The introduction of Tier 3 light-duty vehicles with reduced emissions began in New York State (NYS) in 2017, with required compliance by 2025. We hypothesized that improved air quality during the early implementation of Tier 3 (2017–2019) would result in reduced rates of hospitalizations and emergency department (ED) visits for respiratory infection associated with increased PM_2.5 compared to 2014–2016 (pre-Tier 3). Using data on adult patients hospitalized or having an ED visit for influenza, upper respiratory infection, culture-negative pneumonia, or respiratory bacterial infection, living within 15 miles of six air quality monitoring sites in NY, and a case-crossover design and conditional logistic regression, we estimated the rates of respiratory infection hospitalizations and ED visits associated with increased ambient PM_2.5 concentrations in the previous 0–6 days and each week thereafter up to 1 month. Interquartile range (IQR) increases in PM_2.5 in the previous 6 days were associated with 4.6% (95% CI: − 0.5, 10.1) and 11.9% (95% CI = 6.1, 18.0) increased rates of influenza hospitalizations in 2014–2016 and 2017–2019, respectively. This pattern of larger relative rates in 2017–2019 observed at all lag times was only present in males hospitalized for influenza but not other infections or in females. The rates of respiratory infection visits associated with increased PM_2.5 were generally not reduced in this early Tier 3 implementation period compared to 2014–2016. Limited fleet penetration of Tier 3 vehicles and differences in particle deposition, infection type, and sex by period may all have contributed to this lack of improvement.

纽约州 (NYS) 于 2017 年开始引入减少排放的 Tier 3 轻型车辆，并要求到 2025 年达标。我们假设，Tier 3 早期实施期间（2017-2019 年）空气质量的改善将导致与 2014-2016 年（第 3 级之前）相比，与 PM _2.5增加相关的呼吸道感染住院率和急诊室 (ED) 就诊率有所下降。使用因流感、上呼吸道感染、培养阴性肺炎或呼吸道细菌感染而住院或到急诊室就诊的成年患者的数据，这些患者居住在纽约州六个空气质量监测点 15 英里范围内，并采用病例交叉设计和条件逻辑通过回归，我们估计了前 0-6 天内以及此后直至 1 个月内每周与环境 PM _2.5浓度升高相关的呼吸道感染住院率和急诊就诊率。_{2014-2016 年，前 6 天内 PM 2.5}四分位距 (IQR) 的增加与流感住院率增加 4.6% (95% CI: − 0.5, 10.1) 和 11.9% (95% CI = 6.1, 18.0) 相关分别为 2017-2019 年。2017-2019 年在所有滞后时间观察到的这种相对比率较大的模式仅存在于因流感住院的男性中，而不存在于其他感染或女性中。与 2014-2016 年相比，在早期的第 3 级实施期间，与 PM _2.5增加相关的呼吸道感染就诊率总体上没有降低。3 级车辆的车队渗透率有限以及不同时期颗粒沉积、感染类型和性别的差异可能都是导致这种改善不足的原因。