ABSTRACT
Objective To investigate the correlation between the concentration of air pollutants (PM10, SO2, NO2) and the number of outpatient and emergency visits for pediatric respiratory diseases in a general hospital in Shanghai. Methods Data including pediatric respiratory disease outpatient and emergency visits in a hospital in Pudong New Area of Shanghai from May 1, 2013 to March 20, 2022 were collected. Daily concentration of air pollutants including PM10, SO2 and NO2 and meteorological data in Pudong New Area during the same period were collected. A case-crossover study with distributed lag non-linear model was conducted to explore the correlation between air pollutants (PM10, SO2, NO2) and the number of outpatient and emergency visits for pediatric respiratory diseases. Results The concentrations of PM10, SO2 and NO2 were positively with the number of outpatient and emergency visits for pediatric respiratory diseases. The strongest cumulative effect was observed on six days lag (Lag0-5) for PM10. For a 10 μg/m3 increase of the concentrations of PM10, the corresponding increase of cumulative pediatric respiratory disease outpatients was 1.10% (95%CI:0.97%, 1.23%) in Lag0-5. The strongest cumulative effect was observed on eight days lag (Lag0-7) for SO2 and NO2. For a 10 μg /m3 increase of the concentrations of SO2 and NO2, the corresponding increase of cumulative pediatric respiratory disease outpatients was 5.64% (95%CI:5.16%, 6.13%) and 5.41% (95%CI:5.15%, 5.66%) in Lag 0-7, respectively. The association of PM10 and SO2 with the number of pediatric respiratory disease visits in males was significantly stronger than that in females. The impact of PM10 on the number of pediatric respiratory disease visits in children aged 0-6 was higher than that in children aged 7-14, while the impact of SO2 and NO2 on the number of pediatric respiratory disease visits in children aged 7-14 was higher than that in children aged 0-6. Conclusion The concentration of ambient PM10, SO2, and NO2 is positively correlated with outpatient and emergency visits for pediatric respiratory diseases, with obvious lag and cumulative effect. Boys and children aged 0-6 are more susceptible to the hazard of air pollution.
ABSTRACT
Background Nitrogen dioxide (NO2), a crucial component of traffic pollutants, has been shown in studies to exert toxic effects on the nervous system. However, there is a limited body of research examining the relationship between NO2 exposure and neurological disorders in children. Objective To explore the impact of short-term NO2 exposure on the outpatient visits due to pediatric neurological diseases in Shijiazhuang. Methods From 2013 to 2021, we collected outpatient data related to neurological diseases at the Children's Hospital in Shijiazhuang, Hebei Province. We also collected air pollution data and meteorological data of the same city. The air pollution data included daily average concentrations of inhalable particles (PM10), fine particulate matter (PM2.5), sulfur dioxide (SO2), NO2, carbon monoxide (CO), and daily maximum 8-hour average concentration of ozone (O3). The meteorological data comprised daily average atmospheric pressure, temperature, relative humidity, wind speed, and sunshine duration. Employing a time-stratified case-crossover design, we used conditional logistic regression models to analyze the association between NO2 and pediatric outpatient visits for neurological diseases. Stratification analyses were conducted based on gender (male, female) and age groups (0-6 years, 7-14 years). Results The study included a total of 154348 valid pediatric outpatient visits for neurological diseases. The daily average concentration of NO2 was 49.3 μg·m−3 for the study period. The results from the single-pollutant model indicated that NO2 increased the risk of pediatric neurological outpatient visits, with the highest association observed at lag0. Specifically, for every 10 μg·m⁻³ increase in atmospheric NO2 exposure, there was a 1.40% increase (95%CI: 1.05%, 1.74%) in pediatric neurological outpatient visits. The stratification analyses revealed that increased atmospheric NO2 exposure was associated with an elevated risk of neurological outpatient visits for girls (ER=1.54, 95%CI: 1.01, 2.08) and children aged 7-14 years (ER=2.35, 95%CI: 1.68, 3.02). Even after introducing PM2.5 (ER=1.96, 95%CI: 1.49, 2.43), SO2 (ER=2.09, 95%CI: 1.62, 2.55), and O3 (ER=1.40, 95%CI: 1.06, 1.74) to the models, the impact of NO2 exposure on pediatric neurological outpatient visits remained statistically significant. The results of the multi-pollutant model also indicated a significant association (ER=2.53, 95%CI: 1.97, 3.08). Conclusion The effect of short-term exposure to atmospheric NO2 on the outpatient visits of children with neurological diseases in Shijiazhuang is acute and independent, especially for children aged 7-14.
