{"id":"https://openalex.org/W7225752831","doi":"https://doi.org/10.1021/envhealth.6c00480","title":"Health Risks and Economic Burden of PM2.5 and Its Constituents on Online Purchases of Antibiotics and Antivirals: A Nationwide Study in China","display_name":"Health Risks and Economic Burden of PM2.5 and Its Constituents on Online Purchases of Antibiotics and Antivirals: A Nationwide Study in China","publication_year":2026,"publication_date":"2026-11-10","ids":{"openalex":"https://openalex.org/W7225752831","doi":"https://doi.org/10.1021/envhealth.6c00480"},"language":"en","primary_location":{"id":"doi:10.1021/envhealth.6c00480","doi":"https://doi.org/10.1021/envhealth.6c00480","is_oa":true,"landing_page_url":"https://doi.org/10.1021/envhealth.6c00480","pdf_url":"https://pubs.acs.org/ehnea2/article-pdf/doi/10.1021/envhealth.6c00480/69128026/envhealth.6c00480.pdf","source":{"id":"https://openalex.org/S4387289850","display_name":"Environment & Health","issn_l":"2833-8278","issn":["2833-8278"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","norway-1","oarl"],"host_organization":"https://openalex.org/P4310320006","host_organization_name":"American Chemical Society","host_organization_lineage":["https://openalex.org/P4310320006"],"host_organization_lineage_names":["American Chemical Society"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Environment & Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://pubs.acs.org/ehnea2/article-pdf/doi/10.1021/envhealth.6c00480/69128026/envhealth.6c00480.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5103108111","display_name":"Rui Pan","orcid":"https://orcid.org/0000-0003-4302-9543","observed_orcids":["https://orcid.org/0000-0003-4302-9543"]},"institutions":[{"id":"https://openalex.org/I20231570","display_name":"Peking University","ror":"https://ror.org/02v51f717","country_code":"CN","type":"education","lineage":["https://openalex.org/I20231570"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Rui Pan","raw_affiliation_strings":["Peking University , , ,"],"raw_orcid":"https://orcid.org/0000-0003-4302-9543","affiliations":[{"raw_affiliation_string":"Peking University , , ,","institution_ids":["https://openalex.org/I20231570"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040497140","display_name":"Rui Dong Shen","orcid":"https://orcid.org/0000-0002-5704-4632","observed_orcids":["https://orcid.org/0000-0002-5704-4632"]},"institutions":[{"id":"https://openalex.org/I200296433","display_name":"Chinese Academy of Medical Sciences & Peking Union Medical College","ror":"https://ror.org/02drdmm93","country_code":"CN","type":"education","lineage":["https://openalex.org/I200296433"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Rui Shen","raw_affiliation_strings":["Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, State Key Laboratory of Respiratory Health and Multimorbidity , , ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, State Key Laboratory of Respiratory Health and Multimorbidity , , ,","institution_ids":["https://openalex.org/I200296433"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5011367125","display_name":"Tianjia Guan","orcid":"https://orcid.org/0000-0002-7820-2898","observed_orcids":["https://orcid.org/0000-0002-7820-2898"]},"institutions":[{"id":"https://openalex.org/I200296433","display_name":"Chinese Academy of Medical Sciences & Peking Union Medical College","ror":"https://ror.org/02drdmm93","country_code":"CN","type":"education","lineage":["https://openalex.org/I200296433"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Tianjia Guan","raw_affiliation_strings":["Chinese Academy of Medical Sciences and Peking Union Medical College , , ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chinese Academy of Medical Sciences and Peking Union Medical College , , ,","institution_ids":["https://openalex.org/I200296433"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161370159","display_name":"Luzhao Feng","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I200296433","display_name":"Chinese