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Gómez-García AR, Cevallos Paz AL, Delgado-Garcia D, Jimbo DM. Ecuadorian Provinces with High Morbidity and Mortality Rates Due to Asthma among the Working-Age Population: An Ecological Study to Promote Respiratory Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:909. [PMID: 39063486 PMCID: PMC11276727 DOI: 10.3390/ijerph21070909] [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: 05/19/2024] [Revised: 06/26/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024]
Abstract
Asthma is a significant public health concern. This study identified the provinces with the highest morbidity and mortality rates due to asthma among the working-age population (15-69 years) in the Republic of Ecuador. The secondary objective was to explain the possible differences attributable to occupational exposure. This nationwide ecological study was conducted in 24 provinces between 2016 and 2019. Government databases were used as sources of information. Age-standardized rates were calculated for codes J45 and J46. The hospitalization morbidity rate for asthma decreased from 6.51 to 5.76 cases per 100,000 working-age population, and the mortality rate has consistently been low and stable from 0.14 to 0.15 deaths per 100,000 working-age population. Geographic differences between the provinces were evident. The risk of hospitalization and death due to asthma was higher in the Pacific coast (Manabí with 7.26 and 0.38, Esmeraldas with 6.24 and 0.43, Los Ríos with 4.16 and 0.40, El Oro with 7.98 and 0.21, Guayas with 4.42 and 0.17 and the Andean region (Azuay with 6.33 and 0.45, Cotopaxi (5.84 and 0.48)). The high rates observed in provinces with greater agricultural and industrial development could be national heterogeneity's main determinants and act as occupational risk factors. The contribution of occupational hazards in each province should be examined in depth through ad hoc studies. The findings presented here provide valuable information that should prompt further detailed studies, which will assist in designing public policies aimed at promoting and safeguarding the respiratory health of the population, particularly that of workers. We believe that this study will inspire the creation of regional networks for the research and surveillance of occupational health.
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Affiliation(s)
- Antonio Ramón Gómez-García
- Facultad de Postgrados, Universidad Espíritu Santo, Samborondón 092301, Ecuador
- Ecuadorian Observatory of Occupational Safety and Health, Samborondón 092301, Ecuador
| | | | - Diemen Delgado-Garcia
- Universidad de Aconcagua, San Felipe 2170000, Chile;
- International Pneumoconiosis Observatory, Santiago de Chile 7500494, Chile
| | - Danilo Martínez Jimbo
- Universidad Internacional SEK, Quito 170134, Ecuador;
- Ecuadorian Society of Occupational Medicine, Quito 170519, Ecuador
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Teague WJ, Dipnall JF, Palmer CS, Beck B. Trampoline Park Injury Trends. Pediatrics 2024; 153:e2023061659. [PMID: 38058227 DOI: 10.1542/peds.2023-061659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES Trampolines are an important cause of childhood injury and focus of injury prevention. Understanding and prevention of trampoline park injury is constrained by inadequate exposure data to estimate the at-risk population. This study aimed to measure trampoline park injury incidence and time trends using industry data. METHODS Cross-sectional study to retrospectively analyze reported injuries and exposure in 18 trampoline parks operating in Australia and the Middle East, from 2017 to 2019. Exposure was derived from ticket sales and expressed as jumper hours. Exposure-adjusted incidence was measured using marginalized 0-inflated Poisson modeling and time trends using Joinpoint regression. RESULTS There were 13 256 injured trampoline park users reported from 8 387 178 jumper hours; 11% sustained significant injury. Overall, trampoline park injuries occurred at a rate of 1.14 injuries per 1000 jumper hours (95% confidence intervals 1.00 to 1.28), with rates highest for high-performance (2.11/1000 jumper hours, 1.66 to 2.56) and inflatable bag or foam pit (1.91/1000 jumper hours, 1.35 to 2.50) jumping. Significant injuries occurred at a rate of 0.11 injuries per 1000 jumper hours (0.10 to 0.13), with rates highest for high-performance (0.29/1000 jumper hours, 0.23 to 0.36), and parkour (0.22/1000 jumper hours, 0.15 to 0.28) jumping. Overall, injury rates decreased by 0.72%/month (-1.05 to -0.40) over the study period. CONCLUSIONS Trampoline park injuries occur in important numbers with sometimes serious consequences. However, within these safety standard-compliant parks, exposure-adjusted estimates show injuries to be uncommon and injury rates to be declining. Further reductions are required, especially severe injuries, and this study can enhance injury prevention initiatives.
