Landscape Fire-Sourced PM2.5 and Cause-Specific Renal Hospitalizations: A Multicountry Two-Stage Time-Series Analysis of 12.5 Million Admissions
Abstract
Abstract Landscape fire-sourced PM2.5 (LFS PM2.5) is increasingly recognized as an important air pollutant, but its short-term contribution to renal hospitalizations remains unclear. Here, we assessed the associations between LFS PM2.5 and renal hospitalizations across 1020 locations in Australia, Brazil, Canada, Chile, New Zealand, and Thailand during 2000–2019 using a two-stage time-series design and estimated the attributable hospitalizations. LFS PM2.5 was associated with increased renal hospitalization risk, with the strongest associations observed for acute kidney injury. A 10 μg/m3 increase in cumulative LFS PM2.5 exposure over lag 0–5 was associated with a 1.1% increase in renal hospitalizations (RR = 1.011, 95% CI: 1.007–1.015). Associations were stronger in warmer areas and differed across levels of GDP per capita. Associations were consistently stronger for LFS PM2.5 than for non-LFS PM2.5. We estimated that LFS PM2.5 contributed to 1.38 renal hospitalizations per 100,000 population annually across the study regions. These findings highlight renal disease as an underrecognized health consequence of landscape fire smoke and support strengthened strategies to reduce wildfire smoke exposure under a changing climate.
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Authors: Bo Wen, Yao Yu Wu, Rongbin Xu, Gongbo Chen, Pei Yu, Yanming Liu, Wenhua Yu, Tingting Ye, Wenzhong Huang, Zhengyu Yang, Yiwen Zhang, Zhihu Xu, Shuang Zhou, Ke Ju, Simon Hales, Éric Lavigne, Paulo Hilário Nascimento Saldiva, Micheline de Sousa Zanotti Stagliorio Coêlho, Patricia Matus, Kraichat Tantrakarnapa, Wissanupong Kliengchuay, Michael John Abramson, Guy Marks, Lídia Morawska, Fay Helena Johnston, Jane Shirley Heyworth, Geoffrey Gerard Morgan, Luke Knibbs, Yuming Guo, Shanshan Li
Institutions: University of Hong Kong, Peking University, Universidade de São Paulo, The University of Sydney, UNSW Sydney, Mahidol University, University of Otago, Monash University, Chongqing University, The University of Western Australia, University of Ottawa, Queensland University of Technology, University of Tasmania, Southeast University, Universidad de Los Andes, Chile, Jinan University, Health Canada