Economic estimation and impact of air pollution and temperature extremes on emergency hospital admissions in Spain

IF 8 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Science of the Total Environment Pub Date : 2025-02-22 DOI:10.1016/j.scitotenv.2025.178867

R. Ruiz-Páez , J. Díaz , J.A. López-Bueno , M. Saez , M.A. Barceló , M.A. Navas , C. Linares

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Abstract

Air pollution and extreme temperatures are important public health problems but their effects on morbidity are not usually measured jointly. The objective was thus to analyse the effect of short-term exposure to both air pollution and to heat and cold waves on emergency hospital admissions at a provincial level, and estimate the economic cost.

Time series study analysing emergency hospital admissions due to natural causes (ICD-9:1–799 and ICD-10: A00-R99) across the period 2013–2018. The independent variables were daily mean concentrations of NO₂, PM_2.5, PM₁₀ and ozone, the maximum daily temperature in heat waves, and the minimum daily temperature in cold waves. Generalised linear models with a Poisson regression link were used to calculate the relative risks and attributable risks and estimated the related economic cost.

In relation to air pollution, exposure to NO₂ showed the greatest association with the number of provinces (39 %) and the highest number of attributable admissions (27,823;95%CI:14181–42,610) and an annual cost of €393,25 million. For the O_3, the association with attributable admissions was 22,858; 95%CI:5986–39,683 and an annual cost of €312,76 million. The exposure to PM showed the lowest association with the attributable admissions, 11,203 (95%CI:4470–17,504) and an annual cost of €152,95 million.

In the case of extreme temperatures their impact was very much less (5377; 95CI:2347–8373) than that of air pollution and their annual cost of €76.0 million. According the results found, a considerable number of emergency hospital admissions are mainly attributable to short-term exposure to air pollution instead of the extreme temperatures. The extreme temperatures prevention plans should be implemented to address the impact on health of air pollution and temperatures jointly.

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西班牙空气污染和极端温度对急诊住院的经济估计和影响

空气污染和极端温度是重要的公共卫生问题，但它们对发病率的影响通常不会被联合衡量。因此，目的是分析短期暴露于空气污染和热流和寒流对省一级急诊住院人数的影响，并估计经济成本。时间序列研究分析了2013-2018年期间因自然原因（ICD-9:1-799和icd - 10:00 - r99）导致的急诊住院情况。自变量为NO2、PM2.5、PM10和臭氧的日平均浓度，热浪日最高气温和寒潮日最低气温。采用带泊松回归链接的广义线性模型计算了相对风险和归因风险，并估计了相关的经济成本。在空气污染方面，二氧化氮暴露与省份数量（39%）和最高可归因入院人数（27,823人；95%CI: 14181-42,610）的关系最大，年成本为3.93.25亿欧元。对于O3，与可归因招生的关联为22,858；95%CI: 5986-39,683，年成本为3.312亿欧元。PM暴露与可归因入院人数的关联最低，为11,203例（95%CI: 4470-17,504），年成本为1.5295亿欧元。在极端温度的情况下，它们的影响要小得多(5377；95CI: 2347-8373)比空气污染的成本高，每年的成本为7600万欧元。结果发现，相当多的急诊入院主要是由于短期暴露于空气污染，而不是极端温度。实施极端温度预防计划，共同应对空气污染和温度对健康的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Science of the Total Environment 环境科学-环境科学

CiteScore

17.60

自引率

10.20%

发文量

8726

审稿时长

2.4 months

期刊介绍： The Science of the Total Environment is an international journal dedicated to scientific research on the environment and its interaction with humanity. It covers a wide range of disciplines and seeks to publish innovative, hypothesis-driven, and impactful research that explores the entire environment, including the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. The journal's updated Aims & Scope emphasizes the importance of interdisciplinary environmental research with broad impact. Priority is given to studies that advance fundamental understanding and explore the interconnectedness of multiple environmental spheres. Field studies are preferred, while laboratory experiments must demonstrate significant methodological advancements or mechanistic insights with direct relevance to the environment.