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Affiliation(s)
- Warwick J Teague
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- Surgical Research, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Australia
| | - Cameron S Palmer
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Azarbakhsh H, Dehghani SS, Hassanzadeh J, Janfada M, Razeghi A, Mirahmadizadeh A. Trend analysis of asthma mortality and years of life lost from 2004 to 2019 in Southern Iran. Lung India 2023; 40:412-417. [PMID: 37787353 PMCID: PMC10553790 DOI: 10.4103/lungindia.lungindia_530_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/10/2023] [Accepted: 06/06/2023] [Indexed: 10/04/2023] Open
Abstract
Objective Asthma is a globally important non-communicable disease with major public health consequences. The aim of this study was to determine the mortality rate and years of life lost (YLL) due to asthma in southern Iran. Methods All deaths due to asthma in Fars province from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated. The JoinPoint Regression method was used to examine the trend. Results During the 16-year study period (2004-2019), 1167 deaths due to asthma occurred in Fars province among which 54.7% (638 cases) were men and 29.6% (346 cases) were in the age group of 70-79 years. Crude mortality rate of asthma had decreased by 121% and 84% in males and females, respectively from 2004 to 2019. The total years of life lost due to asthma during the 16-year study period were 7697 (0.24 per 1000 people) in men, 6882 (0.22 per 1000 people) in women. According to the join point regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing: the annual percent change (APC) was -5.6% (95% CI -8.2 to -2.9, P = 0.001) for males, -4.4% (95% CI -7.3 to -1.4, P = 0.008) for females. Conclusion The trend of mortality and years of life lost due to asthma has decreased significantly during the years of study, although in some age groups, especially the age group of 45-59 years which has the highest number of years of life lost, this trend has been constant and unchanged. It is necessary to conduct other studies to investigate the possible reasons for this unchanged trend in vulnerable age groups.
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Affiliation(s)
| | - Seyed S. Dehghani
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jafar Hassanzadeh
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Health Sciences, Institute of Health, Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Janfada
- M.S In Medical Education, Department of Statistics, Health Vice-Chancellor, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmadreza Razeghi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Gutierrez-Albaladejo N, Jimenez-Garcia R, Albaladejo-Vicente R, Villanueva-Orbaiz R, de-Miguel-Diez J, Noriega C, Lopez-de-Andres A. Trends in hospital admissions among children with asthma in Spain (2011-2020). Eur J Pediatr 2023; 182:2409-2419. [PMID: 36917291 PMCID: PMC10011755 DOI: 10.1007/s00431-023-04873-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 03/16/2023]
Abstract
The purpose of this study is to describe and assess changes in incidence, clinical conditions, use of mechanical ventilation, length of hospital stay (LOHS), and in-hospital mortality (IHM) among children hospitalized with asthma in Spain from 2011 to 2020. We analyzed children aged 0 to 15 years hospitalized with an ICD code for asthma included in the Spanish National Hospital Discharge Database (SNHDD). The analysis was conducted for asthma as the primary diagnosis and with asthma in any diagnosis position. Joinpoint regression was used to assess time trends in incidence. We included a total of 85,664 children hospitalized with asthma; of these, 46,727 (54.55%) had asthma coded as the primary diagnosis. The number of boys was higher than the number of girls, irrespective of age group or diagnostic position. The frequency of asthma as primary diagnosis decreased from 55.7% in 2011 to 43.96% in 2020 (p < 0.001). The incidence of hospitalizations because of asthma decreased significantly from 2011 to 2020, with a faster decrease from 2018 onwards. Over time, the proportion of older children increased. In the year 2020, only 55 children had codes for asthma and COVID-19 in their discharge report, and this infection had no effect on hospitalizations this year. A significant increase in the use of non-invasive ventilation (NIV) was observed over time. Irrespective of the diagnostic position, LOHS and IHM remained stable over time, with the IHM under 0.1%. Conclusion: Our results show a decrease in the incidence of hospital admissions with asthma either as the primary diagnosis or in any position. The age of children hospitalized seems to be increasing as the use of NIV. Better management of the disease from primary care and the emergency department as is the use of NIV could explain the reduction in incidence. What is Known: • Asthma is the most common chronic respiratory in childhood in high income countries. • The incidence of hospital admissions with asthma and associated factors is one of the best sources of information on morbidity trends and prognosis. What is New: • The incidence of hospital admissions for asthma in Spain decreased in children between 2011 and 2020 with a more frequent use of non-invasive mechanical ventilation and low mortality rates. • COVID-19 did not cause an increase in admissions with asthma in the year 2020.
