TY - JOUR T1 - Ambient PM<sub>2.5</sub> exposure and hospital cost and length of hospital stay for respiratory diseases in 11 cities in Shanxi Province, China JF - Thorax JO - Thorax DO - 10.1136/thoraxjnl-2020-215838 SP - thoraxjnl-2020-215838 AU - Dawei Cao AU - Dongyan Li AU - Yinglin Wu AU - Zhengmin (Min) Qian AU - Yi Liu AU - Qiyong Liu AU - Jimin Sun AU - Yuming Guo AU - Shiyu Zhang AU - Guangyuan Jiao AU - Xiaoran Yang AU - Chongjian Wang AU - Stephen Edward McMillin AU - Xinri Zhang AU - Hualiang Lin Y1 - 2021/06/04 UR - http://thorax.bmj.com/content/early/2021/06/03/thoraxjnl-2020-215838.abstract N2 - Background Few studies have examined the effects of ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) on hospital cost and length of hospital stay for respiratory diseases in China.Methods We estimated ambient air pollution exposure for respiratory cases through inverse distance-weighted averages of air monitoring stations based on their residential address and averaged at the city level. We used generalised additive models to quantify city-specific associations in 11 cities in Shanxi and a meta-analysis to estimate the overall effects. We further estimated respiratory burden attributable to PM2.5 using the standards of WHO (25 µg/m3) and China (75 µg/m3) as reference.Results Each 10 µg/m3 increase in lag03 PM2.5 corresponded to 0.53% (95% CI: 0.33% to 0.73%) increase in respiratory hospitalisation, an increment of 3.75 thousand RMB (95% CI: 1.84 to 5.670) in hospital cost and 4.13 days (95% CI: 2.51 to 5.75) in length of hospital stay. About 9.7 thousand respiratory hospitalisations, 132 million RMB in hospital cost and 145 thousand days of hospital stay could be attributable to PM2.5 exposures using WHO’s guideline as reference. We estimated that 193 RMB (95% CI: 95 to 292) in hospital cost and 0.21 days (95% CI: 0.13 to 0.30) in hospital stay could be potentially avoidable for an average respiratory case.Conclusion Significant respiratory burden could be attributable to PM2.5 exposures in Shanxi Province, China. The results need to be factored into impact assessment of air pollution policies to provide a more complete indication of the burden addressed by the policies.Data are available upon reasonable request. ER -