1
|
Kloog I, Zhang X. Methods to Advance Climate Science in Respiratory Health: Satellite-Based Environmental Modeling for Temperature Exposure Assessment in Epidemiological Studies. Immunol Allergy Clin North Am 2024; 44:97-107. [PMID: 37973263 DOI: 10.1016/j.iac.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Climate change is a major concern with significant impacts on human health including respiratory outcomes, particularly through changes in air temperature. The rise in global temperature has led to an increase in heat waves and extreme weather events, which pose serious risks to respiratory health. Accurately assessing the effects of air temperature on respiratory health requires a comprehensive approach that incorporates fine-scale exposure assessment to characterize the geospatial environment impacting population health. Recent advances in open-source earth observation data have allowed for improved exposure assessment through temperature modeling.
Collapse
Affiliation(s)
- Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Geography and Environmental Development, Ben-Gurion University, Beer Sheva, Israel; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, The Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
2
|
Arias JC, Ramos MI, Cubillas JJ. Predicting emergency health care demands due to respiratory diseases. Int J Med Inform 2023; 177:105163. [PMID: 37517299 DOI: 10.1016/j.ijmedinf.2023.105163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Timely care in the health sector is essential for the recovery of patients, and even more so in the case of a health emergency. In these cases, appropriate management of human and technical resources is essential. These are limited and must be mobilised in an optimal and efficient manner. OBJECTIVE This paper analyses the use of the health emergency service in a city, Jaén, in the south of Spain. The study is focused on the most recurrent case in this service, respiratory diseases. METHODS Machine Learning algorithms are used in which the input variables are multisource data and the target attribute is the prediction of the number of health emergency demands that will occur for a selected date. Health, social, economic, environmental, and geospatial data related to each of the emergency demands were integrated and related. Linear and nonlinear regression algorithms were used: support vector machine (SVM) with linear kernel and generated linear model (GLM), and the nonlinear SVM with Gaussian kernel. RESULTS Predictive models of emergency demand due to respiratory disseases were generated with am absolute error better than 35 %. CONCLUSIONS This model helps to make decisions on the efficient sizing of emergency health resources to manage and respond in the shortest possible time to patients with respiratory diseases requiring urgent care in the city of Jaén.
Collapse
Affiliation(s)
- J C Arias
- Group TIC-144 of the Andalusian Research Plan, University of Jaen, Spain
| | - M I Ramos
- Department of Cartographic, Geodetic and Photogrammetric Engineering, University of Jaen, Spain.
| | - J J Cubillas
- Department of Information and Communication Technologies applied to Education, International University of La Rioja, Spain
| |
Collapse
|
3
|
Gardin TN, Requia WJ. Air quality and individual-level academic performance in Brazil: A nationwide study of more than 15 million students between 2000 and 2020. ENVIRONMENTAL RESEARCH 2023; 226:115689. [PMID: 36933637 DOI: 10.1016/j.envres.2023.115689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Studies have shown that living and studying in places with poor air quality is associated with cognitive deficits. However, there is still a limitation in the literature in terms of study design and geographic location. Also, only a few studies have looked at the effects of more than one air pollutant. To address this research gap, in this study we estimated the association between air pollution (considering three criteria air pollutants - PM2.5, NO2, and O3) and academic performance (a proxy of cognitive performance) at the student level in Brazil between 2000 and 2020. We assessed academic performance data from a nationwide high school exam. The data included 15,443,772 students who took this national test between 2000 and 2020 in Brazil. Air pollution data was derived from satellite remote sensing observations. We fit mixed-effects regression models with a state-specific random intercept and adjusted for school characteristics, spatio-temporal factors, and socioeconomic status. We performed sub-group analyses by stratifying the analysis by type of school management (private or public), location of the school (urban or rural), sex, and periods. Our findings suggest air pollution exposure was associated with drops in the students' marks varying from 0.13% to 5.39%. To our knowledge, this is the first study that estimates the association between air pollution and individual-level academic performance in Brazil. This study is of substantial environmental and educational importance by supporting policymakers to improve the air quality surrounding schools.
Collapse
Affiliation(s)
- Thiago N Gardin
- School of Public Policy and Government, Fundação Getúlio Vargas Brasília, Distrito Federal, Brazil
| | - Weeberb J Requia
- School of Public Policy and Government, Fundação Getúlio Vargas Brasília, Distrito Federal, Brazil.
| |
Collapse
|
4
|
Requia WJ, Vicedo-Cabrera AM, de Schrijver E, Amini H, Gasparrini A. Association of high ambient temperature with daily hospitalization for cardiorespiratory diseases in Brazil: A national time-series study between 2008 and 2018. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 331:121851. [PMID: 37211231 DOI: 10.1016/j.envpol.2023.121851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/28/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
Further research is needed to examine the nationwide impact of temperature on health in Brazil, a region with particular challenges related to climate conditions, environmental characteristics, and health equity. To address this gap, in this study, we looked at the relationship between high ambient temperature and hospital admissions for circulatory and respiratory diseases in 5572 Brazilian municipalities between 2008 and 2018. We used an extension of the two-stage design with a case time series to assess this relationship. In the first stage, we applied a distributed lag non-linear modeling framework to create a cross-basis function. We next applied quasi-Poisson regression models adjusted by PM2.5, O3, relative humidity, and time-varying confounders. We estimated relative risks (RRs) of the association of heat (percentile 99th) with hospitalization for circulatory and respiratory diseases by sex, age group, and Brazilian regions. In the second stage, we applied meta-analysis with random effects to estimate the national RR. Our study population includes 23,791,093 hospital admissions for cardiorespiratory diseases in Brazil between 2008 and 2018. Among those, 53.1% are respiratory diseases, and 46.9% are circulatory diseases. The robustness of the RR and the effect size varied significantly by region, sex, age group, and health outcome. Overall, our findings suggest that i) respiratory admissions had the highest RR, while circulatory admissions had inconsistent or null RR in several subgroup analyses; ii) there was a large difference in the cumulative risk ratio across regions; and iii) overall, women and the elderly population experienced the greatest impact from heat exposure. The pooled national results for the whole population (all ages and sex) suggest a relative risk of 1.29 (95% CI: 1.26; 1.32) associated with respiratory admissions. In contrast, national meta-analysis for circulatory admissions suggested robust positive associations only for people aged 15-45, 46-65, >65 years old; for men aged 15-45 years old; and women aged 15-45 and 46-65 years old. Our findings are essential for the body of scientific evidence that has assisted policymakers to promote health equity and to create adaptive measures and mitigations.
Collapse
Affiliation(s)
- Weeberb J Requia
- School of Public Policy and Government, Fundação Getúlio Vargas Brasília, Distrito Federal, Brazil.
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Evan de Schrijver
- Institute of Social and Preventive Medicine, University of Bern, Oeschger Center for Climate Change Research, University of Bern, Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Heresh Amini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | |
Collapse
|
5
|
Motlogeloa O, Fitchett JM. Climate and human health: a review of publication trends in the International Journal of Biometeorology. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02466-8. [PMID: 37129619 PMCID: PMC10153057 DOI: 10.1007/s00484-023-02466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
The climate-health nexus is well documented in the field of biometeorology. Since its inception, Biometeorology has in many ways become the umbrella under which much of this collaborative research has been conducted. Whilst a range of review papers have considered the development of biometeorological research and its coverage in this journal, and a few have reviewed the literature on specific diseases, none have focused on the sub-field of climate and health as a whole. Since its first issue in 1957, the International Journal of Biometeorology has published a total of 2183 papers that broadly consider human health and its relationship with climate. In this review, we identify a total of 180 (8.3%, n = 2183) of these papers that specifically focus on the intersection between meteorological variables and specific, named diagnosable diseases, and explore the publication trends thereof. The number of publications on climate and health in the journal increases considerably since 2011. The largest number of publications on the topic was in 2017 (18) followed by 2021 (17). Of the 180 studies conducted, respiratory diseases accounted for 37.2% of the publications, cardiovascular disease 17%, and cerebrovascular disease 11.1%. The literature on climate and health in the journal is dominated by studies from the global North, with a particular focus on Asia and Europe. Only 2.2% and 8.3% of these studies explore empirical evidence from the African continent and South America respectively. These findings highlight the importance of continued research on climate and human health, especially in low- and lower-middle-income countries, the populations of which are more vulnerable to climate-sensitive illnesses.
Collapse
Affiliation(s)
- Ogone Motlogeloa
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer M Fitchett
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa.
| |
Collapse
|
6
|
How Vulnerable Are Patients with COPD to Weather Extremities?—A Pilot Study from Hungary. Healthcare (Basel) 2022; 10:healthcare10112309. [DOI: 10.3390/healthcare10112309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most common causes of death globally, with increasing prevalence and years lived with disability (YLD). We aimed to investigate how extreme weather conditions were associated with the number of daily COPD-related emergency visits. We collected data regarding the number of daily emergency department (ED) visits made by patients with COPD in 2017, along with all relevant daily meteorological data for the same year. An analysis of the relationship between the number of COPD-related ED visits and extreme meteorological events was carried out. Extremely low temperatures (OR = 1.767) and dew points (OR = 1.795), extremely high atmospheric pressure (OR = 1.626), a high amount of precipitation (OR = 1.270), and light wind speed (OR = 1.560) were identified as possible risk factors for a higher number of COPD-related ED visits. In contrast, extremely high temperatures (OR = 0.572) and dew points (OR = 0.606) were found to be possible protective factors for COPD-related ED visits. By determining the meteorological risk factors for a high number of COPD-related ED visits, our study may help provide invaluable data for identifying vulnerable patient groups based on weather events, thus making more optimal capacity planning at the ED possible.
Collapse
|
7
|
Tran HM, Chen TT, Lu YH, Tsai FJ, Chen KY, Ho SC, Wu CD, Wu SM, Lee YL, Chung KF, Kuo HP, Lee KY, Chuang HC. Climate-mediated air pollution associated with COPD severity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 843:156969. [PMID: 35760178 DOI: 10.1016/j.scitotenv.2022.156969] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
Air pollution has been reported to be associated with chronic obstructive pulmonary disease (COPD). Our study aim was to examine the mediating effects of air pollution on climate-associated health outcomes of COPD patients. A cross-sectional study of 117 COPD patients was conducted in a hospital in Taiwan. We measured the lung function, 6-min walking distance, oxygen desaturation, white blood cell count, and percent emphysema (low attenuation area, LAA) and linked these to 0-1-, 0-3-, and 0-5-year lags of individual-level exposure to relative humidity (RH), temperature, and air pollution. Linear regression models were conducted to examine associations of temperature, RH, and air pollution with severity of health outcomes. A mediation analysis was conducted to examine the mediating effects of air pollution on the associations of RH and temperature with health outcomes. We observed that a 1 % increase in the RH was associated with increases in forced expiratory volume in 1 s (FEV1), eosinophils, and lymphocytes, and a decrease in the total-lobe LAA. A 1 °C increase in temperature was associated with decreases in oxygen desaturation, and right-, left-, and upper-lobe LAA values. Also, a 1 μg/m3 increase in PM2.5 was associated with a decrease in the FEV1 and an increase in oxygen desaturation. A 1 μg/m3 increases in PM10 and PM2.5 was associated with increases in the total-, right-, left, upper-, and lower-lobe (PM2.5 only) LAA. A one part per billion increase in NO2 was associated with a decrease in the FEV1 and an increase in the upper-lobe LAA. Next, we found that NO2 fully mediated the association between RH and FEV1. We found PM2.5 fully mediated associations of temperature with oxygen saturation and total-, right-, left-, and upper-lobe LAA. In conclusion, climate-mediated air pollution increased the risk of decreasing FEV1 and oxygen saturation and increasing emphysema severity among COPD patients. Climate change-related air pollution is an important public health issue, especially with regards to respiratory disease.
