Short-Term Associations between Air Pollution Concentrations and Respiratory Health—Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study

International Journal of Environmental Research and Public Health - Tập 14 Số 6 - Trang 587
Tahir Taj1, Ebba Malmqvist1, Emilie Stroh1, Daniel Oudin Åström2,3, Kristina Jakobsson1, Anna Oudin1,3
1Department of Occupational and Environmental Medicine, Lund University, SE-22100 Lund, Sweden
2Center for Primary Health Care Research, Department of Clinical Science, Malmö, Lund University, SE-205 02 Malmö, Sweden
3Department of Occupational and Environmental Medicine, Umeå University, Umeå, SE-22100 Lund, Sweden

Tóm tắt

Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m3 increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m3 increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.

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Tài liệu tham khảo

Guastadisegni, 2010, Determinants of the proinflammatory action of ambient particulate matter in immortalized murine macrophages, Environ. Health Perspect., 118, 1728, 10.1289/ehp.1002105

World Health Organization (WHO) (2008). Chapter 1: Burden: Mortality, morbidity and risk factors. Global Status Report on Noncommunicable Diseases, World Health Organization (WHO).

Vidal, 2015, Chronic respiratory diseases and lung cancer research: A perspective from the european union, Eur. Respir. J., 46, 1270, 10.1183/13993003.00395-2015

(2017, March 22). European Lung White Book. The Burden of Lung Disease. Available online: http://www.erswhitebook.org/chapters/the-burden-of-lung-disease/.

World Health Organization (WHO) (2010). Global Status Report on Noncommunicable Diseases, World Health Organization (WHO).

Atkinson, 2016, Long-term exposure to ambient ozone and mortality: A quantitative systematic review and meta-analysis of evidence from cohort studies, BMJ Open, 6, e009493, 10.1136/bmjopen-2015-009493

Bloemsma, 2016, Panel studies of air pollution in patients with copd: Systematic review and meta-analysis, Environ. Res., 151, 458, 10.1016/j.envres.2016.08.018

DeVries, 2016, Low level air pollution and exacerbation of existing copd: A case crossover analysis, Environ. Health, 15, 98, 10.1186/s12940-016-0179-z

Kurt, 2016, Pulmonary health effects of air pollution, Curr. Opin. Pulm. Med., 22, 138, 10.1097/MCP.0000000000000248

Miri, 2016, Mortality and morbidity due to exposure to outdoor air pollution in mashhad metropolis, Iran. The AirQ model approach, Environ. Res., 151, 451, 10.1016/j.envres.2016.07.039

Xing, 2016, The impact of PM2.5 on the human respiratory system, J. Thorac. Dis., 8, E69

Brunekreef, 2009, Effects of long-term exposure to traffic-related air pollution on respiratory and cardiovascular mortality in The Netherlands: The nlcs-air study, Res. Rep. Health Eff. Inst., 139, 5

Hoek, 2013, Long-term air pollution exposure and cardio-respiratory mortality: A review, Environ. Health, 12, 43, 10.1186/1476-069X-12-43

Pinault, 2016, Risk estimates of mortality attributed to low concentrations of ambient fine particulate matter in the canadian community health survey cohort, Environ. Health, 15, 18, 10.1186/s12940-016-0111-6

Weichenthal, 2016, Fine particulate matter and emergency room visits for respiratory illness. Effect modification by oxidative potential, Am. J. Respir. Crit. Care Med., 194, 577, 10.1164/rccm.201512-2434OC

Sinclair, 2010, A two-time-period comparison of the effects of ambient air pollution on outpatient visits for acute respiratory illnesses, J. Air Waste Manag. Assoc., 60, 163, 10.3155/1047-3289.60.2.163

Sinclair, 2004, Associations and lags between air pollution and acute respiratory visits in an ambulatory care setting: 25-month results from the aerosol research and inhalation epidemiological study, J. Air Waste Manag. Assoc., 54, 1212, 10.1080/10473289.2004.10470979

