NO2 exposure increases eczema outpatient visits in Guangzhou, China: an indication for hospital management

Abstract Background Ambient nitrogen dioxide (NO2) is a common air pollutant in developing countries and causes skin conditions, but its effect on eczema in subtropical areas is not clear in China. Object To measure the effect of short-term exposure of NO2 on the incidence of eczema and the change of outpatient visits. Methods Data of daily temperature, air pollutants, and outpatient visits from 2013 to 2018 were collected in a row. The generalized additive model (GAM) and Poisson distribution were used to assess the association between short-term exposure of NO2 and the outpatient visits of patients with eczema. The cumulative exposure effect of lag 0–3 days and the displacement effect of NO2 and other pollutants were considered as well. A single pollutant model was used to examine the independent association, and a two-pollutant model was adopted to control the confounding effect. Results The daily outpatient visits of eczema increased from 75.26 to 190.85 from 2013 to 2018 (P < 0.001). The combined influence of NO2 and the related pollutant exerted a stronger influence on the incidence of eczema. The maximum effect of NO2 appeared on the exposed day. (lag 0) and disappeared on day 4 (lag 3). The children and seniors were more vulnerable to NO2 exposure. Conclusion Exposure to NO2 is tightly associated with eczema incidence and outpatient visits. The hospitals should react to the visit fluctuations and adjust physician duty shifts to improve outpatient service efficiency.

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Short-Term Effect of Air Pollution on Tuberculosis Based on Kriged Data: A Time-Series Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051522 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1522 ◽

Cited By ~ 2

Author(s):

Shuqiong Huang ◽

Hao Xiang ◽

Wenwen Yang ◽

Zhongmin Zhu ◽

Liqiao Tian ◽

...

Keyword(s):

Air Pollution ◽

Air Pollutants ◽

Additive Model ◽

Ground Level ◽

Air Pollutant ◽

Aerodynamic Diameter ◽

Short Term ◽

Short Term Exposure ◽

Incident Cases ◽

The Impact

Tuberculosis (TB) has a very high mortality rate worldwide. However, only a few studies have examined the associations between short-term exposure to air pollution and TB incidence. Our objectives were to estimate associations between short-term exposure to air pollutants and TB incidence in Wuhan city, China, during the 2015–2016 period. We applied a generalized additive model to access the short-term association of air pollution with TB. Daily exposure to each air pollutant in Wuhan was determined using ordinary kriging. The air pollutants included in the analysis were particulate matter (PM) with an aerodynamic diameter less than or equal to 2.5 micrometers (PM2.5), PM with an aerodynamic diameter less than or equal to 10 micrometers (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ground-level ozone (O3). Daily incident cases of TB were obtained from the Hubei Provincial Center for Disease Control and Prevention (Hubei CDC). Both single- and multiple-pollutant models were used to examine the associations between air pollution and TB. Seasonal variation was assessed by splitting the all-year data into warm (May–October) and cold (November–April) seasons. In the single-pollutant model, for a 10 μg/m3 increase in PM2.5, PM10, and O3 at lag 7, the associated TB risk increased by 17.03% (95% CI: 6.39, 28.74), 11.08% (95% CI: 6.39, 28.74), and 16.15% (95% CI: 1.88, 32.42), respectively. In the multi-pollutant model, the effect of PM2.5 on TB remained statistically significant, while the effects of other pollutants were attenuated. The seasonal analysis showed that there was not much difference regarding the impact of air pollution on TB between the warm season and the cold season. Our study reveals that the mechanism linking air pollution and TB is still complex. Further research is warranted to explore the interaction of air pollution and TB.

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Out-of-hospital cardiac arrests in a large metropolitan area: synergistic effect of exposure to air particulates and high temperature

European Journal of Preventive Cardiology ◽

10.1177/2047487319862063 ◽

2019 ◽

Vol 27 (5) ◽

pp. 513-519 ◽

Cited By ~ 4

Author(s):

Eleonora Tobaldini ◽

Simona Iodice ◽

Rodolfo Bonora ◽

Matteo Bonzini ◽

Annamaria Brambilla ◽

...