ABSTRACT
Background Under the background of global climate change, temperature has increased dramatically. Most studies about association between temperature and human health are conducted in low-altitude areas, but rarely focus on plateau areas. Objective To examine the association between temperature and non-accidental mortality risk in Tibet Plateau, China and to identify vulnerable populations for formulating targeted policies of climate change adaptation. Methods The mortality data, meteorological data, and pollutant data of Tibet area between 2013 to 2019 were collected. Based on time-stratified case-crossover design, conditional logistic regression models were used to analyze the exposure-response relationship between temperature and cause-specific mortality, which was linearized to obtain excess risk for 1 ℃ change; attributable fraction was calculated for assessing burden attributable to temperature; and stratified analyses were further conducted by gender, age (＜65 years old, ≥65 years old), and causes of death (cardiovascular diseases, cerebrovascular diseases, and respiratory diseases). Sensitivity analyses were conducted by adjusting model parameters and variables. Results A total of 26 045 non-accidental deaths were collected in Tibet during 2013 and 2019, and the P50 of temperature was 5.0 ℃. The non-accidental mortality risk increased as temperature become colder. A 1 ℃ decrease in temperature was associated with a 2.01% (95%CI: 0.94%-3.07%) increase in total non-accidental mortality, while the association changed to 2.05% (95%CI: 0.62%-3.47%) for male and 1.96% (95%CI: 0.34%-3.56%) for female, both of statistial significance; 1.45% (95%CI: −0.10%-2.98%) for the people <65 years old (not of significance) and 2.52% (95% CI : 1.04%-3.99%) for the people ≥65 years old (of significance); the excess risk for cardiovascular mortality was 2.65% (95%CI: 1.03%-4.24%), for cerebrovascular mortality was 3.70% (95%CI: 0.74%-6.57%), both of statistical significance, and for respiratory mortality was 2.18% (95%CI: −0.14%-4.44%), without significance. The total attribution number of non-accidental mortality was 5340 (95%CI: 2719-7528), and the total attributable fraction was 20.50% (95%CI: 10.44%-28.91%). The attributable fractions were higher in specific subgroups like male (20.72%), people ≥65 years (23.33%), and people with cardiovascular diseases (26.07%). Conclusion The exposure-response relationship between temperature and non-accidental mortality in Tibet showes that the non-accidental mortality risk increase as temperature become colder. The attributable burden of disease is heavy. Residents being male, ≥65 years, with cardiovascular diseases and respiratory diseases may be vulnerable to nonoptimal temperature.
ABSTRACT
Objective To understand the levels of exposure to traffic-related air pollutants including nitrogen dioxide (NO2),PM10 and PM2.5,and the relationship between the exposure to air pollutants during pre-pregnancy or early pregnancy and birth defects.Methods Data on air pollution and birth defects from 2013 to 2015 was collected.A case-crossover design was employed to analyze the exposure-response relationship between traffic-related air pollutants and birth defects.Results A total of 4 235 pregnant women were studied.During the study period,the daily average concentrations of ambient NO2,PM10 and PM25 appeared as 60.83 μg/m3,104.94 μg/m3 and 103.88 μ.tg/m3,respectively,with the concentration of PM2.5 larger than the 2nd version of Standard National Ambient Air Quality Standard.In addition,there were strong correlations seen between each of the pollutants (P＜0.01).After adjustment for the influence of meteorological factors,it was found that the exposure to high level of NO2 and PM10 during pre-pregnancy or early pregnancy increased the risk on birth defects (P＜0.05).Conclusion Levels of exposure to adverse environmental factors during pre-pregnancy or early pregnancy could increase the risk of birth defects,suggesting that in these sensitive periods,women should try to avoid being exposed to high concentration of traffic-related air pollutants as NO2,PM10 etc.in order to reduce the risk of birth defects.