Taj, 2016, Air pollution is associated with primary health care visits for asthma in sweden: A case-crossover design with a distributed lag non-linear model, Spat. Spatio-Temporal Epidemiol., 17, 37, 10.1016/j.sste.2016.04.010

Yamazaki, 2015, Exposure to air pollution and meteorological factors associated with children’s primary care visits at night due to asthma attack: Case-crossover design for 3-year pooled patients, BMJ Open, 5, e005736, 10.1136/bmjopen-2014-005736

Yamazaki, 2014, Association between PM2.5 and primary care visits due to asthma attack in Japan: Relation to beijing’s air pollution episode in January 2013, Environ. Health Prev. Med., 19, 172, 10.1007/s12199-013-0371-5

Yamazaki, 2009, Modifying effect of age on the association between ambient ozone and nighttime primary care visits due to asthma attack, J. Epidemiol., 19, 143, 10.2188/jea.JE20081025

Hajat, 2002, Effects of air pollution on general practitioner consultations for upper respiratory diseases in London, Occup. Environ. Med., 59, 294, 10.1136/oem.59.5.294

Ostro, 1999, Air pollution and health effects: A study of medical visits among children in Santiago, Chile, Environ. Health Perspect., 107, 69, 10.1289/ehp.9910769

Pettersson, F. (2014). Swedish Infrastructure Policy and Planning Conditions for Sustainability. Faculty of Engineering Environmental and Energy Systems Studies, Department of Environmental and Energy Systems Studies, Lund University.

Stamming, M. (2014). Investments in Transport Infrastructure in Skåne 2014–2025, Region Skåne.

World Health Organization (WHO) (2005). Air Quality Guidelines for Particulate Matter, Ozone, Nitrogen Dioxide and Sulfur Dioxide, World Health Organization (WHO). Summary of Risk Assessment.

European Commission (2017, March 22). European Air Quality Standards. Available online: http://ec.europa.eu/environment/air/quality/standards.htm.

IVL Swedish Environmental Research Institute (2017, March 22). National Surveillance. Available online: http://www.ivl.se/sidor/omraden/luft/luftovervakning/nationell-overvakning.html.

Perrakis, 2014, Controlling for seasonal patterns and time varying confounders in time-series epidemiological models: A simulation study, Stat. Med., 33, 4904, 10.1002/sim.6271

Bateson, 2001, Selection bias and confounding in case-crossover analyses of environmental time-series data, Epidemiology, 12, 654, 10.1097/00001648-200111000-00013

Gasparrini, 2010, Distributed lag non-linear models, Stat. Med., 29, 2224, 10.1002/sim.3940

Gasparrini, 2012, Multivariate meta-analysis for non-linear and other multi-parameter associations, Stat. Med., 31, 3821, 10.1002/sim.5471

R. Core. Team (2016). R: A Language and Environment for Statistical Computing, R. Core. Team.

Lavigne, 2012, Air pollution and emergency department visits for asthma in Windsor, Canada, Can. J. Public Health, 103, 4, 10.1007/BF03404060

Tramuto, 2011, Urban air pollution and emergency room admissions for respiratory symptoms: A case-crossover study in Palermo, Italy, Environ. Health, 10, 31, 10.1186/1476-069X-10-31

Weichenthal, 2015, Estimating risk of emergency room visits for asthma from personal versus fixed site measurements of NO2, Environ. Res., 137, 323, 10.1016/j.envres.2015.01.006

Zheng, X.Y., Ding, H., Jiang, L.N., Chen, S.W., Zheng, J.P., Qiu, M., Zhou, Y.X., Chen, Q., and Guan, W.J. (2015). Association between air pollutants and asthma emergency room visits and hospital admissions in time series studies: A systematic review and meta-analysis. PloS ONE, 10.

