear model (DLNM) was
used to reveal the description of those fractures in the exposed and lag dimensions
at the same time. Based on gender and age (<18 years old, 18–69 years old and >69
years old), stratified analysis was performed. Sensitivity analysis was performed
to ascertain the robustness of the results.
Results
Between 2014 and 2019, fracture incidences in Shijiazhuang exhibited an overall increasing
trend, with an obvious seasonality. PM2.5 was positively related to daily fracture cases and the effects were more obvious
in women, adolescents and people of working age. When PM2.5 concentrations increased by one interquartile range (IQR) (70 μg/m3), RR exhibited a unimodal distribution. Its peak appeared on the 16th day of lag
(RR=1.005987, 95% CI:1.002472,1.009652), and the RRs were also statistically significant
from the 10th to 22nd day of lag. Similarly, cumulative effects of each increase in
the concentration of PM2.5 IQR also showed a unimodal distribution. The largest cumulative effect occurred on
the 28th day of lag (RR=1.084457, 95% CI:1.012207,1.161864), and the cumulative RRs
were also statistically significant from the 19th day to 30nd days. In the dose-response
relationship, as PM2.5 concentrations increased, RR increased.
Conclusion
Year by year, fractures in Shijiazhuang City exhibited an increasing trend. PM2.5 can affect the occurrence of those fractures. The impact on women, adolescents and
people of working age is even greater. The supervision of PM2.5 should be strengthened while large-scale emissions should be limited.
Keywords
Abbreviations:
PM2.5 (particulate matter with aerodynamic diameters of less than 2.5 µm), IQR (interquartile range), DLNM (distributed lag nonlinear model), IOF (International Osteoporosis Foundation), EFPIA (European Federation of Pharmaceutical Industry Associations), PM (Particulate matter), 25OHD (25-hydroxyvitamin D)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 08, 2022
Accepted:
August 6,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