ABSTRACT
Objective To understand the levels of exposure to traffic-related air pollutants including nitrogen dioxide (NO2),PM10 and PM2.5,and the relationship between the exposure to air pollutants during pre-pregnancy or early pregnancy and birth defects.Methods Data on air pollution and birth defects from 2013 to 2015 was collected.A case-crossover design was employed to analyze the exposure-response relationship between traffic-related air pollutants and birth defects.Results A total of 4 235 pregnant women were studied.During the study period,the daily average concentrations of ambient NO2,PM10 and PM25 appeared as 60.83 μg/m3,104.94 μg/m3 and 103.88 μ.tg/m3,respectively,with the concentration of PM2.5 larger than the 2nd version of Standard National Ambient Air Quality Standard.In addition,there were strong correlations seen between each of the pollutants (P＜0.01).After adjustment for the influence of meteorological factors,it was found that the exposure to high level of NO2 and PM10 during pre-pregnancy or early pregnancy increased the risk on birth defects (P＜0.05).Conclusion Levels of exposure to adverse environmental factors during pre-pregnancy or early pregnancy could increase the risk of birth defects,suggesting that in these sensitive periods,women should try to avoid being exposed to high concentration of traffic-related air pollutants as NO2,PM10 etc.in order to reduce the risk of birth defects.
ABSTRACT
Objective To investigate the correlation between meteorological factors and the incidence of acute cardiovascular disease.Methods The number of calls for ambulance in case of cardiovascular disease between 2006 to 2010 was obtained from Beijing 120 emergency center and the data of meteorological factor during for the same period from Beijing Meteorological professional were collected,and then the impact of the weather factors of different seasons of weather factors on the incidence of cardiovascular disease was ere analyzed by time-stratified case-crossover design.Results The average daily incidence cases of cardiovascular disease in four seasons average daily were 5.61,4.55,5.05 and 6.03 respectively.The association between temperature Temperature and the incidence of acute cardiovascular disease was were non-linear relationship changes in spring and autumn seasons.Atmosphere Air pressure and the incidence were negatively correlated in the winter.The relative humidity of airand the incidence were related in the spring,summer,autumn.Wind and the incidence were related in the spring,summer,but negative correlation in the autumn,winter.Conclusions The incidences of acute cardiovascular disease are higher more in winter and spring than in summer and autumn.The incidences of cardiovascular disease are related with temperature,relative humidity,wind speed and other meteorological factors.,The influence of meteorological factors on the incidence of the disease delays to occur after changes in weather.
ABSTRACT
Case-crossover study is research using only data from cases, patient with interested event. Getting control from own data, the case-crossover study is classified into self-controlled study. It has a lot of condition to be valid study. When study satisfies the conditions, the case-crossover has a lot of advantage in which it is not necessary to collect information of control group patients, and the control is to be matched genetic and other background. The paper is summarized the case-crossover study design. (Jpn J Pharmacoepidemiol 2013; 18(2): 90-94)
ABSTRACT
Objective To analyze the association between the concentration of ambient inhalable particulate matter (PM10) and population mortality for cerebrovascular diseases and to explore the impact of PM10 on cerebrovascular diseases.Methods Data including meteorological factors,air pollutants (NO2,SO2 and PM10) and cerebrovascular disease mortality in one district of Beijing from 2004 to 2008 were collected and both symmetric bidirectional case-crossover design and conditional logistic regression model were used to analyze the associations among them.Results After adjusting the influence of meteorological factors as daily average temperature and relative humidity,the single pollutant model showed that there was no significant lag effect.In the multipollutant model,the effect of the every 105.43 μg/m3 increase of ambient PM10 had a larger impact on the daily death of the cerebrovascular diseases with statistically significant difference (P＜0.05).The effect of ambient PM10 pollution on daily death of cerebrovascular diseases was significant for females,65 year-olds and in winter season.Conclusion Our data showed that elevated levels of ambient PM10was positively associated with the increase of cerebrovascular disease mortality.The elevated levels of ambient PM10 could lead to thc increase of the daily mortality on cerebrovascular diseases for females,elderly who were 65 or older and in winter seasons.