Collapse
Affiliation(s)
- Huan Minh Tran
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam.
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yueh-Hsun Lu
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK.
| | - Han-Pin Kuo
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| |
Collapse
|
8
|
Han Q, Liu Z, Jia J, Anderson BT, Xu W, Shi P. Web-Based Data to Quantify Meteorological and Geographical Effects on Heat Stroke: Case Study in China. GEOHEALTH 2022; 6:e2022GH000587. [PMID: 35949256 PMCID: PMC9356531 DOI: 10.1029/2022gh000587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/16/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
Heat stroke is a serious heat-related health outcome that can eventually lead to death. Due to the poor accessibility of heat stroke data, the large-scale relationship between heat stroke and meteorological factors is still unclear. This work aims to clarify the potential relationship between meteorological variables and heat stroke, and quantify the meteorological threshold that affected the severity of heat stroke. We collected daily heat stroke search index (HSSI) and meteorological data for the period 2013-2020 in 333 Chinese cities to analyze the relationship between meteorological variables and HSSI using correlation analysis and Random forest (RF) model. Temperature and relative humidity (RH) accounted for 62% and 9% of the changes of HSSI, respectively. In China, cases of heat stroke may start to occur when temperature exceeds 36°C and RH exceeds 58%. This threshold was 34.5°C and 79% in the north of China, and 36°C and 48% in the south of China. Compared to RH, the threshold of temperature showed a more evident difference affected by altitude and distance from the ocean, which was 35.5°C in inland cities and 36.5°C in coastal cities; 35.5°C in high-altitude cities and 36°C in low-altitude cities. Our findings provide a possible way to analyze the interaction effect of meteorological variables on heat-related illnesses, and emphasizes the effects of geographical environment. The meteorological threshold quantified in this research can also support policymaker to establish a better meteorological warning system for public health.
Collapse
Affiliation(s)
- Qinmei Han
- State Key Laboratory of Earth Surface Processes and Resource EcologyBeijing Normal UniversityBeijingChina
- Academy of Disaster Reduction and Emergency ManagementMinistry of Emergency Management and Ministry of EducationBeijing Normal UniversityBeijingChina
- Faculty of Geographical ScienceBeijing Normal UniversityBeijingChina
| | - Zhao Liu
- School of Linkong Economics and ManagementBeijing Institute of Economics and ManagementBeijingChina
| | - Junwen Jia
- School of System ScienceBeijing Normal UniversityBeijingChina
| | | | - Wei Xu
- State Key Laboratory of Earth Surface Processes and Resource EcologyBeijing Normal UniversityBeijingChina
- Academy of Disaster Reduction and Emergency ManagementMinistry of Emergency Management and Ministry of EducationBeijing Normal UniversityBeijingChina
- Faculty of Geographical ScienceBeijing Normal UniversityBeijingChina
| | - Peijun Shi
- State Key Laboratory of Earth Surface Processes and Resource EcologyBeijing Normal UniversityBeijingChina
- Academy of Disaster Reduction and Emergency ManagementMinistry of Emergency Management and Ministry of EducationBeijing Normal UniversityBeijingChina
- Faculty of Geographical ScienceBeijing Normal UniversityBeijingChina
- Academy of Plateau Science and SustainabilityPeople's Government of Qinghai Province and Beijing Normal UniversityXiningChina
| |
Collapse
|
9
|
Li C, Managi S. Impacts of air pollution on COVID-19 case fatality rate: a global analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:27496-27509. [PMID: 34982383 PMCID: PMC8724597 DOI: 10.1007/s11356-021-18442-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/28/2021] [Indexed: 05/22/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is still rapidly spreading globally. To probe high-risk cities and the impacts of air pollution on public health, this study explores the relationship between the long-term average concentration of air pollution and the city-level case fatality rate (CFR) of COVID-19 globally. Then, geographically weighted regression (GWR) is applied to examine the spatial variability of the relationships. Six air pollution factors, including nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), PM2.5 (particles with diameter ≤2.5 μm), PM10 (particles with diameter ≤10 μm), and air quality index (AQI), are positively associated with the city-level COVID-19 CFR. Our results indicate that a 1-unit increase in NO2 (part per billion, PPB), SO2 (PPB), O3 (PPB), PM2.5 (microgram per cubic meter, μg/m3), PM10 (μg/m3), AQI (score), is related to a 1.450%, 1.005%, 0.992%, 0.860%, 0.568%, and 0.776% increase in the city-level COVID-19 CFR, respectively. Additionally, the effects of NO2, O3, PM2.5, AQI, and probability of living with poor AQI on COVID-19 spatially vary in view of the estimation of the GWR. In other words, the adverse impacts of air pollution on health are different among the cities. In summary, long-term exposure to air pollution is negatively related to the COVID-19 health outcome, and the relationship is spatially non-stationary. Our research sheds light on the impacts of slashing air pollution on public health in the COVID-19 pandemic to help governments formulate air pollution policies in light of the local situations.
Collapse
Affiliation(s)
- Chao Li
- Urban Institute & School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Shunsuke Managi
- Urban Institute & School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan.
| |
Collapse
|
10
|
Hoffmann C, Maglakelidze M, von Schneidemesser E, Witt C, Hoffmann P, Butler T. Asthma and COPD exacerbation in relation to outdoor air pollution in the metropolitan area of Berlin, Germany. Respir Res 2022; 23:64. [PMID: 35307034 PMCID: PMC8935815 DOI: 10.1186/s12931-022-01983-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/11/2022] [Indexed: 01/05/2023] Open
Abstract
Background Ambient air pollution poses a major risk for the development and aggravation of respiratory diseases. Evidence suggests that even in low-level air pollution environments there is a risk for an increase in adverse respiratory symptoms. We examined whether variations in daily air pollution levels of nitrogen dioxide, ozone, or particulate matter in Berlin, Germany were associated with hospital admissions of chronic obstructive pulmonary disease (COPD) and asthma patients in a time series analysis. Methods We calculated single and multi-pollutant models, investigated possible lags in effect, and analysed the influence of meteorological variables on the results. Data from January 2005 through December 2015 were used to quantify the concentration–response. Results The risk ratio for asthma patients to be hospitalised on the same day of NO2 exposure was 1.101 per 10 µg/m3 NO2 increase (95% CI: 1.013 to 1.195), for COPD patients 1.123 (95% CI: 1.081 to 1.168). Neither the exposure to ozone (95% CI: 0.904 to 1.020), PM10 (95% CI: 0.990 to 1.127), nor PM2.5 (95% CI: 0.981 to 1.148) was associated with an increased risk ratio for asthma patients to be hospitalised. Risk ratios for the hospital admission of COPD patients were also not increased due to ozone (95% CI: 0.981 to 1.033), PM10 (95% CI: 0.988 to 1.032), or PM2.5 (95% CI: 0.966 to 1.019) exposure. The presented risk ratios and confidence intervals relate to the day of exposure. We found no increased hospitalisation risks with a delayed occurrence on subsequent days. Conclusions A quantifiable, statistically significant increase in risk for asthma and COPD exacerbations owing to NO2 exposure at levels well below European regulatory limit values was observed. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01983-1.
Collapse
|
11
|
Ku Y, Kwon SB, Yoon JH, Mun SK, Chang M. Machine Learning Models for Predicting the Occurrence of Respiratory Diseases Using Climatic and Air-Pollution Factors. Clin Exp Otorhinolaryngol 2022; 15:168-176. [PMID: 34990536 PMCID: PMC9149237 DOI: 10.21053/ceo.2021.01536] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/19/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Because climatic and air-pollution factors are known to influence the occurrence of respiratory diseases, we used these factors to develop machine learning models for predicting the occurrence of respiratory diseases. Methods We obtained the daily number of respiratory disease patients in Seoul. We used climatic and air-pollution factors to predict the daily number of patients treated for respiratory diseases per 10,000 inhabitants. We applied the relief-based feature selection algorithm to evaluate the importance of feature selection. We used the gradient boosting and Gaussian process regression (GPR) methods, respectively, to develop two different prediction models. We also employed the holdout cross-validation method, in which 75% of the data was used to train the model, and the remaining 25% was used to test the trained model. We determined the estimated number of respiratory disease patients by applying the developed prediction models to the test set. To evaluate the performance of each model, we calculated the coefficient of determination (R2) and the root mean square error (RMSE) between the original and estimated numbers of respiratory disease patients. We used the Shapley Additive exPlanations (SHAP) approach to interpret the estimated output of each machine learning model. Results Features with negative weights in the relief-based algorithm were excluded. When applying gradient boosting to unseen test data, R2 and RMSE were 0.68 and 13.8, respectively. For GPR, the R2 and RMSE were 0.67 and 13.9, respectively. SHAP analysis showed that reductions in average temperature, daylight duration, average humidity, sulfur dioxide (SO2), total solar insolation amount, and temperature difference increased the number of respiratory disease patients, whereas increases in atmospheric pressure, carbon monoxide (CO), and particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5) increased the number of respiratory disease patients. Conclusion We successfully developed models for predicting the occurrence of respiratory diseases using climatic and air-pollution factors. These models could evolve into public warning systems.