Colucci, 2006, Particulate matter (PM10) air pollution, daily mortality, and hospital admissions: Recent findings, Ig Sanita Pubblica, 62, 289

Filleul, 2001, Short-term relationships between urban atmospheric pollution and respiratory mortality: Time series studies, Rev. Mal. Respir., 18, 387

Lippmann, 1989, Health effects of ozone. A critical review, JAPCA, 39, 672, 10.1080/08940630.1989.10466554

Schwela, 2000, Air pollution and health in urban areas, Rev. Environ. Health, 15, 13, 10.1515/REVEH.2000.15.1-2.13

Brand, 2016, Respiratory hospital admissions in young children living near metal smelters, pulp mills and oil refineries in two Canadian provinces, Environ. Int., 94, 24, 10.1016/j.envint.2016.05.002

Carugno, 2016, Air pollution exposure, cause-specific deaths and hospitalizations in a highly polluted Italian region, Environ. Res., 147, 415, 10.1016/j.envres.2016.03.003

Fung, 2006, Association between air pollution and multiple respiratory hospitalizations among the elderly in Vancouver, Canada, Inhal. Toxicol., 18, 1005, 10.1080/08958370600904538

Mills, 2016, Distinguishing the associations between daily mortality and hospital admissions and nitrogen dioxide from those of particulate matter: A systematic review and meta-analysis, BMJ Open, 6, e010751, 10.1136/bmjopen-2015-010751

Samek, 2016, Overall human mortality and morbidity due to exposure to air pollution, Int. J. Occup. Med. Environ. Health, 29, 417, 10.13075/ijomeh.1896.00560

Ciencewicki, 2016, Effects of mannose-binding lectin on pulmonary gene expression and innate immune inflammatory response to ozone, Am. J. Physiol. Lung Cell. Mol. Physiol., 311, 280, 10.1152/ajplung.00205.2015

Lay, 2007, Ozone enhances markers of innate immunity and antigen presentation on airway monocytes in healthy individuals, J. Allergy Clin. Immunol., 120, 719, 10.1016/j.jaci.2007.05.005

Lazaar, 2011, Sb-656933, a novel CXCR2 selective antagonist, inhibits ex vivo neutrophil activation and ozone-induced airway inflammation in humans, Br. J. Clin. Pharmacol., 72, 282, 10.1111/j.1365-2125.2011.03968.x

Hernandez, 2012, Airway cells from atopic asthmatic patients exposed to ozone display an enhanced innate immune gene profile, J. Allergy Clin. Immunol., 129, e251, 10.1016/j.jaci.2011.11.007

Koenig, 1999, Air pollution and asthma, J. Allergy Clin. Immunol., 104, 717, 10.1016/S0091-6749(99)70280-0

Chen, 2001, Air pollution and health effects in Northern Nevada, Rev. Environ. Health, 16, 133, 10.1515/REVEH.2001.16.2.133

Li, 2016, Short-term exposure to ambient fine particulate matter increases hospitalizations and mortality in COPD: A systematic review and meta-analysis, Chest, 149, 447, 10.1378/chest.15-0513

Marino, 2015, Impact of air quality on lung health: Myth or reality?, Ther. Adv. Chronic Dis., 6, 286, 10.1177/2040622315587256

Zanobetti, 2006, The effect of ozone and PM10 on hospital admissions for pneumonia and chronic obstructive pulmonary disease: A national multicity study, Am. J. Epidemiol., 163, 579, 10.1093/aje/kwj078

Atkinson, 2001, Acute effects of particulate air pollution on respiratory admissions: Results from aphea 2 project. Air pollution and health: A European approach, Am. J. Respir. Crit. Care Med., 164, 1860, 10.1164/ajrccm.164.10.2010138

Atkinson, 2015, Fine particle components and health—A systematic review and meta-analysis of epidemiological time series studies of daily mortality and hospital admissions, J. Expo. Sci. Environ. Epidemiol., 25, 208, 10.1038/jes.2014.63

Fusco, 2001, Air pollution and hospital admissions for respiratory conditions in Rome, Italy, Eur. Respir. J., 17, 1143, 10.1183/09031936.01.00005501

Huang, 2014, Outdoor air pollution: A global perspective, J. Occup. Environ. Med., 56, S3, 10.1097/JOM.0000000000000240

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International Journal of Environmental Research and Public Health

Tập 14 Số 6

587

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