ABSTRACT
Objective To explore the effects of heat wave on daily deaths caused by acute myocardial infarction (AMI) in Beijing.Methods A case-crossover design was used to study the impact of 5 heat waves on the daily number of AMI deaths from Jan.1,1999 to Jun.30,2000.The effect of heat wave on death in different gender or age groups was also compared.The 7th day before and after death occurred was chosen as its own bi-directional self-control.The OR value and its corresponding risk period was used to reflect the impact of heat wave on daily number of AMI deaths,lag days and duration.Results There were five heat waves during the study period.The first heat wave sustained 9 days and the maximum temperature was 38.8 ℃ with average humidity as 46.7％.The OR value for the AMI death was 1.437 (95％CI:1.066-1.937).The second heat wave lasted 3 days,with the maximum temperature of 36.8 ℃ and average humidity of 61.0％.The OR value for the AM1 death was 1.846 (95％ CI:0.671-5.076).The third heat wave continued 7 days,with the maximum temperature of 41.5 ℃ with average humidity of 58.5％.The OR value for the daily death counts caused by AMI was 2.427 (95％ CI:1.825-3.229).The fourth lasted for 3 days,with the maximum temperature of 39.6 ℃ and average humidity as 3 1.9％.The OR value for the AMI deaths was 2.857 (95％ CI:1.088-7.506).The fifth heat wave lasted for 4 days,with the maximum temperature as 37.4 ℃,and average humidity as 42.0％ during this period.The OR value for daily death counts caused by AMI was 1.500(95％CI:0.632-3.560).The OR value of the first heat wave for daily death counts of men and women caused by AMI were 1.153 (95％CI:0.756-1.758 ) and 1.818 (95％CI:1.185-2.790) respectively.The OR value for daily death counts of under 65 age was 1.200 (95％ CI:0.669-2.153),with the OR value for the older than 64 age group was 1.534 (95％ CI:1.083-2.173).The OR value for daily death counts of older than 64 age women was 1.818 (95％CI:1.109-2.981 ).The OR values of the third heat wave for daily death counts of men and women caused by AMI were 2.392 (95％CI:1.649-3.470) and 2.514 (95％CI:1.613-3.919) respectively.The OR value for daily death counts of under 65 age group was 2.000 (95％CI:1.149-3.482 ) and the OR value for the older than 64 age group was 2.623 (95％CI:1.880-3.660).The OR value for daily death counts of older than 64 age group women was 2.800 (95％CI:1.676-4.678).Conclusion (1) Significant increase for daily death counts of AMI in Beijing was noticed during the heat wave and usually causing hysteretic effect.The lag phase was 0-2 days in general.(2)The increase of maximum temperature was greater at the beginning day when the heat wave occurred in the previous day,with shorter lag time and greater risk of AMI death.(3)The risk of AMI death in women was greater than in men during the heat wave period.(4)The risk of AMI death among those older than 64 age group was greater than the under 65 year olds.(5)The impact of heat wave to the elderly female was greater.
ABSTRACT
Objective:It is well known that the use of benzodiazepines is associated with falling in elderly people, but there have been few researches focused on changes in the dose of benzodiazepines and falls. If the association between changes in the dose of benzodiazepines and falling becomes clear, we may take an action to prevent falling.In this study, we investigated the association between changes in the dose of benzodiazepines and falling among elderly inpatients in an acute-care hospital.<br>Design:Falling generally results from an interaction of multiple and diverse risk factors and situations, and medication history of each subject must be considered in this study. We conducted a case-crossover study in which a case was used as his/her own control at different time periods. Therefore covariates that were not time-dependent were automatically adjusted in this study.<br>Methods:Subjects were patients who had falling at one hospital between April 1, 2008 and November 30, 2009. Data were collected from incident report forms and medical records. Odds ratio for changes in the dose of benzodiazepines were calculated using conditional logistic regression analyses.<br>Results:A total of 422 falling by elderly people were eligible for this study. The odds ratio for increased amounts of benzodiazepines was 2.02(95% Confidence Interval(CI):1.15, 3.56). On the other hand, the odds ratio for decreased amounts of benzodiazepines was 1.11(95%CI:0.63,1.97).<br>Conclusion:There was an association between increased amounts of benzodiazepines and falling. Hence, it is considered meaningful to pay attention to falling when amounts of benzodiazepines are increased to prevent falling in hospitals.
ABSTRACT
Los estudios de casos y autocontroles se clasifican como una variante de los estudios de casos y controles. Se han mencionado en la literatura científica desde hace aproximadamente 18 años, y son empleados en investigaciones epidemiológicas con exposiciones agudas o transitorias que pueden generar un evento en salud (infarto agudo del miocardio, asma, lesiones, enfermedades infectocontagiosas, entre otras). Para su manejo se requiere definir conceptos tales como disparadores, tiempo de inducción, periodo de caso, periodo de control. Su uso es limitado en la evaluación de exposiciones crónicas o no intermitentes. Por otro lado, este diseño reduce sesgos de selección, de información, de confusión y el sobrepareamiento. Una de sus ventajas es que requieren menor tamaño de muestra que un estudio clásico de casos y controles, donde los periodos de control se pueden obtener del mismo sujeto, sin la necesidad de entrevistar a otro tipo de controles. No obstante, para el cálculo del tamaño de la muestra se debe tener encuenta el enfoque de diseños pareados. Éste es un diseño donde los principios teóricos de homogeneidad, simultaneidad y representatividad se cumplen de manera singular.
