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
Background: PM<sub>2.5</sub> exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM<sub>2.5</sub> constitutes. This study evaluated the effects of increased short-term exposure to PM<sub>2.5</sub> constituents on chro...
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doaj-cab441aa46bc4d098f88934a9f130ee12021-04-21T23:01:56ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012021-04-01184400440010.3390/ijerph18094400Short-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 AreaYii-Ting Huang0Chien-Chih Chen1Yu-Ni Ho2Ming-Ta Tsai3Chih-Min Tsai4Po-Chun Chuang5Fu-Jen Cheng6Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, TaiwanCollege of Medicine, Chang Gung University, Guishan District, Taoyuan City 333, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, TaiwanDepartment of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, TaiwanBackground: PM<sub>2.5</sub> exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM<sub>2.5</sub> constitutes. This study evaluated the effects of increased short-term exposure to PM<sub>2.5</sub> 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 PM<sub>2.5</sub>, PM<sub>10</sub>, and the four PM<sub>2.5</sub> components, including organic carbon (OC), elemental carbon (EC), nitrate (NO<sub>3</sub><sup>−</sup>), and sulfate (SO<sub>4</sub><sup>2−</sup>), 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 PM<sub>2.5</sub> 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 <i>p</i> = 0.019). The risk of COPD exacerbation after exposure to PM<sub>2.5</sub> was higher in individuals who are currently smoking, with malignancy, or during cold season, but the differences did not achieve statistical significance. Conclusion: PM<sub>2.5</sub> 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.https://www.mdpi.com/1660-4601/18/9/4400air pollutionchronic obstructive pulmonary disease (COPD)constituentsemergency departmentparticulate matter |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yii-Ting Huang Chien-Chih Chen Yu-Ni Ho Ming-Ta Tsai Chih-Min Tsai Po-Chun Chuang Fu-Jen Cheng |
spellingShingle |
Yii-Ting Huang Chien-Chih Chen Yu-Ni Ho Ming-Ta Tsai Chih-Min Tsai Po-Chun Chuang Fu-Jen Cheng 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 International Journal of Environmental Research and Public Health air pollution chronic obstructive pulmonary disease (COPD) constituents emergency department particulate matter |
author_facet |
Yii-Ting Huang Chien-Chih Chen Yu-Ni Ho Ming-Ta Tsai Chih-Min Tsai Po-Chun Chuang Fu-Jen Cheng |
author_sort |
Yii-Ting Huang |
title |
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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2021-04-01 |
description |
Background: PM<sub>2.5</sub> exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM<sub>2.5</sub> constitutes. This study evaluated the effects of increased short-term exposure to PM<sub>2.5</sub> 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 PM<sub>2.5</sub>, PM<sub>10</sub>, and the four PM<sub>2.5</sub> components, including organic carbon (OC), elemental carbon (EC), nitrate (NO<sub>3</sub><sup>−</sup>), and sulfate (SO<sub>4</sub><sup>2−</sup>), 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 PM<sub>2.5</sub> 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 <i>p</i> = 0.019). The risk of COPD exacerbation after exposure to PM<sub>2.5</sub> was higher in individuals who are currently smoking, with malignancy, or during cold season, but the differences did not achieve statistical significance. Conclusion: PM<sub>2.5</sub> 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. |
topic |
air pollution chronic obstructive pulmonary disease (COPD) constituents emergency department particulate matter |
url |
https://www.mdpi.com/1660-4601/18/9/4400 |
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