Collapse
Affiliation(s)
- Yunseo Ku
- Department of Biomedical Engineering, Chungnam National University College of Medicine, Daejeon, Korea
| | - Soon Bin Kwon
- Department of Neurology, Columbia University, New York, NY, USA
| | - Jeong-Hwa Yoon
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| |
Collapse
|
12
|
Requia WJ, Amini H, Mukherjee R, Gold DR, Schwartz JD. Health impacts of wildfire-related air pollution in Brazil: a nationwide study of more than 2 million hospital admissions between 2008 and 2018. Nat Commun 2021; 12:6555. [PMID: 34772927 PMCID: PMC8589982 DOI: 10.1038/s41467-021-26822-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 10/21/2021] [Indexed: 11/12/2022] Open
Abstract
We quantified the impacts of wildfire-related PM2.5 on 2 million hospital admissions records due to cardiorespiratory diseases in Brazil between 2008 and 2018. The national analysis shows that wildfire waves are associated with an increase of 23% (95%CI: 12%-33%) in respiratory hospital admissions and an increase of 21% (95%CI: 8%-35%) in circulatory hospital admissions. In the North (where most of the Amazon region is located), we estimate an increase of 38% (95%CI: 30%-47%) in respiratory hospital admissions and 27% (95%CI: 15%-39%) in circulatory hospital admissions. Here we report epidemiological evidence that air pollution emitted by wildfires is significantly associated with a higher risk of cardiorespiratory hospital admissions.
Collapse
Affiliation(s)
- Weeberb J Requia
- School of Public Policy and Government, Fundação Getúlio Vargas Brasília, Distrito Federal, Brazil.
| | - Heresh Amini
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Rajarshi Mukherjee
- Department of Biostatistics, Harvard T.H. Chan School of Public Health Boston, Boston, Massachusetts, USA
| | - Diane R Gold
- Harvard T.H. Chan School of Public Health, Harvard University Boston, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health Boston, Boston, Massachusetts, USA
| |
Collapse
|
13
|
Associations between Dust Exposure and Hospitalizations in El Paso, Texas, USA. ATMOSPHERE 2021. [DOI: 10.3390/atmos12111413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Southwestern USA has been identified as one of the most persistent dust-producing regions of North America, where exposure to inhalable particulate matter (PM10) originating from desertic landscape during dust events/dust exposures (DEs) can reach hazardous levels. El Paso, Texas’s ambient air has reached hazardous levels of PM10 from dust with near zero visibility due to these natural events originating in the surrounding Chihuahuan Desert. The aim of this study was to investigate whether dust exposures in El Paso (generally acute, short-term exposures from nearby source areas) are associated with significant increases in hospitalizations on the day of the exposure and up to seven days afterwards. Using a Poisson regression, it was found that the relative risks of hospitalizations due to a variety of conditions were associated with dust exposures (through increases of 100 μg/m3 maximum hourly PM10 and/or increases of 4.5 m/s maximum hourly wind speed) in El Paso County, Texas between 2010 and 2014. Valley fever, coronary atherosclerosis, genitourinary diseases, neurodegenerative diseases, injury and poisoning, circulatory system conditions, respiratory system diseases, births, septicemia, Associated Diseases (the aggregation of hospital admissions for all causes, each associated with at least 5% of hospitalizations), and all ICD-9 admissions were significantly positively associated with dust exposures, indicated from higher to lower significant risk, at different lag periods after exposure. These findings, showing that an association does exist between dust exposures and hospitalizations, have important implications for residents of the world’s dryland cities.
Collapse
|
14
|
The Impact of Air Pollutants and Meteorological Factors on Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Study. Ann Am Thorac Soc 2021; 19:214-226. [PMID: 34499589 DOI: 10.1513/annalsats.202103-298oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Chronic obstructive lung disease (COPD) is a chronic progressive disease. Although smoking is the most important risk factor, 30% of COPD patients are never smokers, and environmental agents are also influential. The effects of air pollutants and meteorological factors on COPD exacerbations have not been studied extensively. OBJECTIVE We aimed to investigate the air pollutants and meteorological factors that impact the incidence of COPD exacerbations. METHODS We obtained clinical data of COPD exacerbation cases from The National Health Insurance Service (NHIS) and merged it with 24-hour average values of air pollutants and meteorological factors from national databases. Patients who reside in eight metropolitan cities, where observatory stations are densely located, were selected for analysis. RESULTS In 1,404,505 COPD patients between 2013 and 2018, 15,282 COPD exacerbations leading to hospitalization or emergency room visits were identified. Among the various air pollutants and meteorological factors, particulate matter (PM)2.5, PM10, NO2, SO2, CO, O3, average temperature and diurnal temperature range (DTR) were associated with COPD exacerbations. GAM model analysis with cubic splines showed an inverted U-shaped relationship with PM2.5, PM10, CO, NO2, SO2, O3, DTR and humidity, while it displayed a U-shaped pattern with the average temperature. Distinct patterns were found from 2015-2016 to 2017-2018. CONCLUSIONS PM2.5, PM10, CO, NO2, O3, SO2, average temperature, humidity, and DTR affected the incidence of COPD exacerbations in various patterns, up to 10 lag days.
Collapse
|
15
|
Li M, Chen S, Zhao H, Tang C, Lai Y, Ung COL, Su J, Hu H. The short-term associations of chronic obstructive pulmonary disease hospitalizations with meteorological factors and air pollutants in Southwest China: a time-series study. Sci Rep 2021; 11:12914. [PMID: 34155257 PMCID: PMC8217527 DOI: 10.1038/s41598-021-92380-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/31/2021] [Indexed: 11/09/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is the fourth major cause of mortality and morbidity worldwide and is projected to be the third by 2030. However, there is little evidence available on the associations of COPD hospitalizations with meteorological factors and air pollutants in developing countries/regions of Asia. In particular, no study has been done in western areas of China considering the nonlinear and lagged effects simultaneously. This study aims to evaluate the nonlinear and lagged associations of COPD hospitalizations with meteorological factors and air pollutants using time-series analysis. The modified associations by sex and age were also investigated. The distributed lag nonlinear model was used to establish the association of daily COPD hospitalizations of all 441 public hospitals in Chengdu, China from Jan/2015-Dec/2017 with the ambient meteorological factors and air pollutants. Model parameters were optimized based on quasi Akaike Information Criterion and model diagnostics was conducted by inspecting the deviance residuals. Subgroup analysis by sex and age was also performed. Temperature, relative humidity, wind and Carbon Monoxide (CO) have statistically significant and consistent associations with COPD hospitalizations. The cumulative relative risk (RR) was lowest at a temperature of 19℃ (relative humidity of 67%). Both extremely high and low temperature (and relative humidity) increase the cumulative RR. An increase of wind speed above 4 mph (an increase of CO above 1.44 mg/m3) significantly decreases (increases) the cumulative RR. Female populations were more sensitive to low temperature and high CO level; elderly (74+) populations are more sensitive to high relative humidity; younger populations (< = 74) are more susceptible to CO higher than 1.44 mg/m3. Therefore, people with COPD should avoid exposure to adverse environmental conditions of extreme temperatures and relative humidity, low wind speed and high CO level, especially for female and elderly patients who were more sensitive to extreme temperatures and relative humidity.
Collapse
Affiliation(s)
- Meng Li
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Shengqi Chen
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Hanqing Zhao
- Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China
| | - Chengxiang Tang
- School of Public Administration, Guangzhou University, Guangzhou, China
| | - Yunfeng Lai
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Jinya Su
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, CO4 3SQ, UK.
| | - Hao Hu
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.
| |
Collapse
|
16
|
Linssen RS, den Hollander B, Bont L, van Woensel JBM, Bem RA. The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis. Pathogens 2021; 10:pathogens10050567. [PMID: 34067031 PMCID: PMC8150834 DOI: 10.3390/pathogens10050567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/21/2021] [Accepted: 05/05/2021] [Indexed: 12/01/2022] Open
Abstract
Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands.
Collapse
Affiliation(s)
- Rosalie S. Linssen
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
- Amsterdam Reproduction & Development (AR&D) and the Amsterdam Infection & Immunity (AR&I) Research Institutes Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-20-56-62453-E
| | - Bibiche den Hollander
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Louis Bont
- UMCU Laboratory of Translational Immunology, University Medical Center Utrecht, Wilhelmina Children’s Hospital, 3584 EA Utrecht, The Netherlands;
- Respiratory Syncytial Virus Network (ReSViNET) Foundation, 3703 CD Zeist, The Netherlands
| | - Job B. M. van Woensel
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | - Reinout A. Bem
- Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands; (B.d.H.); (J.B.M.v.W.); (R.A.B.)
| | | |
Collapse
|
17
|
What Are the Effects of Meteorological Factors on Exacerbations of Chronic Obstructive Pulmonary Disease? ATMOSPHERE 2021. [DOI: 10.3390/atmos12040442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the greatest global public health challenges. Acute exacerbations of COPD lead to the accelerated deterioration of lung function, reduced quality of life, a higher number of hospitalizations, and increased mortality. The factor causing the exacerbation is usually an infectious agent, but the impact of environmental factors is being studied more thoroughly. Among them, meteorological factors are the least examined. Multiple studies have shown that lower temperatures during the cold season, as well as sudden temperature changes regardless of the season, have the most significant negative effect on patients with COPD. However, higher temperatures, especially during summer heatwaves, can also cause COPD exacerbation and it is expected that this will be an even more important health problem in the future considering climate changes. The effects of other meteorological factors on acute exacerbation of COPD, such as atmospheric pressure, solar radiation, rainfall, wind speed, and humidity are far less investigated and opposing results have been obtained in different studies. Thus, there is a need for further research in this area that would result in clinical recommendations and public health interventions that could decrease the global burden of COPD.
Collapse
|
18
|
Ghada W, Estrella N, Pfoerringer D, Kanz KG, Bogner-Flatz V, Ankerst DP, Menzel A. Effects of weather, air pollution and Oktoberfest on ambulance-transported emergency department admissions in Munich, Germany. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:143772. [PMID: 33229084 DOI: 10.1016/j.scitotenv.2020.143772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/16/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Climate change and increasing risks of extreme weather events affect human health and lead to changes in the emergency department (ED) admissions and the emergency medical services (EMS) operations. For a better allocation of resources in the healthcare system, it is essential to predict ED numbers based on environmental variables. This publication aims to quantify weather, air pollution and calendar-related effects on daily ED admissions. METHODS Analyses were based on 575,725 admissions from the web-based IVENA system recording all patients in the greater Munich area with pre-hospital emergency care in ambulance operations during 2014-2018. Linear models were used to identify statistically significant associations between daily ED admissions and calendar, meteorological and pollution factors, allowing for lag effects of one to three days. Separate analyses were performed for seasons, with additional subset analyses by sex, age and surgical versus internal department. RESULTS ED admissions were exceptionally high during the three-week Oktoberfest, particularly for males and on the weekends, as well as during the New Year holiday. Admissions significantly increased during the years of study, decreased in spring and summer holidays, and were lower on Sundays while higher on Mondays. In the warmer seasons, admissions were significantly associated with higher temperature, adjusting for the effects of sunshine and humidity in all age groups except for the elderly. Adverse weather conditions in non-summer seasons were either linked to increasing ED admissions (from storms, gust) or decreasing them from rain. Mostly, but not exclusively, in winter, increasing ED admissions were associated with colder minimum temperatures as well as with higher NO and PM10 concentrations. CONCLUSIONS In addition to standard calendar-related factors, incorporating seasonal weather, air pollutant and interactions with patient demographics into resource planning models can improve the daily allocation of resources and staff of EMS operations at hospital and city levels.