Keyword(s):

Climate Change ◽

Air Pollution ◽

High Temperature ◽

Metropolitan Area ◽

Cardiac Event ◽

Cumulative Exposure ◽

Maximum Effect ◽

Short Term ◽

Short Term Exposure

Aims Air pollution and climate change are intrinsically linked to emerging hazards for global health. High air particulate matter (PM) levels may trigger out-of-hospital cardiac arrest (OHCA). High temperature could act synergistically with PM in determining OHCA. The aim of the present study was to investigate the effect of PM exposure alone, and in combination with temperature, on the risk of OHCA, in a large European metropolitan area with population >4 million. Methods We evaluated the association between short-term PM exposure, temperature, and the risk of OHCA over a two-year study period, allowing us to investigate 5761 events using a time-stratified case-crossover design combined with a distributed lag non-linear model. Results Higher risk of OHCA was associated with short-term exposure to PM10. The strongest association was experienced three days before the cardiac event where the estimated change in risk was 1.70% (0.48–2.93%) per 10 µg/m3 of PM. The cumulative exposure risk over the lags 0–6 was 8.5% (0.0–17.9%). We observed a joint effect of PM and temperature in triggering cardiac arrests, with a maximum effect of 14.9% (10.0–20.0%) increase, for high levels of PM before the cardiac event, in the presence of high temperature. Conclusion The present study helps to clarify the controversial role of PM as OHCA determinant. It also highlights the role of increased temperature as a key factor in triggering cardiac events. This evidence suggests that tackling both air pollution and climate change might have a relevant impact in terms of public health.

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Community characteristics affecting lag-structure of short-term exposure effect of ambient particulate matter on mortality: contextual variation of cumulative exposure effect and mortality displacement in 72 municipalities of seven major cities of South K

ISEE Conference Abstracts ◽

10.1289/isee.2020.virtual.p-0184 ◽

2020 ◽

Vol 2020 (1) ◽

Author(s):

H. Kim ◽

M.L. Bell ◽

J. Lee

Keyword(s):

Particulate Matter ◽

Cumulative Exposure ◽

Ambient Particulate Matter ◽

Community Characteristics ◽

Short Term ◽

Exposure Effect ◽

Contextual Variation ◽

Short Term Exposure ◽

Lag Structure

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Short-term Exposure of PM2.5 and PM10 Increases the Number of Outpatients with Eczema in Guangzhou: A Time-Series Study

10.21203/rs.3.rs-108684/v1 ◽

2020 ◽

Author(s):

Ji Zhang ◽

Yicheng Yang ◽

Jing Xu ◽

Dian Jing ◽

Bo Sun ◽

...

Keyword(s):

Air Pollution ◽

Meteorological Data ◽

Additive Model ◽

Positive Association ◽

The Elderly ◽

Short Term ◽

Outpatient Visits ◽

Short Term Exposure ◽

Pm2.5 And Pm10 ◽

The Relationship

Abstract Background: The worldwide prevalence of eczema has continued to rise over the past decades.This has led to emphasis on the association between air pollution and eczema. This study investigated the relationship between daily exposure to air pollution and the number of eczema outpatient visits in Guangzhou with the overarching goal of providing novel insights on the interventions for eczema aggravation and prevention.Methods: Daily air pollution data, meteorological data, and number of eczema outpatients were obtained from 18th January 2013 to 31st December 2018 in Guangzhou. A generalized additive model with Poisson distribution was used to assess the association between the number of eczema outpatient visits and short-term exposure of PM2.5 and PM10. In addition, the effect of PM2.5 and PM10 by age (<65 years, ≥65 years) and gender was evaluated. Results: A total of 293,343 eczema outpatient visits were recorded. The obtained results indicated that a 10μg/m3 increase of the same day/ lag 1 day/ lag 2 days PM2.5 was associated with increments of 2.33%(RR=1.0233, 95%CI: 1.0206-1.0260, P<0.001), 1.81% (RR=1.0181, 95%CI: 1.0153-1.0209, P<0.001), and 0.95%(RR=1.0095, 95%CI: 1.0068-1.0123, P<0.001) in eczema outpatients risk, respectively. On the other hand, a 10μg/m3 increase of PM10 was associated with eczema outpatients risk increments of 1.97%(RR=1.0197, 95%CI: 1.0177-1.0217, P<0.001), 1.65%(RR=1.0165, 95%CI: 1.0145-1.0186, P<0.001), and 0.98%(RR=1.0098, 95%CI: 1.0078-1.0118, P<0.001), respectively. Furthermore, the effects of PM on the increment of eczema were similar in the male and female groups. Results obtained after age stratification analyses indicated that the strongest positive association between PM2.5 exposure and eczema were observed at lag 0 day with the percent changes being 4.72% (95%CI, 4.18-5.28%, P<0.001), 1.92%(95%CI: 1.65-2.19%, P<0.001) and 3.34% (95%CI, 2.9- 3.78%, P<0.001) in <12 years old, ≥12 and <65years old, and ≥65 years old groups, respectively. Conclusion: Short-term exposure of PM2.5 and PM10 increases the number of eczema outpatients especially among children and the elderly. This study has provided a further understanding of the relationship between air pollutants and eczema, which will benefit disease prevention and lower the health burden.

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Spatio-temporal associations of air pollutant concentrations, GP respiratory consultations and respiratory inhaler prescriptions: a 5-year study of primary care in the borough of Lambeth, South London

Environmental Health ◽

10.1186/s12940-021-00730-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Mark Ashworth ◽

◽

Antonis Analitis ◽

David Whitney ◽

Evangelia Samoli ◽

...

