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Causal effect of PM on morbidity of cause-specific respiratory diseases based on a negative control exposure. | LitMetric
Background : Extensive studies have linked PM and PM with respiratory diseases (RD). However, few is known about causal association between PM and morbidity of RD. We aimed to assess the causal effects of PM on cause-specific RD.Methods : Hospital admission data were obtained for RD during 2014 and 2019 in Beijing, China. Negative control exposure and extreme gradient boosting with SHapley Additive exPlanation was used to explore the causality and contribution between PM and RD. Stratified analysis by gender, age, and season was conducted.Results : A total of 1,183,591 admissions for RD were recorded. Per interquartile range (28 μg/m) uptick in concentration of PM corresponded to a 3.08% [95% confidence interval (CI): 1.66%-4.52%] increment in morbidity of total RD. And that was 4.47% (95% CI: 2.46%-6.52%) and 0.15% (95% CI: 1.44%-1.78%), for COPD and asthma, respectively. Significantly positive causal associations were observed for PM with total RD and COPD. Females and the elderly had higher effects on total RD, COPD, and asthma only in the warm months (Z = 3.03, P = 0.002; Z = 4.01, P < 0.001; Z = 3.92, P < 0.001; Z = 2.11, P = 0.035; Z = 2.44, P = 0.015). Contribution of PM ranked first, second and second for total RD, COPD, and asthma among air pollutants.Conclusion : PM was causally associated with increased morbidity of total RD and COPD, but not causally associated with asthma. Females and the elderly were more vulnerable to PM-associated effects on RD.
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