Case crossover studies are considered as a variant of case control studies, and they have been included in the scientific literature since approximately eighteen years ago. They have also been used in epidemiological research on acute or intermittent exposures that may lead to a number of events including heart attack or cardiac arrest, injuries, asthma, etc. Application of this particular study design requires defining concepts such as: triggers, induction time, case period and control period. Its use is limited in studies on chronic exposures. On the other hand, this type of design may reduce selection and misclassification bias, confounding, and overmatching. Another advantage is that it requires a small sample size because the same case can be used as its own control in one or several periods. Nevertheless, sample size calculation must be assessed as a matched case-control study. This is a type of study in which theoretical principles are accomplished in a sui generis manner.
Subject(s)
Case-Control Studies , Cross-Over Studies , BiasABSTRACT
Objective Using case-crossover design to explore the association between ambient air pollution and the hospital emergency room visits for respiratory diseases (International Classification of Diseases, tenth vision ICD-10: J00-J99) in Beijing, China. Methods Data regarding the daily hospital emergency room visits' of the respiratory diseases (ICD-10: J00-J99)were obtained in 2004.01.01-2005.12.31, from the Peking University Third Hospital and data on relevant air pollution and meteorological factors from the local municipal environmental monitoring center and meteorology bureau of Beijing, respectively. Time-stratified case-crossover technique was used to evaluate their relationships. Results from the bi-directional control sampling approach were compared with unidirectional approach. Results Using a unidirectional control sampling approach,the results obtained from a conditional logistic regression model (multi-pollutant model) after adjusting for meteorological variables, showed that the ORs of the hospital emergency room visits for the respiratory diseases associated with each 10 μg/m3 increment of PM10, SO2, NO2 were 1.010(95%CI: 1.005-1.014), 1.010(95%CI: 1.001-1.018) ,0.996(95%CI:0.983-1.009) respectively.In the bi-directional control sampling approach, the ORs were 1.002(95%CI:0.998-1.005)、 1.011 (95%CI:1.003-1.018)、 1.012(95%CI: 1.001-1.022). Conclusion Results from this study provided evidence that higher levels of ambient air pollutants increased the risk of hospital emergency room visits for respiratory diseases.
ABSTRACT
Objective To explore the impct of heat wave on the daily deaths caused by cardiovascular disease and cerebrovascular diseases in Beijing.Methods A case-crossover design was used to study the impact of 5 heat waves on the daily number of deaths from cardiovascular diseases and cerebrovascular disease,from Jan.1,1999 to Jun.30,2000.We also investigated the relationship between the heat wave and acute myocardial infarction deaths.The 7th day before death was chose as the indicator of self-control.The OR value of different lengths of risk period was calculated.The highest OR value and its corresponding risk period was used to reflect the impact of heat wave on daily number of cardiovascular and cerebrovascular disease deaths,lag days and their durations.Results There were five heat waves during the study period.The first heat wave lasted for 9 days,with the maximum temperature as 38.8 ℃ and average humidity as 46.7%.The Off value for the cardiovascular disease death,cerebrovascular disease death and acute myocardial infarction death were 1.384(95%CI:1.128-1.697),1.776(95%CI:1.456-2.167)and 1.276(95%CI:0.905-1.799)respectively.The second heat wave lasted 3 days,with the maximum temperature of 36.8 ℃ and average humidity of 61.0%.The OR value for the three causes of death were 1.385(95%CI:0.678-2.826),1.300(95% CI:0.726-2.329)and 2.000(95% CI:0.684-5.851)respectively.The third heat wave continued for 7 days,with the maximum temperature of 41.5 ℃,and average humidity of 58.5%.The OR value for the daily death counts caused by cardiovascular disease,cerebrovascular diseases and acute myocardial infarction were 2.613(95%CI:2.116-3.228),2.317(95%CI:1.875-2.863)and 3.088(95%CI:2.098-4.546)respectively.The fourth wave lasted for 3 days,with the maximum temperature as 39.6 ℃ and average humidity as 31.9%.The OR value for the deaths caused by cardiovascular disease,cerebrovascular diseases and acute myocardial infarction were 1.333(95%CI:0.724-2.457),2.429(95%CI:1.007-5.856)and 3.333(95%67:0.917-12.112)respectively.The fifth heat wave lasted for 4 days.The maximum temperature was 37.4 ℃,and the average humidity was 42.0% during the period.The OR value for daily death counts caused by cardiovascular disease,cerebrovascular disease and acute myocardial infarction were 2.333(95%CI:1.187-4.588),1.727(95%CI:0.822-3.630)and 1.800(95%CI:0.603-5.371)respectively.Conclusions(1)There were significant increases for daily death counts of both cardiovascular and cerebrovascular disease in Beijing during the heat wave and there appeared hysteresis effect as well.The lag phase of cardiovascular disease and cerebrovascular disease death was generally 2-4 days and acute myocardial infarction death usually was 0-2 days.(2)The rising of maximum temperature was greater at the beginning day of heat wave than the previous day,but the lag time was shorter,and the risk of death was greater,especially for the risk of deaths from cerebrovascular disease.(3)Fluctuations of daily maximum air temperature during the heat wave could increase the risk of death from cardiovascular disease.
