Ultrafine Particles and Hospital Visits for Chronic Lower Respiratory Diseases in New York State.

RATIONALE:Exposure to particulate matter is associated with various adverse health outcomes. Ultrafine particles are a unique public health challenge due to their size. However, limited studies have examined their impacts on human health, especially across seasons and demographics. OBJECTIVES:To evaluate the effect of ultrafine particle exposure on the risk of visiting the emergency department for a chronic lower respiratory disease in New York State NYS, 2013-2018. METHODS:We used a case-crossover design and conditional logistic regression to estimate how ultrafine particle exposure led to chronic lower respiratory disease-related emergency department visits. GEOS-Chem-APM, a state-of-the-art chemical transport model with a size-resolved particle microphysics model, generated air pollution simulation data. We then matched ultrafine particle exposure estimates to geocoded health records for asthma, bronchiectasis, chronic bronchitis, emphysema, unspecified bronchitis, and other chronic airway obstructions in NYS from 2013-2018. In addition, we assessed interactions with age, ethnicity, race, sex, meteorological factors, and season. MEASUREMENTS AND MAIN RESULTS:Each interquartile range increase in ultrafine particle exposure led to a 0.37% increased risk of a respiratory-related emergency department visit on lag 0-0 (95% CI: 0.23-0.52%) and a 1.81% increase on lag 0-6 (95% CI: 1.58-2.03%). The highest risk was in the subtype emphysema (lag 0-5: 4.18%, 95% CI: 0.16-8.37%), followed by asthma (lag 0-6: 2.00%), chronic bronchitis (lag 0-6: 1.78%), other chronic airway obstructions (lag 0-6: 1.60%), and unspecified bronchitis (lag 0-6: 1.49%). We also found significant interactions between UFP health impacts and season (fall, 3.29%), temperature (<90th percentile, 2.27%), relative humidity (>90th percentile, 4.63%), age (children <18, 3.19%), and sex (men, 2.06%) on lag 0-6. CONCLUSION:In this study, UFP exposure increased chronic lower respiratory disease-related emergency department visits across all seasons and demographics, yet these associations varied according to various factors, which requires more research.