Collapse
Affiliation(s)
- Wael Ghada
- TUM School of Life Sciences, Technical University of Munich, Freising, Germany.
| | - Nicole Estrella
- TUM School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Dominik Pfoerringer
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Karl-Georg Kanz
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Emergency Medical Services Authority, Munich, Germany
| | - Viktoria Bogner-Flatz
- Emergency Medical Services Authority, Munich, Germany; Department of General, Trauma and Reconstructive Surgery, Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - Donna P Ankerst
- TUM School of Life Sciences, Technical University of Munich, Freising, Germany; Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Annette Menzel
- TUM School of Life Sciences, Technical University of Munich, Freising, Germany; Institute for Advanced Study, Technical University of Munich, Garching, Germany
| |
Collapse
|
19
|
Fonseca-Rodríguez O, Sheridan SC, Lundevaller EH, Schumann B. Effect of extreme hot and cold weather on cause-specific hospitalizations in Sweden: A time series analysis. ENVIRONMENTAL RESEARCH 2021; 193:110535. [PMID: 33271141 DOI: 10.1016/j.envres.2020.110535] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
Considering that several meteorological variables can contribute to weather vulnerability, the estimation of their synergetic effects on health is particularly useful. The spatial synoptic classification (SSC) has been used in biometeorological applications to estimate the effect of the entire suite of weather conditions on human morbidity and mortality. In this study, we assessed the relationships between extremely hot and dry (dry tropical plus, DT+) and hot and moist (moist tropical plus, MT+) weather types in summer and extremely cold and dry (dry polar plus, DP+) and cold and moist (moist polar, MP+) weather types in winter and cardiovascular and respiratory hospitalizations by age and sex. Time-series quasi-Poisson regression with distributed lags was used to assess the relationship between oppressive weather types and daily hospitalizations over 14 subsequent days in the extended summer (May to August) and 28 subsequent days during the extended winter (November to March) over 24 years in 4 Swedish locations from 1991 to 2014. In summer, exposure to hot weather types appeared to reduce cardiovascular hospitalizations while increased the risk of hospitalizations for respiratory diseases, mainly related to MT+. In winter, the effect of cold weather on both cause-specific hospitalizations was small; however, MP+ was related to a delayed increase in cardiovascular hospitalizations, whilst MP+ and DP + increased the risk of hospitalizations due to respiratory diseases. This study provides useful information for the staff of hospitals and elderly care centers who can help to implement protective measures for patients and residents. Also, our results could be helpful for vulnerable people who can adopt protective measures to reduce health risks.
Collapse
Affiliation(s)
- Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, 901 85, Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden.
| | - Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH, 44242, USA.
| | | | - Barbara Schumann
- Department of Epidemiology and Global Health, Umeå University, 901 85, Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden.
| |
Collapse
|
20
|
Fonseca-Rodríguez O, Sheridan SC, Lundevaller EH, Schumann B. Hot and cold weather based on the spatial synoptic classification and cause-specific mortality in Sweden: a time-stratified case-crossover study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1435-1449. [PMID: 32328787 PMCID: PMC7445203 DOI: 10.1007/s00484-020-01921-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/12/2020] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
The spatial synoptic classification (SSC) is a holistic categorical assessment of the daily weather conditions at specific locations; it is a useful tool for assessing weather effects on health. In this study, we assessed (a) the effect of hot weather types and the duration of heat events on cardiovascular and respiratory mortality in summer and (b) the effect of cold weather types and the duration of cold events on cardiovascular and respiratory mortality in winter. A time-stratified case-crossover design combined with a distributed lag nonlinear model was carried out to investigate the association of weather types with cause-specific mortality in two southern (Skåne and Stockholm) and two northern (Jämtland and Västerbotten) locations in Sweden. During summer, in the southern locations, the Moist Tropical (MT) and Dry Tropical (DT) weather types increased cardiovascular and respiratory mortality at shorter lags; both hot weather types substantially increased respiratory mortality mainly in Skåne. The impact of heat events on mortality by cardiovascular and respiratory diseases was more important in the southern than in the northern locations at lag 0. The cumulative effect of MT, DT and heat events lagged over 14 days was particularly high for respiratory mortality in all locations except in Jämtland, though these did not show a clear effect on cardiovascular mortality. During winter, the dry polar and moist polar weather types and cold events showed a negligible effect on cardiovascular and respiratory mortality. This study provides valuable information about the relationship between hot oppressive weather types with cause-specific mortality; however, the cold weather types may not capture sufficiently effects on cause-specific mortality in this sub-Arctic region.
Collapse
Affiliation(s)
- Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden.
| | - Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH, 44242, USA
| | | | - Barbara Schumann
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden
| |
Collapse
|
21
|
Dohmen LME, Spigt M, Melbye H. The effect of atmospheric pressure on oxygen saturation and dyspnea: the Tromsø study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1103-1110. [PMID: 32125519 PMCID: PMC7295717 DOI: 10.1007/s00484-020-01883-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
A drop in atmospheric pressure, as observed at high altitudes, leads to decreased oxygen saturation. The effect of regular changes in barometric pressure at sea level has never been studied in a general population. A cohort of adults aged 40 years were examined with pulse oximetry at two separate visits, and the local barometric pressure was available from the local weather station. The study aimed at determining the effect of atmospheric pressure on oxygen saturation also called SpO2, as well as on shortness of breath. Based on spirometry, the participants were divided into two groups, with normal and decreased lung function. Decreased lung function was defined as forced expiratory volume in 1 s (FEV1) below lower limit or normal (LLN) or FEV1/FVC (FVC, forced vital capacity) below LLN, with GLI 2012 reference values. The statistical analysis included uni/multivariable linear and logistic regression. A total of 7439 participants of the Tromsø 7 cohort study were included. There was a significant association between barometric pressure and SpO2 < 96%, and we found that a reduction of 166.67 hPa was needed to get a 1% reduction in SpO2. The change in atmospheric pressure was not significantly associated with shortness of breath, also not in subjects with reduced lung function.
Collapse
Affiliation(s)
- Lisa M E Dohmen
- Department of Family Medicine, CAPHRI, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Mark Spigt
- Department of Family Medicine, CAPHRI, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
- General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Hasse Melbye
- General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
22
|
Zhang Y, Liu X, Kong D, Fu J, Liu Y, Zhao Y, Lian H, Zhao X, Yang J, Fan Z. Effects of Ambient Temperature on Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Results from a Time-Series Analysis of 143318 Hospitalizations. Int J Chron Obstruct Pulmon Dis 2020; 15:213-223. [PMID: 32099346 PMCID: PMC6996111 DOI: 10.2147/copd.s224198] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose To evaluate the associations between acute exacerbations of chronic obstructive pulmonary disease (AECOPD) hospitalizations and daily mean temperature (Tmean) as well as daily apparent temperature (AT), and to explore the practical values of these two indices in policymaking and patient education. Methods Daily AECOPD hospitalizations and Meteorological data in Beijing were obtained between 2013 and 2016. Distributed lag non-linear model was adopted to investigate the association between daily ambient temperature and AECOPD hospitalizations. The cumulative effects of cold/hot temperature were abstracted. For the extreme and moderate low-temperature effect estimates, we, respectively, computed the RR of AECOPD hospitalizations at the 1st and 10th percentiles of temperature in comparison with that at the 25th percentile of temperature. For the extreme and moderate high temperature effect estimates, we, respectively, computed the RR of AECOPD hospitalizations at the 99th and 90th percentiles of temperature in comparison with that at the 75th percentile of temperature. Results During the study period, 143, 318 AECOPD hospitalizations were collected. A reverse J-shape relationship was found between temperature and AECOPD hospitalizations. When comparing the effect of Tmean, higher RRs were associated with increases in AT on AECOPD hospitalizations but a lower value of Akaike’s Information Criterion for quasi-Poisson (Q-AIC). The RR of extremely low temperature of Tmean and AT were 1.55 (95% CI: 1.21,2.00) and 2.08 (95% CI: 1.44,3.01), respectively. Moderate low temperature also had an adverse impact on AECOPD hospitalizations. No associations were found between high temperature and AECOPD risk. We found the females and those aged <65 years to be more susceptible to temperature change. Conclusion Lower temperature is associated with a higher risk for AECOPD hospitalizations. Ambient temperature is probably a better predictor in terms of quantifying risk than mean temperature when studying temperature impact on health.
Collapse
Affiliation(s)
- Yongqiao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaole Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Dehui Kong
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hui Lian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaoyi Zhao
- Department of Physical Medicine and Rehabilitation, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, People's Republic of China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| |
Collapse
|
23
|
Qu F, Liu F, Zhang H, Chao L, Guan J, Li R, Yu F, Yan X. The hospitalization attributable burden of acute exacerbations of chronic obstructive pulmonary disease due to ambient air pollution in Shijiazhuang, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:30866-30875. [PMID: 31446603 DOI: 10.1007/s11356-019-06244-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 08/16/2019] [Indexed: 05/04/2023]
Abstract
Few studies have investigated the acute exacerbations of chronic obstructive pulmonary disease (AECOPD)-associated attributable burden under exposure to high levels of air pollution among Asians. Data on hospitalization for AECOPD, air pollution and meteorological factors from 1 January 2013 to 31 December 2016 were collected in Shijiazhuang, China. We used a Poisson generalized linear regression model combined with a distributed lag nonlinear model (DLNM) to evaluate the relative cumulative risk for a lag of 0-7 days and examined the potential effect modifications by age and sex via stratification analyses, controlling for long-term trends, seasonal patterns, meteorological factors, and other possible confounders. Then, we computed hospitalization percentages attributable to air pollutants. The AECOPD-associated relative cumulative risks for PM2.5, PM10, NO2, SO2, and CO for a lag of 0-7 days were significantly positively correlated with hospitalization. The associations were stronger in females and retired patients. The NO2 Cum RR of AECOPD admission was the greatest. A 10μg/m3 increase in daily NO2 concentration was associated with 6.7% and 5.7% increases in COPD hospitalizations in the retired and female groups, respectively. The results showed that 13%, 9.4%, 1.7%, 9.7%, and 8.8% of AECOPD hospitalizations were attributable to exposure to PM2.5, PM10, SO2, NO2, and CO, respectively. If the air pollutant concentration was reduced to the 24-h average grade II levels of NAAQS of China, the AECOPD attributable percentage for PM2.5 and PM10 would decrease by 80%. The air pollutants PM2.5, PM10, SO2, NO2, and CO were significantly relevant to AECOPD-associated hospitalization. The associations differed by individual characteristics. The retired and female populations were highly vulnerable.
