摘要Objective Chronic obstructive pulmonary disease(COPD)is a major health concern in northwest China;however,the impact of particulate matter(PM)exposure during sand-dust storms(SDS)remains poorly understood.Therefore,this study aimed to investigate the association between PM exposure on SDS days and COPD hospitalization risk in arid regions.Methods Data on daily COPD hospitalizations were collected from 323 hospitals from 2018 to 2022,along with the corresponding air pollutant and meteorological data for each city in Gansu Province.Employing a space-time-stratified case-crossover design and conditional Poisson regression,we analyzed 265,379 COPD hospitalizations.Results PM exposure during SDS days significantly increased COPD hospitalization risk[relative risk(RR)for PM2.5,lag 3:1.028,95%confidence interval(CI):1.021-1.034],particularly among men and the elderly,and during the cold season.The burden of PM exposure on COPD hospitalization was substantially high in Northwest China,especially in the arid and semi-arid regions.Conclusion Our findings revealed a positive correlation between PM exposure during SDS episodes and elevated hospitalization rates for COPD in arid and semi-arid zones in China.This highlights the urgency of developing region-specific public health strategies to address adverse respiratory outcomes associated with SDS-related air quality deterioration.