Acute Effects of Nitrogen Dioxide Exposure and Risk of Cardiorespiratory Hospital Admissions in Peninsular Malaysia: A Time-series Study
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Abstract
Ambient air pollution, specifically nitrogen dioxide (NO2), is linked to adverse health outcomes, including increased risk of cardiorespiratory diseases. However, limited research has investigated the temporal relationship between short-term NO2 exposure and cardiorespiratory hospital admissions in Peninsular Malaysia. Materials and methods: This time-series study examines the impact of NO2 on hospital admissions across eight districts from 2011 to 2019. We used daily hospital admissions data from the Ministry of Health and NO2 concentrations from the Department of Environment. Quasi-Poisson regression models estimated the associations between NO2 exposure and admissions, accounting for potential confounders like temperature, humidity, day of the week, and public holidays. Results: The findings revealed a significant positive association between short-term NO2 exposure and cardiorespiratory admissions, particularly at lags of 0 and 1 days. For cardiovascular diseases, each 10 μg/m3 increase in NO2 was associated with a 1.07% to 9.17% increase in admissions at lag 0. For respiratory diseases, a 10 μg/m3 increase corresponded to a 0.60% to 12.64% increase in admissions at lag 0. The impact was more pronounced for cardiovascular than respiratory admissions. Conclusion: This study provides compelling evidence of the influence of short-term NO2 exposure on cardiorespiratory hospital admissions in Peninsular Malaysia. These findings highlight the importance of addressing air pollution and implementing interventions to reduce the burden of diseases associated with NO2 exposure.
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