Collapse
Affiliation(s)
- Fangfang Qu
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- Hebei Institute of Respiratory Disease, Shijiazhuang, China
| | - Feifei Liu
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- Hebei Institute of Respiratory Disease, Shijiazhuang, China
| | - Huiran Zhang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- Hebei Institute of Respiratory Disease, Shijiazhuang, China
| | - Lingshan Chao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- Hebei Institute of Respiratory Disease, Shijiazhuang, China
| | - Jitao Guan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- Hebei Institute of Respiratory Disease, Shijiazhuang, China
| | - Rongqin Li
- Department of Central Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Fengxue Yu
- Department of Central Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Xixin Yan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China.
- Hebei Institute of Respiratory Disease, Shijiazhuang, China.
| |
Collapse
|
24
|
Qu F, Liu F, Zhang H, Chao L, Guan J, Li R, Yu F, Yan X. Comparison of air pollutant-related hospitalization burden from AECOPD in Shijiazhuang, China, between heating and non-heating season. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:31225-31233. [PMID: 31463744 DOI: 10.1007/s11356-019-06242-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/16/2019] [Indexed: 06/10/2023]
Abstract
Few researches have been investigated on the effects of ambient air pollutants from coal combustion on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalizations. The whole time series was split into heating season and non-heating season. We used a quasi-Poisson generalized linear regression model combined with distributed lag non-linear models (DLNMs) to estimate the relative cumulative risk and calculate the air pollutant hospitalization burden of AECOPD for lag 0-7 days in heating season and non-heating season. There were higher PM2.5, PM10, NO2, SO2, and CO concentrations in heating seasons than non-heating season in Shijiazhuang; however, O3 was higher in non-heating season than heating season. The AECOPD-associated relative cumulative risks for PM2.5, PM10, NO2, and SO2 for lag 0-7 days were significantly positively associated with hospitalization in heating and non-heating season; we found that the cumulative relative risk of NO2 was the greatest in every 1 unit of air pollutants during the heating season and the cumulative relative risk of SO2 was the greatest during the non-heating season. The results showed that 17.8%, 12.9%, 1.7%, 16.7%, and 10.5% of AECOPD hospitalizations could be attributable to PM2.5, PM10, SO2, NO2, and CO exposure in heating season, respectively. However, the results showed that 19.5%, 22.4%, 15%, 8.3%, and 10.4% of AECOPD hospitalizations could be attributable to PM2.5, PM10, SO2, NO2, and O3 exposure in non-heating season, respectively. The attributable burden of AECOPD hospitalization in heating season and non-heating season are different. PM2.5, PM10, NO2, and CO are the main factors of heating season, while PM10, PM2.5, SO2, and O3 are the main factors of non-heating season. In conclusions, the centralized heating can change the influence of attributable risk. When government departments formulate interventions to reduce the risk of acute hospitalization of chronic obstructive pulmonary disease (COPD), the influence of heating on disease burden should be considered.
Collapse
Affiliation(s)
- Fangfang Qu
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Feifei Liu
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Huiran Zhang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Lingshan Chao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Jitao Guan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Rongqin Li
- Department of Central Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Fengxue Yu
- Department of Central Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Xixin Yan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China.
- HeBei institute of Respiratory Disease, Shijiazhuang, China.
| |
Collapse
|
25
|
Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101696. [PMID: 31091805 PMCID: PMC6573000 DOI: 10.3390/ijerph16101696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/03/2019] [Accepted: 05/10/2019] [Indexed: 01/13/2023]
Abstract
Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.
Collapse
|
26
|
Figgs LW. Emergency department asthma diagnosis risk associated with the 2012 heat wave and drought in Douglas County NE, USA. Heart Lung 2019; 48:250-257. [PMID: 30686617 DOI: 10.1016/j.hrtlng.2018.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 12/03/2018] [Accepted: 12/16/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Global climate change concerns are forcing local public health agencies to assess potential disease risk. OBJECTIVE Determine if risk of an emergency department asthma diagnosis in Douglas County, NE, was higher during the 2012 heatwave compared to 2011. METHODS Retrospective, observational, case-control design selecting subjects from 2011 and 2012 emergency department (ED) admissions. Risk was estimated by conditional logistic regression. RESULTS The asthma ED risk estimate was 1.23 (95%CI = 0.96-1.57) times higher in 2012 than 2011, for the same calendar period. Asthma ED diagnosis risk was 3.37 (95%CI = 2.27-4.17) times higher among subjects <19years old compared to older subjects, and 3.25 (95%CI = 2.63-4.02) times higher among African-Americans than non-African-Americans, adjusted for heatwave exposure. Absolute humidity appears inversely related to asthma diagnosis risk ( χ2 = 16.6; p < 0.001). CONCLUSION Asthma ED diagnosis risk was not significantly higher in 2012 compared to 2011. Risk was elevated among subjects less than 19years old, and among African Americans; adjusted for heatwave exposure.
Collapse
Affiliation(s)
- Larry W Figgs
- Environmental Health Division, Douglas County Health Department, 1111 South 41 Street, Omaha, NE 68105, United States.
| |
Collapse
|
27
|
Chronic lifestyle diseases display seasonal sensitive comorbid trend in human population evidence from Google Trends. PLoS One 2018; 13:e0207359. [PMID: 30540756 PMCID: PMC6291106 DOI: 10.1371/journal.pone.0207359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 10/30/2018] [Indexed: 02/08/2023] Open
Abstract
Seasonal and human physiological changes are important factors in the development of many diseases. But, the study of genuine seasonal impact on these diseases is difficult to measure due to many other environment and lifestyle factors which directly affect these diseases. However, several clinical studies have been conducted in different parts of the world, and it has clearly indicated that certain groups of population are highly subjected to seasonal changes, and their maladaptation can possibly lead to several disorders/diseases. Thus, it is crucial to study the significant seasonal sensitive diseases spread across the human population. To narrow down these disorders/diseases, the study hypothesized that high altitude (HA) associated diseases and disorders are of the strong variants of seasonal physiologic changes. It is because, HA is the only geographical condition for which humans can develop very efficient physiological adaptation mechanism called acclimatization. To study this hypothesis, PubMed was used to collect the HA associated symptoms and disorders. Disease Ontology based semantic similarity network (DSN) and disease-drug networks were constructed to narrow down the benchmark diseases and disorders of HA. The DSN which was further subjected to different community structure analysis uncovered the highly associated or possible comorbid diseases of HA. The predicted 12 lifestyle diseases were assumed to be “seasonal (sensitive) comorbid lifestyle diseases (SCLD)”. A time series analyses on Google Search data of the world from 2004–2016 was conducted to investigate whether the 12 lifestyle diseases have seasonal patterns. Because, the trends were sensitive to the term used as benchmark; the temporal relationships among the 12 disease search volumes and their temporal sequences similarity by dynamic time warping analyses was used to predict the comorbid diseases. Among the 12 lifestyle diseases, the study provides an indirect evidence in the existence of severe seasonal comorbidity among hypertension, obesity, asthma and fibrosis diseases, which is widespread in the world population. Thus, the present study has successfully addressed this issue by predicting the SCLD, and indirectly verified them among the world population using Google Search Trend. Furthermore, based on the SCLD seasonal trend, the study also classified them as severe, moderate, and mild. Interestingly, seasonal trends of the severe seasonal comorbid diseases displayed an inverse pattern between USA (Northern hemisphere) and New Zealand (Southern hemisphere). Further, knowledge in the so called “seasonal sensitive populations” physiological response to seasonal triggers such as winter, summer, spring, and autumn become crucial to modulate disease incidence, disease course, or clinical prevention.
Collapse
|
28
|
Abstract
Over the past 30 years, information technology has gradually transformed the way health care is provisioned for patients. Chronic Obstructive Pulmonary Disease (COPD) is an incurable malady that threatens the lives of millions around the world. The huge amount of medical information in terms of complex interdependence between progression of health problems and various other factors makes the representation of data more challenging. This study investigated how formal semantic standards could be used for building an ontology knowledge repository to provide ubiquitous healthcare and medical recommendations for COPD patient to reduce preventable harm. The novel contribution of the suggested framework resides in the patient-centered monitoring approach, as we work to create dynamic adaptive protection services according to the current context of patient. This work executes a sequential modular approach consisting of patient, disease, location, devices, activities, environment and services to deliver personalized real-time medical care for COPD patients. The main benefits of this project are: (1) adhering to dynamic safe boundaries for the vital signs, which may vary depending on multiple factors; (2) assessing environmental risk factors; and (3) evaluating the patient’s daily activities through scheduled events to avoid potentially dangerous situations. This solution implements an interrelated set of ontologies with a logical base of Semantic Web Rule Language (SWRL) rules derived from the medical guidelines and expert pneumologists to handle all contextual situations.
Collapse
|
29
|
Müller A, Ráthonyi G, Bíró M, Ráthonyi-Ódor K, Bács Z, Ács P, Hegyi G, Bácsné Bába É. The effect of complex climate therapy on rehabilitation results of elderly asthmatic and chronic obstructive airways disease (COPD) patients. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
30
|
Zeng J, Zhang X, Yang J, Bao J, Xiang H, Dear K, Liu Q, Lin S, Lawrence WR, Lin A, Huang C. Humidity May Modify the Relationship between Temperature and Cardiovascular Mortality in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111383. [PMID: 29135955 PMCID: PMC5708022 DOI: 10.3390/ijerph14111383] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 11/30/2022]
Abstract
Background: The evidence of increased mortality attributable to extreme temperatures is widely characterized in climate-health studies. However, few of these studies have examined the role of humidity on temperature-mortality association. We investigated the joint effect between temperature and humidity on cardiovascular disease (CVD) mortality in Zhejiang Province, China. Methods: We collected data on daily meteorological and CVD mortality from 11 cities in Zhejiang Province during 2010–2013. We first applied time-series Poisson regression analysis within the framework of distributed lag non-linear models to estimate the city-specific effect of temperature and humidity on CVD mortality, after controlling for temporal trends and potential confounding variables. We then applied a multivariate meta-analytical model to pool the effect estimates in the 11 cities to generate an overall provincial estimate. The joint effects between them were calculated by the attributable fraction (AF). The analyses were further stratified by gender, age group, education level, and location of cities. Results: In total, 120,544 CVD deaths were recorded in this study. The mean values of temperature and humidity were 17.6 °C and 72.3%. The joint effect between low temperature and high humidity had the greatest impact on the CVD death burden over a lag of 0–21 days with a significant AF of 31.36% (95% eCI: 14.79–38.41%), while in a condition of low temperature and low humidity with a significant AF of 16.74% (95% eCI: 0.89, 24.44). The AFs were higher at low temperature and high humidity in different subgroups. When considering the levels of humidity, the AFs were significant at low temperature and high humidity for males, youth, those with a low level of education, and coastal area people. Conclusions: The combination of low temperature and high humidity had the greatest impact on the CVD death burden in Zhejiang Province. This evidence has important implications for developing CVD interventions.