ABSTRACT
OBJECTIVES: We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH). METHODS: We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure. RESULTS: Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD. CONCLUSIONS: Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Adrenergic alpha-Antagonists/therapeutic use , Cross-Over Studies , Drug-Related Side Effects and Adverse Reactions/complications , Fractures, Bone/chemically induced , Korea/epidemiology , Prostatic Hyperplasia/drug therapy , Risk AssessmentABSTRACT
the mood of anger, sadness agitation, having some kind of infection were related to IVT. Case-crossover design seemed to be able to identify the risk factors of IVT and its intensity.
ABSTRACT
Objective To explore the association between ambient average temperature and hospital emergency room visits for cardiovascular diseases(International Classification of Diseases,Tenth Vision ICD-10:I00-I99) in Beijing,China.Methods Data was collected on daily hospital emergency room visits for cardiovascular diseases from Peking University Third Hospital,including meteorological data(daily average temperature,relative humidity,wind speed,and atmospheric pressure) from the China Meteorological Data Sharing Service System,and on air pollution from the Beijing Municipal Environmental Monitoring Center.Time-stratified case-crossover design was used to analyze data on 4 seasolls.Results After adjusting data on air pollution,1 degree(℃) increase of ambient average temperature would associate with the emergency room visits of odds ratio(Ors)as 1.282(95%CI:1.250-1.315).1.027(95%CI:1.001-1.055),0.661(95%CI:0.637-0.687),and 0.960 (95%CI:0.937-0.984) in spring,summer,autumn,and winter respectively.After controlling the influence of relative humidity,wind speed,and atmospheric pressure,1℃ increase in the ambient average temperature would be associated with the emergency room visits on Ors value as 1.423 (95%CI:1.377-1.471).1.082(95%CI:1.041-1.124),0.633(95%CI:0.607-0.660)and 0.971(95%CI:0.944-1.000) in spring,summer,auttmm,and winter respectively.Conclusion These data on outcomes suggested that the elevated level of ambient temperature would increase the hospital emergeney room visits for cardiovascular diseases in spring and summer while the elevated level of ambient temperature would decrease the hospital emergency room visits for the cardiovascular diseases in autumn and winter,suggesting that patients with cardiovascular diseases should pay attention to the climate change.
ABSTRACT
Objective To explore the relationship bet-ween air pollution and acute onset of cerebral hemorrhage in Hangzhou.Methods Time-stratified case-crossover study was used to analyze the effect of aerosol optical depth(AOD),PM10,SO2 and NO2 on the acute onset of cerebral hemorrhage.Conditional logistic regression was used to estimate the odds ratios(Ors) and their 95% confidence intervals(Cis) in relation to an increase of one unit of AOD and 10 μg/m3 of air pollutants.Results After adjusted temperature and relative humidity,the Ors of acute onset of cerebral hemorrhage by a unit increase in AOD at a 2 day-lag were 1.727(95%CI:1.103-2.703)in first half year and 2.412 (95%CI:1.230-4.733) at a 2 day-lag in spring.For a 10 μg/m3 increase in SO2,the Ors were 1.119(95% CI:1.019-1.229),1.230(95%CI:1.092-1.386),1.254(95%CI:1.076-1.460) in the whole year(2 day-lag),in first half year(2 day-lag) and in spring(2 day-lag),respectively.NO2 exposure in first half year(2 day-lag) was associated with cerebral hemorrhage,with OR as 0.841(95% CI:0.734-0.964).However,there were no statistical significances for AOD,SO2,NO2 in the rest time-periods(P>0.05).Additionally,no association was found between PM10 and the acute onset of cerebral hemorrhage in any time-periods(P>0.05).Conclusion Our data showed that there was association between air pollution and the acute onset of cerebral hemorrhage,especially in spring and in the first half of the year.
