Short-Term Effect of Moderate Level Air Pollution on Outpatient Visits for Multiple Clinic Departments: A Time-Series Analysis in Xi’an China

Qingnan Wang, Zhuo Chen, Wei Huang, Bo Kou, Jingwei Li

Research output: Journal PublicationArticlepeer-review


There is limited evidence concerning the association between air pollution and different outpatient visits in moderately polluted areas. This paper investigates the effects of moderate-level air pollution on outpatient visits associated with six categories of clinic department. We analyzed a total of 1,340,791 outpatient visits for the pediatric, respiratory, ear-nose-throat (ENT), cardiovascular, ophthalmology, and orthopedics departments from January 2016 to December 2018. A distributed lag nonlinear model was used to analyze the associations and was fitted and stratified by age and season (central heating season and nonheating season). We found (Formula presented.) had the largest effect on pediatrics visits (RR = 1.105 (95%CI: 1.090, 1.121)). Meanwhile, (Formula presented.) and (Formula presented.) had greater effects on ENT visits for people under 50 years old. The results showed a strong association between (Formula presented.) and cardiovascular outpatient visits in the nonheating season (RR = 1.273, 95% CI: 1.189,1.358). The results showed every 10 (Formula presented.) increase in (Formula presented.) was associated with a lower number of respiratory outpatient visits. Significant different associations were observed in (Formula presented.), (Formula presented.), CO, and (Formula presented.) on ophthalmology visits between the heating and nonheating seasons. Although no significant association has been found in existing studies, our findings showed (Formula presented.) and (Formula presented.) were significantly related to orthopedic outpatient visits for people under 60 (RR = 1.063 (95%CI: 1.032, 1.095), RR = 1.055 (95%CI: 1.011, 1.101)). This study also found that the effect-level concentrations of air pollutants for some clinic departments were lower than the national standards, which means that people should also pay more attention when the air quality is normal.

Original languageEnglish
Article number166
Issue number2
Publication statusPublished - Feb 2023


  • distributed nonlinear model
  • exposure–response effect
  • moderate pollution
  • ophthalmology disease
  • outpatient visits
  • pediatric department disease

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis
  • Chemical Health and Safety


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