Keyword(s):

Primary Care ◽

Negative Binomial ◽

Hospital Admissions ◽

Air Pollutant ◽

Respiratory Morbidity ◽

Short Term ◽

Short Term Exposure ◽

Short And Long Term ◽

Spatio Temporal

Abstract Background Although the associations of outdoor air pollution exposure with mortality and hospital admissions are well established, few previous studies have reported on primary care clinical and prescribing data. We assessed the associations of short and long-term pollutant exposures with General Practitioner respiratory consultations and inhaler prescriptions. Methods Daily primary care data, for 2009–2013, were obtained from Lambeth DataNet (LDN), an anonymised dataset containing coded data from all patients (1.2 million) registered at general practices in Lambeth, an inner-city south London borough. Counts of respiratory consultations and inhaler prescriptions by day and Lower Super Output Area (LSOA) of residence were constructed. We developed models for predicting daily PM2.5, PM10, NO2 and O3 per LSOA. We used spatio-temporal mixed effects zero inflated negative binomial models to investigate the simultaneous short- and long-term effects of exposure to pollutants on the number of events. Results The mean concentrations of NO2, PM10, PM2.5 and O3 over the study period were 50.7, 21.2, 15.6, and 49.9 μg/m3 respectively, with all pollutants except NO2 having much larger temporal rather than spatial variability. Following short-term exposure increases to PM10, NO2 and PM2.5 the number of consultations and inhaler prescriptions were found to increase, especially for PM10 exposure in children which was associated with increases in daily respiratory consultations of 3.4% and inhaler prescriptions of 0.8%, per PM10 interquartile range (IQR) increase. Associations further increased after adjustment for weekly average exposures, rising to 6.1 and 1.2%, respectively, for weekly average PM10 exposure. In contrast, a short-term increase in O3 exposure was associated with decreased number of respiratory consultations. No association was found between long-term exposures to PM10, PM2.5 and NO2 and number of respiratory consultations. Long-term exposure to NO2 was associated with an increase (8%) in preventer inhaler prescriptions only. Conclusions We found increases in the daily number of GP respiratory consultations and inhaler prescriptions following short-term increases in exposure to NO2, PM10 and PM2.5. These associations are more pronounced in children and persist for at least a week. The association with long term exposure to NO2 and preventer inhaler prescriptions indicates likely increased chronic respiratory morbidity.

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Acute effects of air pollution on ischaemic stroke onset and deaths: a time-series study in Changzhou, China

BMJ Open ◽

10.1136/bmjopen-2017-020425 ◽

2018 ◽

Vol 8 (7) ◽

pp. e020425 ◽

Cited By ~ 8

Author(s):

Huibin Dong ◽

Yongquan Yu ◽

Shen Yao ◽

Yan Lu ◽

Zhiyong Chen ◽

...

Keyword(s):

Time Series ◽

Ischaemic Stroke ◽

Statistical Significance ◽

Additive Model ◽

The Elderly ◽

Acute Effect ◽

Cold Season ◽

Air Pollutant ◽

Generalised Additive Model ◽

Short Term Exposure

ObjectiveTo investigate the acute effect of air pollutants on ischaemic stroke (IS) and IS-related death.SettingFive urban districts in Changzhou, China, between 9 January 2015 and 31 December 2016.ParticipantsA total of 32 840 IS cases and 4028 IS deaths were enrolled.Main outcome measuresA time-series design, generalised additive model and multivariable regression model were used to examine the percentage change (95% CI) in daily IS counts and deaths with an IQR increase in air pollutant levels for different single or multiple lag days in single-pollutant and two-pollutant models.ResultsDaily IS counts increased 0.208% (95% CI 0.036% to 0.381%) with an IQR increment in the levels of nitrogen dioxide (NO2). The estimated risk of NO2was more robust in males and in the cold season. For daily IS counts, the estimated effects of NO2and sulfur dioxide (SO2) were more significant when adjusted for particulate matter with aerodynamic diameters <2.5 µm (PM2.5) and PM10. An IQR increment in the concentration of PM10, SO2and NO2significantly increased IS deaths with 6 days of cumulative effects (0.268%, 95% CI 0.007% to 1.528%; 0.34%, 0.088% to 0.592%; and 0.263%, 0.004% to 0.522%, respectively). Young individuals (<65 years old) had a higher IS mortality risk for PM2.5, PM10, NO2and CO. For IS death, the effect estimates of SO2in the elderly, females and the cold season were more pronounced; statistical significance was also identified for SO2when adjusted for carbon monoxide (CO).ConclusionsThis study suggested that short-term exposure to ambient NO2was associated with increased IS risk. In addition, SO2was associated with increased IS onset and death.

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