ABSTRACT
Objective To investigate the short-term effect of particulate matter in air on the mortality of stroke. Methods Using time-stratified case-crossover study design,an association was examined between stroke mortality and particulate matter with aerodynamic diameter of ＜10μm(PM10) of 2002- 2004 in Hangzhou city.Meanwhile,the acute health effect of other gaseous pollutants (sulfur dioxide,SO2 and nitrogen dioxide,NO2) was also analyzed.Results A total of 9906 deaths of stroke were included.The crude stroke mortality was 83.54 per 100 000.After being adjusted for meteorological factors,when an increase of 10 μg/m3 in PM10,SO2 and NO2 in three days was noticed,it appeared that the increases of mortality of stroke were 0.56%(95%CI:0.14%-0.99%),1.62%(95%CI:0.26%-3.01%) and 2.07%( 95%CI:0.54%-3.62%) respectively.There was no distinct association in multipollutant models.In sensitivity analysis,the associations were found in all single-pollutant models but not statistically significant in multi-pollutant models after replacing the missing values.Conclusion It is suggested that the short-term elevation in PM10 as well as SO2 and NO2 daily concentrations were related to the increase of stroke mortality in Hangzhou city.
ABSTRACT
Objective To explore the association between the concentration of particulate matters with an aerodynamic diameter of <10 μm ( PM10 ) and the hospital emergency room visits for circulatory diseases ( International Classification of Diseases, tenth vision ICD-10 : 100-199) in Beijing, China. Methods We collected data for daily hospital emergency room visits of circulatory diseases ( ICD-10:I00-I99 ) from Peking University Third Hospital and from the ambient air PM10 through the Beijing Municipal Environmental Monitoring Center. A time-stratified case-crossover design was used to evaluate associations between circulatory disease health outcomes and PM10.Results The no-lagged unidirectional case-crossover design with 1:4 matched pairs had the highest odds ratios (ORs) between PM10 and the hospital emergency room visits for circulatory diseases. After adjusting the temperature and the relative humidity, a 10μg/m3 increased in the PM10 were found associated with the emergency room visits on value of ORs of 1.006(95% CI:1.003-1.008) for the total circulatory diseases ( ICD-10:I00-I99), 1.003 (95% CI:0.996-1.010) for coronary heart disease ( ICD-10:I20-I25 ), 1.005 ( 95 % CI:0.997-1.013 ) for cardiac arrhythmia ( ICE)-10:I47-I49), 1.019 (95 % CI:1.005-1.033 ) for heart failure disease ( ICD-10:I50 ),and 1.003 ( 95 % CI : 0.998-1.007 ) for cerebrovascular diseases ( ICD-10:I60-I69 ), respectively. Conclusion These findings suggested that elevated levels of ambient PM10 were positively associated with hospital emergency room visits for the total number of circulatory diseases and heart failure disease.
ABSTRACT
Objective To explore the association between the daily maximum temperature and hospital emergency visits for cardiovascular and cerebrovascular diseases ( ICD-10: I00～I99) in different seasons in Beijing, China. Methods The data of the daily hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10: I00～I99) from a Level-3A hospital in Haidian district in Beijing during 2004-2006 and the corresponding meteorological, air pollution data were collected. The seasonal-stratified case-crossover design and Logistic multiple regression model was used for the data analysis. Results After adjusting the influence of relative humidity, wind speed and atmospheric pressure, for 1℃ increase in daily maximum temperature, the corresponding increase in the hospital emergency visits of the diseases was 17.3%(OR=1.173, 95%CI:1.149～1.197) and 4.2% (OR=1.042, 95%CI: 1.011～1.074) in spring and summer of the years, respectively (P0.05). Conclusion The increase of daily maximum temperature may be a risk factor for daily hospital emergency visits for cardiovascular and cerebrovascular diseases in spring and summer, however, it may be a preventive factor in autumn. The effects of air temperature on health should not be the same in seasons.