The January 2013 Beijing “Airpocalypse” and its acute effects on emergency and outpatient visits at a Beijing Hospital

Joshua M. Ferreri, Roger D. Peng, Michelle L. Bell, Liu Ya, Tiantian Li, G. Brooke Anderson

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Severe air pollution episodes in Europe and the USA in the early- to mid-twentieth century caused large health impacts, spurring national legislation. Similarly severe episodes currently affect developing regions, as exemplified by a particularly extreme episode in January 2013 in Beijing, China. We investigated associations between this episode and medical visits at a Beijing hospital. We obtained fine particulate matter (PM2.5) measurements from the US State Department’s Embassy monitor and daily counts of all-cause, cardiovascular, and respiratory emergency visits, and outpatient visits from a nearby hospital in the Liufang Nanli community. We analyzed whether risks increased during this episode (with daily PM2.5 ≥ 350 μg/m3) using generalized linear modeling, controlling for potential confounders. The episode brought exceptionally high PM2.5 (peak daily average, 569 μg/m3). Risk increased during the episode for all-cause (relative risk 1.29 [95% CI 1.13, 1.46]), cardiovascular (1.55 [0.90, 2.68]) and respiratory (1.33 [1.10, 1.62]) emergency medical visits, and respiratory outpatient visits (1.16 [1.00, 1.33]). Relative risks of all-cause (0.95 [0.82, 1.10]) and cardiovascular (0.83 [0.67, 1.02]) outpatient visits were not statistically significant. Results were robust to modeling choices and episode definitions. This episode was extraordinarily severe, with maximum daily PM2.5 concentration nearly 22-fold above the World Health Organization guideline. During the episode, risk increased for all-cause, cardiovascular, and respiratory emergency medical visits, and respiratory outpatient visits, consistent with previous US-based research. However, no association was found for all-cause or cardiovascular outpatient visits. China-based studies like this one provide critical evidence in developing efforts regarding air pollution remediation in China.

Original languageEnglish (US)
Pages (from-to)301-309
Number of pages9
JournalAir Quality, Atmosphere and Health
Issue number3
StatePublished - Dec 29 2017


  • Air pollution epidemiology
  • Cardiorespiratory outcomes
  • China
  • Fine particulate matter

ASJC Scopus subject areas

  • Pollution
  • Atmospheric Science
  • Management, Monitoring, Policy and Law
  • Health, Toxicology and Mutagenesis


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