Acute Effects of Exposure to Ambient Air Pollutants on Preterm Birth in Xiamen City (2015-2018), China

Backgrounds: Urban energy consumption is one of the important causes of air pollution. The epidemiological risk assessment guided by air pollution is of great significance to the promotion of urban environmental protection. Objectives: The work researched the acute impact of exposure to air pollution on preterm birth (PTB) in Xiamen city from 2015 to 2018. Furthermore, the economic losses were assessed as well. Methods: Association of air pollution and PTB with economic losses were assessed using the generalized additive model. Results: A total of 1991 PTB visits, who are inhabitant in Xiamen, have been investigated. An interquartile range (IQR) (10 mu g/m(3)) increase of PM10, NO2, and SO2 in the current day corresponded to the increase of 0.64% [95% CI: -1.22, 2.54%], 0.52% [95% CI: -5.21, 6.61%], and 2.33% [95% CI: -6.41, 11.58%] in daily PTB visits. Especially, PTB visits were significantly related with PM10 and NO2 in Lag 1 and NO2 and SO2 in Lag 2. Furthermore, for multipollutants, an IQR increase in PM2.5, O-3, and CO, after adjustment with SO2, was related with 5.04% [95% CI: -5.90, 17.24], 2.49% [95% CI: -6.07, 11.81], and 7.10% [95% CI: -2.79, 18.00] increase of PTB morbidity, respectively. The estimates of the number of excess PTBs attributed to typical pollutants PM10 and SO2 were similar to 2400 and 1200 people, respectively, every year. The highest excess PTBs was estimated to occur as a result of PM10 and SO2 effects. Conclusions: Although Xiamen has a relatively low level of air pollution, short-term exposure to NO2, SO2, and PM10 was linked to the increase of PTB visits.