In this study, we applied the generalized additive models (GAMs) including threshold and saturation effect of smooth curve analysis model to evaluate the synergistic effects of air temperature and ozoneon the numbers of chronic obstructive pulmonary disease (COPD) hospitalizations in Shijiazhuang, China. After controlling the potential confounding factors, such as long-term time trends, seasonal patterns, and the effect of holidays and day of the week of time series data, we estimated the synergistic effect of temperature and ozone on COPD hospitalizations, controlling forrelative humidity, PM2.5, SO2, and NO2. In addition, we also evaluated differential associations on samples stratified by sex and age. The results showed that, the thresholds of temperature and ozone in the dose-response relationship with the numbers of COPD hospitalizations were 0.3℃, 19℃, and 100μg/m3, respectively. When the concentration of ozone was above 100μg/m3, the relative risk (RR) of COPD hospitalization was 1.042 (95% confidence interval[CI]:1.020, 1.065) per1℃ increase in temperature, and achieved the maximum of 1.082 (95% CI:1.049, 1.116) when temperature was above 19℃. There were synergistic effects of high temperature and high ozone concentration on the COPD hospitalizations, to which the elderly were more sensitive. However, no significant difference was found regarding gender.
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FU Gui-qin, TIAN Ya-qin, ZHANG Cheng-wei. Synergistic effect of temperature and O3 on the numbers of COPD hospitalizations. CHINA ENVIRONMENTAL SCIENCECE, 2019, 39(12): 5312-5318.
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