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Research Article

Seasonal impact of air particulate matter on morbidity: Interaction effect assessment in a time-stratified case-crossover design

ORCID Icon, , , ORCID Icon & ORCID Icon
Pages 2328-2341 | Received 28 Aug 2021, Accepted 24 Oct 2021, Published online: 03 Nov 2021
 

Abstract

The present study aimed to explore the interaction effect between PM10 and season as well as temperature on hospital admissions (HAs) in a region in North East of Iran. Distributed lag non-linear model in a time-stratified case-crossover design with a fixed and disjointed window was used in order to assess the impact of PM10 on HAs. Two approaches were applied to assess the interaction effect between season and the pollutant named stratification and interaction term in the regression model. In addition, a bivariate response surface model in Generalized Additive Model (GAM) was used to explore the interaction effect between PM10 and weather parameters, in order to see whether the seasonal variation of the PM10 effect is explained by weather conditions or not. The existence of interaction effect between PM10 and season was supported by both approaches; it was evident that spring significantly shared a large proportion of the adverse impact of PM10 on HAs. However, the interactive effects of PM10 and mean temperature were less obvious in this study. The results showed that all people were at risk of HAs due to high levels of PM10, with a particularly more immediate impact on elderlies. The results of the interaction effect can help policymakers to address spring when any preventive interventions are developed in the region.

Acknowledgements

The authors thank the Deputy of Health of North Khorasan University of Medical Sciences for providing the data.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval

The proposal for this study was approved by the Ethics Committee of North Khorasan University of Medical Sciences. Ethics code is IR.NKUMS.REC.1400.032

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Deputy of research and technology, North Khorasan University of Medical Sciences (Grant No. 990175).

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