RESUMO
Proceedings of the European Seminars in Respiratory Medicine course, Inhalation therapy in the next decade: Determinants of adherence to treatment in asthma and COPD, held in Taormina, Italy, on 3-4 March, 2017.
Assuntos
Asma/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Terapia Respiratória/instrumentação , Asma/epidemiologia , Asma/mortalidade , Análise Custo-Benefício , Feminino , História do Século XX , História do Século XXI , Humanos , Itália/epidemiologia , Masculino , Adesão à Medicação/psicologia , Mortalidade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/mortalidade , Pneumologia/história , Pneumologia/organização & administração , Terapia Respiratória/métodosRESUMO
Proceedings of the European Seminars in Respiratory Medicine course, Long-Term Integrated Care of COPD Patients held in Stresa, Italy, on 16-17 June, 2016.
Assuntos
Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/terapia , Pneumologia/organização & administração , Adulto , Prestação Integrada de Cuidados de Saúde/métodos , Europa (Continente)/epidemiologia , Exercício Físico , Feminino , Humanos , Incidência , Pesquisa Interdisciplinar/métodos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Prevalência , Doença Pulmonar Obstrutiva Crônica/classificação , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Autogestão/estatística & dados numéricosRESUMO
BACKGROUND: Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. METHODS: We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0-2 and lag 3-5 in both single and multi-pollutant models, adjusted for daily weather variables. RESULTS: An increase in ozone (O(3)) levels at lag 3-5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0-2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO(2)), CO, nitrate dioxide (NO(2)), and particulate matter (PM(10) and PM(2.5)). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0-2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association. CONCLUSIONS: Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.
