October 19, 2025

Association between outdoor air pollution and acute exacerbation of chronic obstructive pulmonary disease in Xinjiang, China

ZLZhichuang LianXinjiang Medical University JZJiayu ZhangNanchang University SMSumanye MaolahongXinjiang Medical University

Key Points

Increased levels of exposure to air pollutants are linked to higher admissions for acute exacerbations of chronic obstructive pulmonary disease.
Specifically, a 1.61% increase in hospital admissions was observed for every interquartile range increase in NO₂ levels.
Using time-series models allowed for detailed analysis of pollution effects on AECOPD over short-term periods.
Findings highlight the need for targeted public health interventions in regions like Xinjiang where air quality is poor.

Abstract

This study investigated the association between short-term exposure to air pollutants and hospital admissions for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in Northwest China. We analyzed data from a tertiary hospital in Xinjiang (2014–2023), along with air pollutant and meteorological data. Using a time-series approach with generalized additive models and distributed lag nonlinear models, we found that interquartile range increases in PM₂.₅, PM₁₀, NO₂, CO, and O₃ were associated with increased AECOPD admissions of 4.70% (95% CI: 1.48%, 8.01%), 1.61% (0.38%, 2.86%), 15.97% (7.36%, 25.28%), 35.64% (15.84%, 58.82%), and 5.89% (1.10%, 10.90%), respectively, with peak effects at lag 0. Stratified analyses identified sex-, age-, and season-specific relationships, including protective effects of O₃ and CO in males at longer lags, heightened susceptibility to particulate matter and NO₂ in adults aged ≥65 years, and distinct seasonal patterns for NO₂, O₃, and CO. These findings demonstrate that short-term air pollution exposure is significantly associated with AECOPD hospitalizations in this understudied region.

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