Collapse
Affiliation(s)
- Jie Zeng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 510632, China.
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430072, China.
| | - Keith Dear
- School of Public Health, University of Adelaide, Adelaide 5005, Australia.
| | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Shao Lin
- School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA.
| | - Wayne R Lawrence
- School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA.
| | - Aihua Lin
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| |
Collapse
|
31
|
Mu Z, Chen PL, Geng FH, Ren L, Gu WC, Ma JY, Peng L, Li QY. Synergistic effects of temperature and humidity on the symptoms of COPD patients. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1919-1925. [PMID: 28567499 DOI: 10.1007/s00484-017-1379-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 06/07/2023]
Abstract
This panel study investigates how temperature, humidity, and their interaction affect chronic obstructive pulmonary disease (COPD) patients' self-reported symptoms. One hundred and six COPD patients from Shanghai, China, were enrolled, and age, smoking status, St. George Respiratory Questionnaire (SGRQ) score, and lung function index were recorded at baseline. The participants were asked to record their indoor temperature, humidity, and symptoms on diary cards between January 2011 and June 2012. Altogether, 82 patients finished the study. There was a significant interactive effect between temperature and humidity (p < 0.0001) on COPD patients. When the indoor humidity was low, moderate, and high, the indoor temperature ORs were 0.969 (95% CI 0.922 to 1.017), 0.977 (0.962 to 0.999), and 0.920 (95% CI 0.908 to 0.933), respectively. Low temperature was a risk factor for COPD patients, and high humidity enhanced its risk on COPD. The indoor temperature should be kept at least on average at 18.2 °C, while the humidity should be less than 70%. This study demonstrates that temperature and humidity were associated with COPD patients' symptoms, and high humidity would enhance the risk of COPD due to low temperature.
Collapse
Affiliation(s)
- Zhe Mu
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Pei-Li Chen
- Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fu-Hai Geng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Lei Ren
- Department of Respiratory Medicine, Jing'an District Geriatric Hospital of Shanghai, Shanghai, China
| | - Wen-Chao Gu
- Department of Respiratory Medicine, People Hospital of Pudong District, Shanghai, China
| | - Jia-Yun Ma
- Department of Respiratory Medicine, No.3 People Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Qing-Yun Li
- Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
32
|
Götschke J, Mertsch P, Bischof M, Kneidinger N, Matthes S, Renner ED, Schultz K, Traidl-Hoffmann C, Duchna HW, Behr J, Schmude J, Huber RM, Milger K. Perception of climate change in patients with chronic lung disease. PLoS One 2017; 12:e0186632. [PMID: 29045479 PMCID: PMC5646841 DOI: 10.1371/journal.pone.0186632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/04/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Climate change affects human health. The respective consequences are predicted to increase in the future. Patients with chronic lung disease are particularly vulnerable to the involved environmental alterations. However, their subjective perception and reactions to these alterations remain unknown. METHODS In this pilot study, we surveyed 172 adult patients who underwent pulmonary rehabilitation and 832 adult tourists without lung disease in the alpine region about their perception of being affected by climate change and their potential reaction to specific consequences. The patients' survey also contained the COPD Assessment Test (CAT) to rate the severity of symptoms. RESULTS Most of the patients stated asthma (73.8%), COPD (9.3%) or both (11.0%) as underlying disease while 5.8% suffered from other chronic lung diseases. Patients and tourists feel equally affected by current climate change in general, while allergic subjects in both groups feel significantly more affected (p = 0.04). The severity of symptoms assessed by CAT correlates with the degree of feeling affected (p<0.01). The main disturbing consequences for patients are decreased air quality, increasing numbers of ticks and mosquitos and a rising risk for allergy and extreme weather events such as thunderstroms, while tourists are less disturbed by these factors. Increasing number of heat-days is of little concern to both groups. CONCLUSION Overall patients are more sensitive to health-related consequences of climate change. Yet, the hazard of heat-days seems underestimated and awareness should be raised.
Collapse
Affiliation(s)
- Jeremias Götschke
- Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, Munich, Germany
| | - Pontus Mertsch
- Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, Munich, Germany
| | - Michael Bischof
- Chair of Economic Geography and Tourism Research, Department of Geography, University of Munich, Munich, Germany
| | - Nikolaus Kneidinger
- Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, Munich, Germany
| | - Sandhya Matthes
- Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, Munich, Germany
| | - Ellen D. Renner
- Christine Kühne - Center for Allergy Research and Education, CK-CARE, Davos, Switzerland
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Zentrum München - German Research Center for Environmental Health, Augsburg, Germany
- Hochgebirgsklinik Davos, Davos, Switzerland
| | - Konrad Schultz
- Klinik Bad Reichenhall der Deutschen Rentenversicherung Bayern Süd, Bad Reichenhall, Germany
| | - Claudia Traidl-Hoffmann
- Christine Kühne - Center for Allergy Research and Education, CK-CARE, Davos, Switzerland
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Zentrum München - German Research Center for Environmental Health, Augsburg, Germany
| | - Hans-Werner Duchna
- Christine Kühne - Center for Allergy Research and Education, CK-CARE, Davos, Switzerland
- Hochgebirgsklinik Davos, Davos, Switzerland
| | - Jürgen Behr
- Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, Munich, Germany
- Asklepios Fachkliniken München Gauting, Gauting, Germany
| | - Jürgen Schmude
- Chair of Economic Geography and Tourism Research, Department of Geography, University of Munich, Munich, Germany
| | - Rudolf M. Huber
- Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, Munich, Germany
| | - Katrin Milger
- Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, Munich, Germany
- * E-mail:
| |
Collapse
|
33
|
Impact of Air Temperature on London Ambulance Call-Out Incidents and Response Times. CLIMATE 2017. [DOI: 10.3390/cli5030061] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
34
|
Sama SR, Kriebel D, Gore RJ, DeVries R, Rosiello R. Environmental triggers of COPD symptoms: a case cross-over study. BMJ Open Respir Res 2017; 4:e000179. [PMID: 29071071 PMCID: PMC5647479 DOI: 10.1136/bmjresp-2017-000179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 05/15/2017] [Accepted: 06/05/2017] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION This study investigated the hypothesis that common environmental chemical exposures with known irritant or sensitising properties trigger exacerbations for patients with chronic obstructive pulmonary disease (COPD). METHODS We conducted a case cross-over study in 168 patients with COPD who were members of a disease management group in central Massachusetts. Participants completed a baseline health survey and several short exposure surveys. Exposure surveys were administered by a nurse when a participant telephoned to report an exacerbation (case periods) and at a maximum of three randomly identified control periods when they were not experiencing an exacerbation. We compared exposures in the week preceding an exacerbation with exposures in normal (non-exacerbation) weeks. The questionnaire assessed short-term (1 week) home, community and workplace activities and exposures that may be associated with COPD exacerbation. RESULTS Self-reported exercise was negatively associated with exacerbation (OR=0.59, 95% CI: 0.35 to 1.00). Among the environmental chemical exposures, car and truck exhaust (OR=4.36, 95% CI: 1.76 to 10.80) and use of scented laundry products (OR=2.69, 95% CI: 1.31 to 5.52) showed strong positive effects. Self-reported respiratory infections were strongly associated with exacerbation (OR=7.90, 95% CI 4.29 to 14.50). Variations in outdoor temperature were associated with COPD exacerbation risk (moderate versus cold temperature OR=1.95, 95% CI 1.09 to 3.49 and warm versus cold OR=0.43, 95% CI: 0.26 to 0.70). CONCLUSIONS These results suggest that some environmental chemical exposures may play a role in triggering COPD exacerbations. If confirmed, they may provide useful guidance for patients with COPD to better manage their disease.
Collapse
Affiliation(s)
- Susan R Sama
- Department of Public Health, University of Massachusetts Lowell, Lowell, USA
- Research Department, Reliant Medical Group, Worcester, USA
| | - David Kriebel
- Department of Public Health, University of Massachusetts Lowell, Lowell, USA
| | - Rebecca J Gore
- Department of Public Health, University of Massachusetts Lowell, Lowell, USA
| | - Rebecca DeVries
- Department of Public Health, University of Massachusetts Lowell, Lowell, USA
| | | |
Collapse
|
35
|
Trianti SM, Samoli E, Rodopoulou S, Katsouyanni K, Papiris SA, Karakatsani A. Desert dust outbreaks and respiratory morbidity in Athens, Greece. Environ Health 2017; 16:72. [PMID: 28666479 PMCID: PMC5493869 DOI: 10.1186/s12940-017-0281-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 06/26/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND Ambient particulate matter (PM) has an adverse effect on respiratory morbidity. Desert dust outbreaks contribute to increased PM levels but the toxicity of desert dust mixed with anthropogenic pollutants needs clarification. METHODS We identified 132 days with desert dust episodes and 177 matched days by day of the week, season, temperature and humidity between 2001 and 2006 in Athens, Greece. We collected data on regulated pollutants and daily emergency outpatient visits and admissions for respiratory causes. We applied Poisson regression models adjusting for confounding effects of seasonality, meteorology, holidays and influenza epidemics. We evaluated the sensitivity of our results to co-pollutant exposures and effect modification by age and sex. RESULTS A 10 μg/m3 increase in PM10 concentration was associated with 1.95% (95% confidence interval (CI): 0.02%, 3.91%) increase in respiratory emergency room visits. No significant interaction with desert dust episodes was observed. Compared with non-dust days, there was a 47% (95% CI: 29%, 68%) increase in visits in dust days not adjusting for PM10. Desert dust days were associated with higher numbers of emergency room visits for asthma, chronic obstructive pulmonary disease and respiratory infections with increases of 38%, 57% and 60%, respectively (p < 0.001 for all comparisons). Analyses of respiratory hospital admissions provided similar results. PM10 effects decreased when adjusting for desert dust days and were further confounded by co-pollutants. CONCLUSIONS Desert dust episode days are associated with higher respiratory emergency room visits and hospital admissions. This effect is insufficiently explained by increased PM10 levels.
