Environmental Science and Pollution Research

, Volume 26, Issue 30, pp 31225–31233 | Cite as

Comparison of air pollutant-related hospitalization burden from AECOPD in Shijiazhuang, China, between heating and non-heating season

  • Fangfang Qu
  • Feifei Liu
  • Huiran Zhang
  • Lingshan Chao
  • Jitao Guan
  • Rongqin Li
  • Fengxue Yu
  • Xixin YanEmail author
Research Article


Few researches have been investigated on the effects of ambient air pollutants from coal combustion on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalizations. The whole time series was split into heating season and non-heating season. We used a quasi-Poisson generalized linear regression model combined with distributed lag non-linear models (DLNMs) to estimate the relative cumulative risk and calculate the air pollutant hospitalization burden of AECOPD for lag 0–7 days in heating season and non-heating season. There were higher PM2.5, PM10, NO2, SO2, and CO concentrations in heating seasons than non-heating season in Shijiazhuang; however, O3 was higher in non-heating season than heating season. The AECOPD-associated relative cumulative risks for PM2.5, PM10, NO2, and SO2 for lag 0–7 days were significantly positively associated with hospitalization in heating and non-heating season; we found that the cumulative relative risk of NO2 was the greatest in every 1 unit of air pollutants during the heating season and the cumulative relative risk of SO2 was the greatest during the non-heating season. The results showed that 17.8%, 12.9%, 1.7%, 16.7%, and 10.5% of AECOPD hospitalizations could be attributable to PM2.5, PM10, SO2, NO2, and CO exposure in heating season, respectively. However, the results showed that 19.5%, 22.4%, 15%, 8.3%, and 10.4% of AECOPD hospitalizations could be attributable to PM2.5, PM10, SO2, NO2, and O3 exposure in non-heating season, respectively. The attributable burden of AECOPD hospitalization in heating season and non-heating season are different. PM2.5, PM10, NO2, and CO are the main factors of heating season, while PM10, PM2.5, SO2, and O3 are the main factors of non-heating season. In conclusions, the centralized heating can change the influence of attributable risk. When government departments formulate interventions to reduce the risk of acute hospitalization of chronic obstructive pulmonary disease (COPD), the influence of heating on disease burden should be considered.


Ambient air pollution Heating season AECOPD hospitalization Attributable burden Concentration–response curve 



The authors thank the database of the Health Insurance Center of Shijiazhuang City providing population support; we appreciate the Shijiazhuang Environmental Protection Department providing for air pollution monitoring data and Shijiazhuang Meteorological Bureau providing for meteorological data.

Funding information

This work is supported by the National Natural Science Foundation of China (81770020 to XY) and Haze Special Project of Hebei Province Finance Department (2014-1257).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Patient consent

Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Fangfang Qu
    • 1
    • 2
  • Feifei Liu
    • 1
    • 2
  • Huiran Zhang
    • 1
    • 2
  • Lingshan Chao
    • 1
    • 2
  • Jitao Guan
    • 1
    • 2
  • Rongqin Li
    • 3
  • Fengxue Yu
    • 3
  • Xixin Yan
    • 1
    • 2
    Email author
  1. 1.Department of Respiratory and Critical Care MedicineThe Second Hospital of HeBei Medical UniversityShijiazhuangChina
  2. 2.HeBei institute of Respiratory DiseaseShijiazhuangChina
  3. 3.Department of Central LaboratoryThe Second Hospital of Hebei Medical UniversityShijiazhuangChina

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