Short-term effect of air pollutants exposure on hospital admissions for osteoporotic fractures in Beijing, China

Objective To explore the effect of exposure to air pollutants on hospital admissions for osteoporotic fractures in Beijing, China.

Methods The information on admissions of patients with osteoporotic fractures who were admitted to a grade A tertiary hospital in Beijing from January 1, 2016 to December 31, 2018, and the data on air pollutants and meteorological factors during the same period were collected. The effect of exposure to air pollutants on hospital admissions for osteoporotic fractures was analyzed by generalized additive models(GAM).

Results From 2016 to 2018, the average daily mass concentrations of PM_2.5, PM₁₀, NO₂, O₃-8 h, SO₂, and CO in Beijing were 45, 77, 39, 54, 5, and 0.8 mg/m³, respectively. The median(P₂₅, P₇₅) of daily admissions for osteoporotic fractures were 8 (6, 10) cases. The single pollutant model showed that an increase of 10 μg/m³ in PM_2.5 mass concentration could lead to increases of 0.56% (95% CI: 0.06%, 1.06%) and 0.52% (95% CI: 0.02%, 1.03%) in fracture admissions on lag 6 day and lag 7 day, respectively. An increase of 10 μg/m³ in SO₂ mass concentration could lead to increases of 4.74% (95%CI: 0.47%, 9.20%), 5.19% (95%CI: 0.99%, 9.57%), 11.02% (95%CI: 0.54%, 22.59%) and 15.99% (95%CI: 4.33%, 28.94%) in fracture admissions on lag6 day, lag7 day, lag06 days, and lag07 days, respectively. Other air pollutants showed no significant effect on fracture admissions. Stratified analysis showed that PM_2.5 and SO₂ had a greater impact on male patients, while SO₂ had a greater impact on patients in the cold season.

Conclusion Short-term exposure to PM_2.5 and SO₂ can significantly increase the risk of fracture admission, with a lag effect, and the effect varies by gender and season.