Academy of Medical Sciences & Peking Union Medical College","ror":"https://ror.org/02drdmm93","country_code":"CN","type":"education","lineage":["https://openalex.org/I200296433"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Luzhao Feng","raw_affiliation_strings":["Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, State Key Laboratory of Respiratory Health and Multimorbidity , , ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, State Key Laboratory of Respiratory Health and Multimorbidity , , ,","institution_ids":["https://openalex.org/I200296433"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5100445951","display_name":"Tong Zhu","orcid":"https://orcid.org/0000-0002-2752-7924","observed_orcids":["https://orcid.org/0000-0002-2752-7924"]},"institutions":[{"id":"https://openalex.org/I20231570","display_name":"Peking University","ror":"https://ror.org/02v51f717","country_code":"CN","type":"education","lineage":["https://openalex.org/I20231570"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Tong Zhu","raw_affiliation_strings":["Peking University , , ,"],"raw_orcid":"https://orcid.org/0000-0002-2752-7924","affiliations":[{"raw_affiliation_string":"Peking University , , ,","institution_ids":["https://openalex.org/I20231570"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5100445951","https://openalex.org/A5161370159"],"corresponding_institution_ids":["https://openalex.org/I200296433","https://openalex.org/I20231570"],"apc_list":{"value":3500,"currency":"USD","value_usd":3500},"apc_paid":{"value":3500,"currency":"USD","value_usd":3500},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10190","display_name":"Air Quality and Health Impacts","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10190","display_name":"Air Quality and Health Impacts","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11002","display_name":"Indoor Air Quality and Microbial Exposure","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11244","display_name":"Climate Change and Health Impacts","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.6955999732017517},{"id":"https://openalex.org/C191935318","wikidata":"https://www.wikidata.org/wiki/Q148","display_name":"China","level":2,"score":0.5444999933242798},{"id":"https://openalex.org/C501593827","wikidata":"https://www.wikidata.org/wiki/Q12187","display_name":"Antibiotics","level":2,"score":0.5231000185012817},{"id":"https://openalex.org/C119060515","wikidata":"https://www.wikidata.org/wiki/Q1916617","display_name":"Interquartile range","level":2,"score":0.5060999989509583},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5056999921798706},{"id":"https://openalex.org/C2776012195","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory tract infections","level":3,"score":0.4708000123500824},{"id":"https://openalex.org/C12725497","wikidata":"https://www.wikidata.org/wiki/Q810247","display_name":"Baseline (sea)","level":2,"score":0.4250999987125397},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.36410000920295715},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.3488999903202057},{"id":"https://openalex.org/C188897","wikidata":"https://www.wikidata.org/wiki/Q5333508","display_name":"Economic impact analysis","level":2,"score":0.3337000012397766},{"id":"https://openalex.org/C2778715236","wikidata":"https://www.wikidata.org/wiki/Q55622662","display_name":"Discontinuation","level":2,"score":0.325300008058548},{"id":"https://openalex.org/C524218345","wikidata":"https://www.wikidata.org/wiki/Q31218","display_name":"Health economics","level":3,"score":0.3228999972343445},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.31200000643730164},{"id":"https://openalex.org/C30772137","wikidata":"https://www.wikidata.org/wiki/Q5164762","display_name":"Consumption (sociology)","level":2,"score":0.31040000915527344},{"id":"https://openalex.org/C3008058167","wikidata":"https://www.wikidata.org/wiki/Q84263196","display_name":"Coronavirus disease 2019 (COVID-19)","level":4,"score":0.30889999866485596},{"id":"https://openalex.org/C160050368","wikidata":"https://www.wikidata.org/wiki/Q132453","display_name":"Developed country","level":3,"score":0.2802000045776367},{"id":"https://openalex.org/C2780664029","wikidata":"https://www.wikidata.org/wiki/Q5282120","display_name":"Disease burden","level":3,"score":0.27950000762939453},{"id":"https://openalex.org/C2993183539","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory infection","level":3,"score":0.27730000019073486},{"id":"https://openalex.org/C82789193","wikidata":"https://www.wikidata.org/wiki/Q2142611","display_name":"Relative risk","level":3,"score":0.2734000086784363},{"id":"https://openalex.org/C16851059","wikidata":"https://www.wikidata.org/wiki/Q182467","display_name":"Attributable risk","level":3,"score":0.26159998774528503},{"id":"https://openalex.org/C113280763","wikidata":"https://www.wikidata.org/wiki/Q2326546","display_name":"Subclinical infection","level":2,"score":0.260699987411499},{"id":"https://openalex.org/C2984618805","wikidata":"https://www.wikidata.org/wiki/Q2284929","display_name":"Health risk","level":2,"score":0.25949999690055847},{"id":"https://openalex.org/C83864248","wikidata":"https://www.wikidata.org/wiki/Q177323","display_name":"Developing country","level":2,"score":0.25940001010894775},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.25119999051094055}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1021/envhealth.6c00480","doi":"https://doi.org/10.1021/envhealth.6c00480","is_oa":true,"landing_page_url":"https://doi.org/10.1021/envhealth.6c00480","pdf_url":"https://pubs.acs.org/ehnea2/article-pdf/doi/10.1021/envhealth.6c00480/69128026/envhealth.6c00480.pdf","source":{"id":"https://openalex.org/S4387289850","display_name":"Environment & Health","issn_l":"2833-8278","issn":["2833-8278"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","norway-1","oarl"],"host_organization":"https://openalex.org/P4310320006","host_organization_name":"American Chemical Society","host_organization_lineage":["https://openalex.org/P4310320006"],"host_organization_lineage_names":["American Chemical Society"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Environment & Health","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1021/envhealth.6c00480","doi":"https://doi.org/10.1021/envhealth.6c00480","is_oa":true,"landing_page_url":"https://doi.org/10.1021/envhealth.6c00480","pdf_url":"https://pubs.acs.org/ehnea2/article-pdf/doi/10.1021/envhealth.6c00480/69128026/envhealth.6c00480.pdf","source":{"id":"https://openalex.org/S4387289850","display_name":"Environment & Health","issn_l":"2833-8278","issn":["2833-8278"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","norway-1","oarl"],"host_organization":"https://openalex.org/P4310320006","host_organization_name":"American Chemical Society","host_organization_lineage":["https://openalex.org/P4310320006"],"host_organization_lineage_names":["American Chemical Society"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Environment & Health","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225752831.pdf","grobid_xml":"https://content.openalex.org/works/W7225752831.grobid-xml"},"referenced_works_count":45,"referenced_works":["https://openalex.org/W1693051683","https://openalex.org/W2006203329","https://openalex.org/W2022873121","https://openalex.org/W2074344667","https://openalex.org/W2109839011","https://openalex.org/W2126930838","https://openalex.org/W2139643914","https://openalex.org/W2150180906","https://openalex.org/W2162768498","https://openalex.org/W2200503738","https://openalex.org/W2790537821","https://openalex.org/W2803291500","https://openalex.org/W2894751401","https://openalex.org/W2906461844","https://openalex.org/W2944857152","https://openalex.org/W2969621686","https://openalex.org/W2981791904","https://openalex.org/W3021983291","https://openalex.org/W3037319188","https://openalex.org/W3039346021","https://openalex.org/W3092849554","https://openalex.org/W3117