Collapse
Affiliation(s)
- Stavroula-Myrto Trianti
- 2nd Department of Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyros A. Papiris
- 2nd Department of Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Athens, Greece
| | - Anna Karakatsani
- 2nd Department of Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Athens, Greece
| |
Collapse
|
36
|
Ding PH, Wang GS, Guo YL, Chang SC, Wan GH. Urban air pollution and meteorological factors affect emergency department visits of elderly patients with chronic obstructive pulmonary disease in Taiwan. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 224:751-758. [PMID: 28284553 DOI: 10.1016/j.envpol.2016.12.035] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/15/2016] [Accepted: 12/15/2016] [Indexed: 06/06/2023]
Abstract
Both air pollution and meteorological factors in metropolitan areas increased emergency department (ED) visits from people with chronic obstructive pulmonary disease (COPD). Few studies investigated the associations between air pollution, meteorological factors, and COPD-related health disorders in Asian countries. This study aimed to investigate the relationship between the environmental factors and COPD-associated ED visits of susceptible elderly population in the largest Taiwanese metropolitan area (Taipei area, including Taipei city and New Taipei city) between 2000 and 2013. Data of air pollutant concentrations (PM10, PM2.5, O3, SO2, NO2 and CO), meteorological factors (daily temperature, relative humidity and air pressure), and daily COPD-associated ED visits were collected from Taiwan Environmental Protection Administration air monitoring stations, Central Weather Bureau stations, and the Taiwan National Health Insurance database in Taipei area. We used a case-crossover study design and conditional logistic regression models with odds ratios (ORs), and 95% confidence intervals (CIs) for evaluating the associations between the environmental factors and COPD-associated ED visits. Analyses showed that PM2.5, O3, and SO2 had significantly greater lag effects (the lag was 4 days for PM2.5, and 5 days for O3 and SO2) on COPD-associated ED visits of the elderly population (65-79 years old). In warmer days, a significantly greater effect on elderly COPD-associated ED visits was estimated for PM2.5 with coexistence of O3. Additionally, either O3 or SO2 combined with other air pollutants increased the risk of elderly COPD-associated ED visits in the days of high relative humidity and air pressure difference, respectively. This study showed that joint effect of urban air pollution and meteorological factors contributed to the COPD-associated ED visits of the susceptible elderly population in the largest metropolitan area in Taiwan. Government authorities should review existing air pollution policies, and strengthen health education propaganda to ensure the health of the susceptible elderly population.
Collapse
Affiliation(s)
- Pei-Hsiou Ding
- Institute of Environmental Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Air Quality Protection and Noise Control, Environmental Protection Administration, Taipei, Taiwan
| | - Gen-Shuh Wang
- Institute of Environmental Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yue-Leon Guo
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shuenn-Chin Chang
- Department of Environmental Monitoring, Environmental Protection Administration, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Gwo-Hwa Wan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Department of Neurosurgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
| |
Collapse
|
37
|
Islam MS, Chaussalet TJ, Koizumi N. Towards a threshold climate for emergency lower respiratory hospital admissions. ENVIRONMENTAL RESEARCH 2017; 153:41-47. [PMID: 27889676 DOI: 10.1016/j.envres.2016.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/13/2016] [Accepted: 11/18/2016] [Indexed: 06/06/2023]
Abstract
Identification of 'cut-points' or thresholds of climate factors would play a crucial role in alerting risks of climate change and providing guidance to policymakers. This study investigated a 'Climate Threshold' for emergency hospital admissions of chronic lower respiratory diseases by using a distributed lag non-linear model (DLNM). We analysed a unique longitudinal dataset (10 years, 2000-2009) on emergency hospital admissions, climate, and pollution factors for the Greater London. Our study extends existing work on this topic by considering non-linearity, lag effects between climate factors and disease exposure within the DLNM model considering B-spline as smoothing technique. The final model also considered natural cubic splines of time since exposure and 'day of the week' as confounding factors. The results of DLNM indicated a significant improvement in model fitting compared to a typical GLM model. The final model identified the thresholds of several climate factors including: high temperature (≥27°C), low relative humidity (≤ 40%), high Pm10 level (≥70-µg/m3), low wind speed (≤ 2 knots) and high rainfall (≥30mm). Beyond the threshold values, a significantly higher number of emergency admissions due to lower respiratory problems would be expected within the following 2-3 days after the climate shift in the Greater London. The approach will be useful to initiate 'region and disease specific' climate mitigation plans. It will help identify spatial hot spots and the most sensitive areas and population due to climate change, and will eventually lead towards a diversified health warning system tailored to specific climate zones and populations.
Collapse
Affiliation(s)
| | - Thierry J Chaussalet
- Health and Social Care Modelling Group, Department of Business Information Systems, School of Electronics and Computer Science, University of Westminster, London, UK
| | - Naoru Koizumi
- School of Policy, Government, and International Affairs, Center for Study of International Medical Policies and Practices, George Mason University, Virginia, USA
| |
Collapse
|
38
|
DeVries R, Kriebel D, Sama S. Low level air pollution and exacerbation of existing copd: a case crossover analysis. Environ Health 2016; 15:98. [PMID: 27756407 PMCID: PMC5070120 DOI: 10.1186/s12940-016-0179-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 09/10/2016] [Indexed: 05/12/2023]
Abstract
BACKGROUND Exacerbations of chronic obstructive pulmonary disease (COPD) contribute greatly to increased morbidity, mortality and diminished quality of life. Recent studies report moderately strong positive associations between exposures to several air pollutants and COPD-related emergency department (ED) visits and hospital admissions (HA). Studies that use clinically defined exacerbations rather than counting ED visits and HA may be more sensitive to environmental triggers like air pollution, but very few such studies exist. Participants in a COPD disease management group living in an area of low air pollution and who were followed closely for the earliest signs of an exacerbation provided an opportunity to study associations between air pollution and COPD exacerbation. METHODS Associations between short term exposures to air pollutants, including sulfur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter < 2.5 microns (PM2.5), and COPD exacerbation were assessed among 168 patients residing in central Massachusetts, a region with air pollution levels well below USEPA National Ambient Air Quality Standards (NAAQS). Case-crossover analyses and multivariate conditional logistic regression were used to estimate associations between 7-day average concentrations of each air pollutant, as measured at central site monitors, and COPD exacerbation experienced in the patients' homes during the period 2012-2013, while controlling for temperature and self-reported influenza. RESULTS We found that short-term exposures to SO2 were associated with an increase in COPD exacerbation risk (odds ratio (OR) = 2.45, 95 % CI: 1.75-3.45 per 1 ppb increase) after adjustment for PM2.5. Short-term exposures to NO2 concentrations showed a weaker association, (OR = 1.17, 95 % CI: 1.05-1.30 per 1 ppb increase) after adjustment for PM2.5. An unexpectedly modest negative association was seen for short-term exposures to PM2.5. CONCLUSIONS Despite living in an area with air pollution concentrations below current USEPA NAAQS, these COPD patients appeared to suffer increased risk of COPD exacerbation following short-term exposures to increased concentrations of SO2 and NO2. An unexpected negative association with PM2.5 may result from the complex air chemistry of low level PM in this region.
Collapse
Affiliation(s)
- Rebecca DeVries
- Department of Work Environment, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854 USA
| | - David Kriebel
- Department of Work Environment, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854 USA
| | - Susan Sama
- Department of Work Environment, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854 USA
| |
Collapse
|
39
|
Meng G, Tan Y, Fang M, Yang H, Liu X, Zhao Y. Meteorological Factors Related to Emergency Admission of Elderly Stroke Patients in Shanghai: Analysis with a Multilayer Perceptron Neural Network. Med Sci Monit 2015; 21:3600-7. [PMID: 26590182 PMCID: PMC4662240 DOI: 10.12659/msm.895334] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to predict the emergency admission of elderly stroke patients in Shanghai by using a multilayer perceptron (MLP) neural network. Material/Methods Patients (>60 years) with first-ever stroke registered in the Emergency Center of Neurology Department, Shanghai Tenth People’s Hospital, from January 2012 to June 2014 were enrolled into the present study. Daily climate records were obtained from the National Meteorological Office. MLP was used to model the daily emergency admission into the neurology department with meteorological factors such as wind level, weather type, daily maximum temperature, lowest temperature, average temperature, and absolute temperature difference. The relationships of meteorological factors with the emergency admission due to stroke were analyzed in an MLP model. Results In 886 days, 2180 first-onset elderly stroke patients were enrolled, and the average number of stroke patients was 2.46 per day. MLP was used to establish a model for the prediction of dates with low stroke admission (≤4) and those with high stroke admission (≥5). For the days with low stroke admission, the absolute temperature difference accounted for 40.7% of admissions, while for the days with high stroke admission, the weather types accounted for 73.3%. Conclusions Outdoor temperature and related meteorological parameters are associated with stroke attack. The absolute temperature difference and the weather types have adverse effects on stroke. Further study is needed to determine if other meteorological factors such as pollutants also play important roles in stroke attack.
Collapse
Affiliation(s)
- Guilin Meng
- Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland)
| | - Yan Tan
- Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland)
| | - Min Fang
- Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland)
| | - Hongyan Yang
- Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland)
| | - Xueyuan Liu
- Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland)
| | - Yanxin Zhao
- Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland)
| |
Collapse
|
40
|
Almagro P, Hernandez C, Martinez-Cambor P, Tresserras R, Escarrabill J. Seasonality, ambient temperatures and hospitalizations for acute exacerbation of COPD: a population-based study in a metropolitan area. Int J Chron Obstruct Pulmon Dis 2015; 10:899-908. [PMID: 26056439 PMCID: PMC4431472 DOI: 10.2147/copd.s75710] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Excluding the tropics, exacerbations of chronic obstructive pulmonary disease (COPD) are more frequent in winter. However, studies that directly relate hospitalizations for exacerbation of COPD to ambient temperature are lacking. The aim of this study was to assess the influence of temperature on the number of hospitalizations for COPD. METHODS This was a population-based study in a metropolitan area. All hospital discharges for acute exacerbation of COPD during 2009 in Barcelona and its metropolitan area were analyzed. The relationship between the number of hospitalizations for COPD and the mean, minimum, and maximum temperatures alongside comorbidity, humidity, influenza rate, and environmental pollution were studied. RESULTS A total of 9,804 hospitalization discharges coded with COPD exacerbation as a primary diagnosis were included; 75.4% of cases were male with a mean age of 74.9±10.5 years and an average length of stay of 6.5±6.1 days. The highest number of admissions (3,644 [37.2%]) occurred during winter, followed by autumn with 2,367 (24.1%), spring with 2,347 (23.9%), and summer with 1,446 (14.7%; P<0.001). The maximum, minimum, and mean temperatures were associated similarly with the number of hospitalizations. On average, we found that for each degree Celsius decrease in mean weekly temperature, hospital admissions increased by 5.04% (r(2)=0.591; P<0.001). After adjustment for humidity, comorbidity, air pollution, and influenza-like illness, only mean temperatures retained statistical significance, with a mean increase of 4.7% in weekly admissions for each degree Celsius of temperature (r(2)=0.599, P<0.001). CONCLUSION Mean temperatures are closely and independently related to the number of hospitalizations for COPD.
