Short-Term Effects of Particulate Matter and Its Constituents on Emergency Room Visits for Chronic Obstructive Pulmonary Disease: A Time-Stratified Case-Crossover Study in an Urban Area
| Autor: | Yii-Ting Huang, Fu-Jen Cheng, Chien-Chih Chen, Po-Chun Chuang, Chih-Min Tsai, Yu-Ni Ho, Ming-Ta Tsai |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty emergency department Health Toxicology and Mutagenesis air pollution Taiwan 010501 environmental sciences complex mixtures 01 natural sciences Article Pulmonary Disease Chronic Obstructive Young Adult 03 medical and health sciences Interquartile range Internal medicine Statistical significance medicine Humans Cities chronic obstructive pulmonary disease (COPD) constituents Adverse effect 0105 earth and related environmental sciences particulate matter Air Pollutants 0303 health sciences COPD Cross-Over Studies business.industry Public Health Environmental and Occupational Health 030311 toxicology Retrospective cohort study Environmental Exposure Emergency department medicine.disease Crossover study Confidence interval Medicine Emergency Service Hospital business |
| Zdroj: | International Journal of Environmental Research and Public Health Volume 18 Issue 9 International Journal of Environmental Research and Public Health, Vol 18, Iss 4400, p 4400 (2021) |
| ISSN: | 1660-4601 |
| Popis: | Background: PM2.5 exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM2.5 constitutes. This study evaluated the effects of increased short-term exposure to PM2.5 constituents on chronic obstructive pulmonary disease (COPD)-related emergency department (ED) visits and determined the susceptible groups. Methods: This retrospective observational study performed in a medical center from 2007 to 2010, and enrolled non-trauma patients aged > 20 years who visited the emergency department (ED) and were diagnosed as COPD. Concentrations of PM2.5, PM10, and the four PM2.5 components, including organic carbon (OC), elemental carbon (EC), nitrate (NO3−), and sulfate (SO42−), were collected by three PM supersites in Kaohsiung City. We used an alternative design of the Poisson time series regression models called a time-stratified and case-crossover design to analyze the data. Results: Per interquartile range (IQR) increment in PM2.5 level on lag 2 were associated with increments of 6.6% (95% confidence interval (CI), 0.5–13.0%) in risk of COPD exacerbation. An IQR increase in elemental carbon (EC) was significantly associated with an increment of 3.0% (95% CI, 0.1–5.9%) in risk of COPD exacerbation on lag 0. Meanwhile, an IQR increase in sulfate, nitrate, and OC levels was not significantly associated with COPD. Patients were more sensitive to the harmful effects of EC on COPD during the warm season (interaction p = 0.019). The risk of COPD exacerbation after exposure to PM2.5 was higher in individuals who are currently smoking, with malignancy, or during cold season, but the differences did not achieve statistical significance. Conclusion: PM2.5 and EC may play an important role in COPD events in Kaohsiung, Taiwan. Patients were more susceptible to the adverse effects of EC on COPD on warm days. |
| Databáze: | OpenAIRE |
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