194849","https://openalex.org/W3122276914","https://openalex.org/W3134926361","https://openalex.org/W3136179920","https://openalex.org/W3173411623","https://openalex.org/W3211121796","https://openalex.org/W4214877860","https://openalex.org/W4303983678","https://openalex.org/W4312071818","https://openalex.org/W4317532255","https://openalex.org/W4318820465","https://openalex.org/W4391784665","https://openalex.org/W4398615132","https://openalex.org/W4403619591","https://openalex.org/W4405416761","https://openalex.org/W4406934314","https://openalex.org/W4407555667","https://openalex.org/W4408687094","https://openalex.org/W4409224884","https://openalex.org/W4409377041","https://openalex.org/W4409450289","https://openalex.org/W4409566239","https://openalex.org/W4411154772","https://openalex.org/W4412490684"],"related_works":[],"abstract_inverted_index":{"Abstract":[0],"While":[1],"previous":[2],"studies":[3],"have":[4],"shown":[5],"that":[6],"fine":[7],"particulate":[8],"matter":[9],"(PM2.5)":[10],"has":[11],"been":[12],"associated":[13,53,151,228],"with":[14,54,103,152,188,198,229],"respiratory":[15],"tract":[16],"infections":[17],"caused":[18],"by":[19,112],"bacterial":[20],"and":[21,27,35,50,57,71,85,120,132,164,193,204,207,215,225,234,247,254],"viral":[22],"pathogens":[23],"based":[24],"on":[25,32,89],"mortality":[26],"morbidity":[28],"data,":[29],"its":[30,58,86],"impact":[31],"subclinical":[33],"manifestations":[34],"related":[36],"partial":[37],"self-treatment":[38],"behaviors":[39],"remains":[40],"poorly":[41],"understood.":[42],"This":[43],"nationwide":[44],"study":[45,128],"investigates":[46],"the":[47,80,175],"health":[48,214,223,252],"risks":[49,119,183,224],"economic":[51,121,216,226],"burden":[52],"daily":[55],"PM2.5":[56,84,125,143,179,218],"major":[59,87],"constituents":[60,88],"in":[61,68,73,142,161,171,201,236],"relation":[62],"to":[63,124,249],"online":[64,90,135,230],"purchases":[65,163,173,231],"of":[66,83,232],"antibiotics":[67,233],"344":[69],"cities":[70,75],"antivirals":[72,235],"299":[74],"across":[76],"China.":[77,237],"We":[78,115],"analyzed":[79],"city-specific":[81],"effects":[82],"purchase":[91],"data":[92],"from":[93],"China\u2019s":[94],"Meituan":[95],"platform":[96],"(2022\u20132024)":[97],"using":[98],"a":[99,153,165],"time-stratified":[100],"case-crossover":[101],"design":[102],"distributed":[104],"lag":[105,147],"linear":[106],"models.":[107],"City-level":[108],"estimates":[109],"were":[110],"pooled":[111,181],"random-effect":[113],"meta-analysis.":[114],"subsequently":[116],"quantified":[117],"attributable":[118,213],"burdens":[122],"due":[123],"exposure.":[126],"The":[127],"included":[129],"111,408,946":[130],"antibiotic":[131,162],"21,395,469":[133],"antiviral":[134,172],"purchases.":[136],"An":[137],"interquartile":[138],"range":[139],"(IQR)":[140],"increase":[141,160,170],"total":[144],"mass":[145],"at":[146,174],"0\u20137":[148],"days":[149],"was":[150,196],"1.04%":[154],"[95%":[155],"confidence":[156],"interval":[157],"(CI):":[158],"1.03\u20131.05%]":[159],"1.14%":[166],"(95%":[167],"CI:":[168],"1.10\u20131.17%)":[169],"national":[176],"level.":[177],"Among":[178],"constituents,":[180],"relative":[182],"(RRs)":[184],"showed":[185],"similar":[186],"magnitude,":[187],"only":[189],"marginal":[190],"variations.":[191],"Geographic":[192],"seasonal":[194],"heterogeneity":[195],"observed,":[197],"stronger":[199],"associations":[200],"southern":[202],"areas":[203],"winter.":[205],"Central":[206],"Eastern":[208],"China":[209],"accounted":[210],"for":[211,243],"most":[212],"burdens.":[217],"exposure":[219],"significantly":[220],"increases":[221],"both":[222],"costs":[227],"These":[238],"findings":[239],"provide":[240],"critical":[241],"evidence":[242],"policymakers,":[244],"healthcare":[245],"providers,":[246],"researchers":[248],"optimize":[250],"environmental":[251],"policies":[253],"medical":[255],"resource":[256],"allocation":[257],"strategies.":[258]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-11T00:00:00"}