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Affiliation(s)
| | - Rodrigo Jimenez-Garcia
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain.
| | - Romana Albaladejo-Vicente
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Rosa Villanueva-Orbaiz
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Javier de-Miguel-Diez
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Concepción Noriega
- Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28871, Alcalá de Henares, Madrid, Spain
| | - Ana Lopez-de-Andres
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
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Temporal trends of hospitalizations, comorbidity burden and in-hospital outcomes in patients admitted with asthma in the United States: Population-based study. PLoS One 2022; 17:e0276731. [PMID: 36516114 PMCID: PMC9750011 DOI: 10.1371/journal.pone.0276731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Asthma is a prevalent chronic respiratory condition and remains a common cause for hospitalization. However, contemporary data on asthma hospitalization rates, comorbidity burden, and in-hospital outcomes are lacking. METHODS Survey-weighted analysis of hospitalization records with a primary diagnosis of asthma using data from the US National (Nationwide) Inpatient Sample between 2004 and 2017. Outcomes were number of hospitalizations per 100,000 population and in-hospital outcomes including receipt of ventilation, length of stay, and hospital costs. Patient and admission characteristics and comorbidity burden were examined over time. Multivariable logistic and linear regression models were fitted for over-time risks of the outcomes. RESULTS Among 3,098,863 asthma admissions between 2004 and 2017, mean (±SD) age was 29 (±25), 57% females, 36% White, 40% had Medicaid as primary payer. During 2004-2017, asthma hospitalizations declined from 89 to 56 per 100,000 population; length of stay remained overall stable; median (interquartile range IQR) inflation-adjusted hospital costs doubled from $8,446 (9,227) in 2004 to $17,756 (19,434) in 2017. Common comorbidities in patients admitted with asthma were hypertension and diabetes in adults, but gastroesophageal reflux disease, obstructive sleep apnoea, anemia, and obesity in children. Over time, the prevalence of mental illness increased by >50%. Severe asthma (IRR, 2.48; 95%CI: 2.27-2.72) and psychoses (IRR, 1.10; 1.05-1.14) were predictors of prolonged hospitalization. Asian/Pacific Islanders were more likely to receive ventilation (OR: 2.35; 1.73-3.20) than White patients. Hospital costs were significantly higher in females and adults with hypertension (coefficient, 1405.2; 283.1-2527.4) or psychoses (coefficient, 1978.4; 674.9-3282.0). CONCLUSIONS US asthma hospitalization rates fluctuated in earlier years but declined over time, which may reflect improvements in community care and declining asthma prevalence. Comorbidity burden, including mental illness, increased over time and is associated with in-hospital outcomes. This highlights the changing landscape of asthma admissions which may inform redesigning services to support pre-hospitalization asthma care and help further reduce admissions, particularly among patients with multimorbidity.
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Muacevic A, Adler JR. Hospitalization Pattern for Chronic Lower Respiratory Diseases in Australia: A Retrospective Ecological Study. Cureus 2022; 14:e33162. [PMID: 36726920 PMCID: PMC9885383 DOI: 10.7759/cureus.33162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Chronic lower respiratory diseases are among the commonest causes of hospital admission worldwide. Identifying the trends in hospital admission due to chronic lower respiratory diseases is important for public health and policy makers. AIM The aim of this study was to examine the hospitalization profile related to chronic lower respiratory diseases in Australia during the past 21 years. METHOD A retrospective ecological study was conducted using hospital admission data taken from the National Hospital Morbidity Database (NHMD). Hospital admissions data for chronic lower respiratory diseases were extracted for the period between 1998 and 2019. The Pearson Chi-square test for independence was used to estimate the variation in hospital admission rates. RESULTS The hospitalization rate for chronic lower respiratory diseases rate decreased by 14.4%, from 568.90 (95%CI 565.50-572.30) in 1998 to 486.95 (95%CI 484.24-489.66) in 2019 per 100,000 persons, p<0.05. Rates of same-day hospitalization for chronic lower respiratory diseases increased by 62.7% from 1998 to 2019, while rates of overnight-stay hospital admission for chronic lower respiratory diseases decreased by 23.7% from 1998 to 2019. During the study duration, the hospitalization rates for bronchiectasis and other chronic obstructive pulmonary disease increased by 120.0% and 34.7%, respectively. The hospital admissions rates for emphysema, status asthmaticus, simple and mucopurulent chronic bronchitis, bronchitis, not specified as acute or chronic, unspecified chronic bronchitis, and asthma decreased by 94.8%, 92.6%, 70.7%, 66.3%, 46.0%, and 32.3%, respectively. The rates of hospitalization among patients aged 75 years and above increased by 3.9%, while younger age groups including those aged younger than 15 years, 15-59 years, and 60-74 years showed a reduction in the rate of hospitalization by 53%, 22.8%, and 19.7%, respectively. CONCLUSION Overall, the hospitalization rate for chronic lower respiratory diseases is seen to have decreased over the study period. Patients with chronic obstructive pulmonary disease (COPD) and the elderly group have a higher rate of hospitalization. Future studies are needed to investigate factors associated with the increase in the rate of hospitalization among the elderly age group.