Collapse
Affiliation(s)
- Pere Almagro
- Acute Geriatric Care Unit, Internal Medicine, University Hospital Mútua de Terrasa, University of Barcelona, Barcelona, Spain
| | - Carme Hernandez
- Respiratory Disease Management Plan, Department of Health of the Autonomous Government of Catalonia, Observatory of Respiratory Therapy, Spain
- Integrated Care Unit, Medical and Nursing Management, Hospital Clínic Barcelona, Barcelona, Spain
- Chronic Diseases Care Program, Hospital Clinic, Hospital Clínic & REDISSEC (Health Services Research on Chronic Patients Network), Barcelona, Spain
| | - Pable Martinez-Cambor
- Oficina de Investigación Biosanitaria de Oviedo, Asturias, Spain
- Universidad Autonoma de Chile, Santiago, Chile
| | - Ricard Tresserras
- Respiratory Disease Management Plan, Department of Health of the Autonomous Government of Catalonia, Observatory of Respiratory Therapy, Spain
- Health Department, Hospital Clinic, Hospital Clínic & REDISSEC (Health Services Research on Chronic Patients Network), Barcelona, Spain
| | - Joan Escarrabill
- Respiratory Disease Management Plan, Department of Health of the Autonomous Government of Catalonia, Observatory of Respiratory Therapy, Spain
- Chronic Diseases Care Program, Hospital Clinic, Hospital Clínic & REDISSEC (Health Services Research on Chronic Patients Network), Barcelona, Spain
| |
Collapse
|
41
|
Hervás D, Utrera JF, Hervás-Masip J, Hervás JA, García-Marcos L. Can meteorological factors forecast asthma exacerbation in a paediatric population? Allergol Immunopathol (Madr) 2015; 43:32-6. [PMID: 24168972 DOI: 10.1016/j.aller.2013.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 07/06/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Asthma exacerbations attended in emergency departments show a marked seasonality in the paediatric age. This seasonal pattern can change from one population to another and the factors involved are poorly understood. OBJECTIVES To evaluate the association between meteorological factors and schooling with asthma exacerbations in children attended in the paediatric emergency department of a district hospital. METHODS We conducted a retrospective review of the medical records of children 5-14 years of age attended for asthma exacerbations during a 4-year period (2007-2011). Climatic data were obtained from a weather station located very close to the population studied. The number of asthma exacerbations was correlated to temperature, barometric pressure, relative humidity, rainfall, wind speed, wind distance, solar radiation, water vapour pressure and schooling, using regression analyses. RESULTS During the study period, 371 children were attended for asthma exacerbations; median age was eight years (IQR: 6-11), and 59% were males. Asthma exacerbations showed a bimodal pattern with peaks in spring and summer. Maximum annual peak occurred in week 39, within 15 days from school beginning after the summer holidays. A regression model with mean temperature, water vapour pressure, relative humidity, maximum wind speed and schooling could explain 98.4% (p<0.001) of monthly asthma exacerbations. CONCLUSIONS The combination of meteorological factors and schooling could predict asthma exacerbations in children attended in a paediatric emergency department.
Collapse
Affiliation(s)
- D Hervás
- University Institute of Health Sciences-IUNICS, University of the Balearic Islands, Spain; Department of Paediatrics, Inca Hospital, Mallorca Spain.
| | - J F Utrera
- Department of Paediatrics, Inca Hospital, Mallorca Spain
| | - J Hervás-Masip
- University Institute of Health Sciences-IUNICS, University of the Balearic Islands, Spain
| | - J A Hervás
- University Institute of Health Sciences-IUNICS, University of the Balearic Islands, Spain
| | - L García-Marcos
- Respiratory Medicine and Allergy Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia, Spain
| |
Collapse
|
42
|
Flight WG, Bright-Thomas RJ, Sarran C, Mutton KJ, Morris J, Webb AK, Jones AM. The effect of the weather on pulmonary exacerbations and viral infections among adults with cystic fibrosis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:1845-1851. [PMID: 24452385 DOI: 10.1007/s00484-013-0786-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/23/2013] [Accepted: 12/27/2013] [Indexed: 06/03/2023]
Abstract
The effect of changes in the weather on the respiratory health of patients with cystic fibrosis (CF) is unclear. We conducted a prospective study to determine the impact of climate and season on the incidence of viral respiratory infections (VRI) and pulmonary exacerbations (PEx) among adults with CF. Between December 2010 and April 2012, 98 adults with CF were followed for 12 months. Polymerase chain reaction assays for nine viruses were performed on sputum, nose and throat swabs every 2 months and additionally at onset of PEx. Hourly temperature and relative humidity measurements were recorded throughout the study. Statistical analysis utilized generalized estimating equation (GEE) models. Pre-specified criteria for VRI and PEx were met at 29% and 37% of visits, respectively. Rhinovirus accounted for 72% of identified viruses. Incidence of rhinovirus peaked in autumn while non-rhinovirus VRI peaked in winter. Rhinovirus was associated with increased mean temperatures (OR 1.07; p = 0.001), while non-rhinovirus VRI was associated with lower mean temperatures (OR 0.87; p < 0.001). PEx occurred frequently throughout the study with no clear seasonal pattern observed. There was no significant association between climate variables and the incidence of either PEx or antibiotic prescription. There is a seasonal pattern to VRI in adults with CF. The incidence of VRI but not PEx is associated with changes in ambient temperature.
Collapse
Affiliation(s)
- W G Flight
- University Hospital of South Manchester NHS Foundation Trust, Manchester, UK,
| | | | | | | | | | | | | |
Collapse
|
43
|
Sarran C, Halpin D, Levy ML, Prigmore S, Sachon P. A retrospective study of the impact of a telephone alert service (Healthy Outlook) on hospital admissions for patients with chronic obstructive pulmonary disease. NPJ Prim Care Respir Med 2014; 24:14080. [PMID: 25340279 PMCID: PMC4373472 DOI: 10.1038/npjpcrm.2014.80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 08/01/2014] [Accepted: 08/31/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Healthy Outlook is a service delivered by the UK Met Office directly to patients with chronic obstructive pulmonary disease (COPD) that has been in place since 2006. Its objective is to reduce the severity and length of COPD exacerbations, hence improving the quality of life and life expectancy. AIMS To assess the effect of the Healthy Outlook service on hospital admission rates of all general practitioners that have used the service. METHODS Control practices were selected for each of the 661 participating practices. The number of hospital admissions for each practice was extracted from the Hospital Episode Statistics database. The differences in admission rates per practice between the first year of use of the Healthy Outlook service and the previous year were compared by paired t-test analyses. RESULTS For admissions with a primary diagnosis of COPD, the difference between participating and control practices was -0.8% (95% confidence interval (CI)=-1.8 to 0.2%; P=0.13). For admissions with a primary or co-morbid diagnosis of COPD, the difference was -2.3% (95% CI=-4.2 to -0.4%; P=0.02). CONCLUSIONS Participation in the Healthy Outlook service reduces hospital admission rates for patients coded on discharge with COPD (including co-morbid).
Collapse
Affiliation(s)
| | | | - Mark L Levy
- Allergy and Respiratory Research Group, Centre for Population Health Sciences: GP Section, University of Edinburgh, Edinburgh, UK
| | | | | |
Collapse
|
44
|
Tseng CM, Chen YT, Ou SM, Hsiao YH, Li SY, Wang SJ, Yang AC, Chen TJ, Perng DW. The effect of cold temperature on increased exacerbation of chronic obstructive pulmonary disease: a nationwide study. PLoS One 2013; 8:e57066. [PMID: 23554858 PMCID: PMC3598847 DOI: 10.1371/journal.pone.0057066] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 01/17/2013] [Indexed: 11/28/2022] Open
Abstract
Background Seasonal variations in the acute exacerbation of chronic obstructive pulmonary disease (COPD) have been reported. However, the influence of air temperature and other meteorological factors on COPD exacerbation remains unclear. Methods National Health Insurance registry data from January 1, 1999 to December 1, 2009 and meteorological variables from the Taiwan Central Weather Bureau for the same period were analyzed. A case-crossover study design was used to investigate the association between COPD exacerbation and meteorological variables. Results A total of 16,254 cases who suffered from COPD exacerbation were enrolled. We found that a 1°C decrease in air temperature was associated with a 0.8% increase in the exacerbation rate on event-days (95% confidence interval (CI), 1.015–1.138, p = 0.015). With a 5°C decrease in mean temperature, the cold temperature (28-day average temperature) had a long-term effect on the exacerbation of COPD (odds ratio (OR), 1.106, 95% CI 1.063–1.152, p<0.001). In addition, elderly patients and those who did not receive inhaled medication tended to suffer an exacerbation when the mean temperature dropped 5°C. Higher barometric pressure, more hours of sunshine, and lower humidity were associated with an increase in COPD exacerbation. Conclusions This study demonstrated the effect of cold temperatures on the COPD exacerbation rate. Elderly patients and those without inhaled medicine before the exacerbation event were affected significantly by lower mean temperatures. A more comprehensive program to prevent cold stress in COPD patients may lead to a reduction in the exacerbations rate of COPD.
Collapse
Affiliation(s)
- Ching-Min Tseng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yung-Tai Chen
- Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuo-Ming Ou
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Han Hsiao
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Szu-Yuan Li
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Albert C. Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Diahn-Warng Perng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
45
|
Hondula DM, Davis RE, Knight DB, Sitka LJ, Enfield K, Gawtry SB, Stenger PJ, Deaton ML, Normile CP, Lee TR. A respiratory alert model for the Shenandoah Valley, Virginia, USA. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2013; 57:91-105. [PMID: 22438053 DOI: 10.1007/s00484-012-0537-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 02/20/2012] [Accepted: 02/20/2012] [Indexed: 05/31/2023]
Abstract
Respiratory morbidity (particularly COPD and asthma) can be influenced by short-term weather fluctuations that affect air quality and lung function. We developed a model to evaluate meteorological conditions associated with respiratory hospital admissions in the Shenandoah Valley of Virginia, USA. We generated ensembles of classification trees based on six years of respiratory-related hospital admissions (64,620 cases) and a suite of 83 potential environmental predictor variables. As our goal was to identify short-term weather linkages to high admission periods, the dependent variable was formulated as a binary classification of five-day moving average respiratory admission departures from the seasonal mean value. Accounting for seasonality removed the long-term apparent inverse relationship between temperature and admissions. We generated eight total models specific to the northern and southern portions of the valley for each season. All eight models demonstrate predictive skill (mean odds ratio = 3.635) when evaluated using a randomization procedure. The predictor variables selected by the ensembling algorithm vary across models, and both meteorological and air quality variables are included. In general, the models indicate complex linkages between respiratory health and environmental conditions that may be difficult to identify using more traditional approaches.
Collapse
Affiliation(s)
- David M Hondula
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA 22904, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|