Perceptions of activity-supportive environment and motorcycle use among urban Taiwanese adults

Long-term exposure to multiple air pollutants and risk of Parkinson's disease: a population-based multipollutant model study

BACKGROUND

Recent evidence suggests brain-first Parkinson's disease (PD) may start from the olfactory system, indicating potential inhalational exposure to causal agents. We investigated the impact of long-term exposure to various air pollutants on PD incidence using both single- and multi-pollutant models to account for interactions between pollutants.

METHODS

This retrospective population study used data from Taiwan's National Health Insurance Research Database (2006 and 2018) and included individuals aged 40-65 without PD. Personal exposure levels to various air pollutants, including PM2.5, PM10, NO2, O3, SO2 and CO, were calculated using the hybrid Kriging/land-use regression method. Cox regression models were used to analyse the association between pollutants and PD incidence, adjusting for covariates.

RESULTS

A total of 5 113 322 individuals without PD (mean age 50.1±6.9 years, 47.3% men) were followed for an average of 11.2±2.4 years, during which 20 694 incident cases of PD were identified. In the single-pollutant model, exposure to PM2.5 (HR 2.65 (95% CI 2.59 to 2.72)), PM10 (HR 3.13 (3.04 to 3.22)), NO2 (HR 1.74 (1.68 to 1.80)) and SO2 (HR 1.68 (1.65 to 1.71)) was associated with an increased risk of PD. These associations remained robust in the multipollutant model. A positive association between exposure to O3 and an increased risk of PD (HR 1.29 (1.25-1.33)) was observed after adjusting for co-pollutants.

CONCLUSIONS

This nationwide cohort study employing multiple-pollutant models for considering the interaction effects revealed an association between exposure to multiple air pollutants and the risk of PD, emphasising the need for early prevention strategies.

Population-based prevalence of somatic symptom disorder and comorbid depression and anxiety in Taiwan

OBJECTIVE

The nationwide prevalence of somatic symptom disorder (SSD) has not yet been investigated in Asia. SSD is often comorbid with depression and anxiety, and the effects of these conditions on medical utilization await clarification. We hence performed a study in Taiwan to explore these issues.

METHODS

Using telephone-based sampling and interview, we obtained data for 3161 participants whose age, gender and living area were compatible with the Taiwan population. We gathered scores of the Patient Health Questionnaire-15 (PHQ-15), Health Anxiety Questionnaire (HAQ) and Patient Health Questionnaire-4 (PHQ-4). Individuals with a PHQ-15 score of at least 4 and a HAQ score of at least 17 were considered to have SSD. Descriptive statistics were used to clarify the prevalence and normative data of the questionnaires. We used multiple logistic regression analyses to investigate the relation between diagnoses and medical utilization.

RESULTS

The prevalence of SSD was 5.00% and women had a higher SSD prevalence than men; participants aged 40-49 years had the highest SSD prevalence. In SSD patients, 33.58% had depression or anxiety. After correcting for demographics, SSD and anxiety (but not depression) were associated with a significantly high level of outpatient/emergency department attendance. Comorbid depression or anxiety did not significantly increase the medical utilization of SSD patients.

CONCLUSION

The nationwide SSD prevalence in Taiwan is compatible with the description in the DSM-5. The comorbidity of SSD and depression/anxiety is common, but depression or anxiety does not significantly increase the SSD patients' medical utilization.

Understanding COVID-19 preventive behavior: An application of the health belief model in the Philippine setting

BACKGROUND

With the Philippines emerging as the hotspot in the Western Pacific Region for the COVID-19 cases, the study aimed to understand the COVID-19 preventive behavior of Filipinos using the health belief model (HBM).

MATERIALS AND METHODS

The cross-sectional study included 304 respondents recruited for the whole month of July 2020 through various social media platforms. Participants were requested to answer an online questionnaire, and results were analyzed using SPSS software.

RESULTS

The majority of respondents were female (71.1%), with an average age of 29, college graduate (57.6%), and living in an area where modified general community quarantine is implemented (63.2%). Good preventive behavior was noted among the participants, and not shaking of hands with others and refraining from touching of surfaces were reported as the most practiced behavior. Spearman's correlation and Pearson's Chi-square showed that age and sex are significant predictors for the HBM constructs and preventive behavior. Furthermore, results showed that cues to action, self-efficacy, and perceived barrier have a significant association with COVID-19 preventive behavior.

CONCLUSION

Findings prove that HBM is useful in understanding preventive behaviors in times of coronavirus pandemic. Strategies that promote a supportive environment and help overcome the perceived barriers can guide Filipinos to adopt the desired health behavior. Interventions to promote preventive behaviors should be focused on males and younger individuals.

Ambulance traffic accidents in Taiwan

BACKGROUND/PURPOSE

Ambulance traffic accidents (ATAs) are the leading cause of occupation-related fatalities among emergency medical service (EMS) personnel. We aim to use the Taiwan national surveillance system to analyze the characteristics of ATAs and to assist EMS directors in developing policies governing ambulance operations.

METHODS

A retrospective, cross-sectional and largely descriptive study was conducted using Taiwan national traffic accidents surveillance data from January 1, 2011 to October 31, 2016.

RESULTS

Among the 1,627,217 traffic accidents during the study period, 715 ATAs caused 8 deaths within 24 h and 1844 injured patients. On average, there was one ATA for every 8598 ambulance runs. Compared to overall traffic accidents, ATAs were 1.7 times more likely to result in death and 1.9 times more likely to have injured patients. Among the 715 ATAs, 8 (1.1%) ATAs were fatal and 707 (98.9%) were nonfatal. All 8 fatalities were associated with motorcycles. The urban areas were significantly higher than the rural areas in the annual number of ATAs (14.2 ± 7.3 [7.0-26.7] versus 3.1 ± 1.9 [0.5-8.4], p = 0.013), the number of ATA-associated fatalities per year (0.2 ± 0.2 [0.0-0.7] versus 0.1 ± 0.1 [0.0-0.2], p = 0.022), and the annual number of injured patients (who needed urgent hospital visits) in ATAs (19.4 ± 7.3 [10.5-30.9] versus 5.2 ± 3.8 [0.9-15.3], p < 0.001).

CONCLUSION

The ATA-associated fatality rate in Taiwan was high, and all fatalities were associated with motorcycles. ATAs in a highly motorcycle-populated area may require further investigation. An ambulance traffic accident reporting system should be built to provide EMS policy guidance for ATA reduction and outcome improvements.