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Beghé B, Fabbri L, Clini E. Persistent asthma hospitalisations and deaths require a national asthma prevention plan. Intern Emerg Med 2022; 17:953-955. [PMID: 35578148 DOI: 10.1007/s11739-022-02964-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Bianca Beghé
- Section of Respiratory Diseases, Department of Medicine and Surgery, SMECHIMAI, University of Modena and Reggio Emilia, AOU di Modena Policlinico, Largo del Pozzo 71, 41124, Modena, Italy.
| | - Leonardo Fabbri
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Enrico Clini
- Section of Respiratory Diseases, Department of Medicine and Surgery, SMECHIMAI, University of Modena and Reggio Emilia, AOU di Modena Policlinico, Largo del Pozzo 71, 41124, Modena, Italy
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Cabrera A, Picado C, Rodriguez A, Garcia-Marcos L. Asthma, rhinitis and eczema symptoms in Quito, Ecuador: a comparative cross-sectional study 16 years after ISAAC. BMJ Open Respir Res 2021; 8:8/1/e001004. [PMID: 34580136 PMCID: PMC8477327 DOI: 10.1136/bmjresp-2021-001004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/02/2021] [Indexed: 01/15/2023] Open
Abstract
Background In 2003, the International Study of Asthma and Allergies in Childhood (ISAAC) estimated the prevalence of asthma, rhinitis and eczema symptoms in Quito, Ecuador. Since then, no update of this study has been done in the last years. This study examined changes in the prevalence of asthma–rhinitis–eczema symptoms over a 16 years period in Quito and explored possible risk factors. Methods We conducted a comparative cross-sectional study in an adolescent population following the Global Asthma Network (GAN) methodology. A written questionnaire was used to explore symptoms of asthma–rhinitis–eczema. We calculated the prevalence and 95% CIs for each of the symptoms and compared them with the ISAAC results. We conducted bivariate and multivariate analysis using logistic regression to identify possible risk factors for recent wheeze, rhinitis and eczema. Results A total of 2380 adolescents aged between 13 and 14 years were evaluated. The prevalence of doctor diagnosis for asthma, rhinitis and eczema was 3.4%, 8.5% and 2.2%, respectively. Compared with ISAAC results, we found a lower prevalence of wheeze and eczema symptoms: wheeze ever (37.6% vs 12.7%), recent wheeze (17.8% vs 6.5%), asthma ever (6.9% vs 4.6%), recent rush (22.4% vs 13.9%) and eczema ever (11.7% vs 3.6%). The prevalence of rhinitis symptoms in the GAN study was higher than the ISAAC results: nose symptoms in the past 12 months (36.6% vs 45.8%) and nose and eye symptoms in the past 12 months (23.1% vs 27.9). Significant associations were observed between symptoms of asthma–rhinitis–eczema and sex, race/ethnicity, smoking habit, physical exercise and sedentary activities. Conclusions In the last two decades, the prevalence of asthma and eczema symptoms in adolescent population in the city of Quito has significantly declined; however, the prevalence of rhinitis symptoms has increased. The reduction in asthma symptoms could be related to better managing the disease and changes in local environmental risk factors in the last years. Further studies must be conducted in the country to evaluate the change in trends in asthma and other related allergic diseases.
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Affiliation(s)
- Angelita Cabrera
- Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain.,Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Cesar Picado
- Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Alejandro Rodriguez
- Facultad de Ciencias Médicas de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Luis Garcia-Marcos
- Arrixaca University Children's Hospital, Respiratory and Allergy Units, University of Murcia, Murcia, Spain
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