Short-Term Effects of Particulate Matter and Its Constituents on Emergency Room Visits for Chronic Obstructive Pulmonary Disease: A Time-Stratified Case-Crossover Study in an Urban Area

Yii-Ting Huang, Chien-Chih Chen, Yu-Ni Ho, Ming-Ta Tsai, Chih-Min Tsai, Po-Chun Chuang and Fu-Jen Cheng
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Yii-Ting Huang: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, Taiwan
Chien-Chih Chen: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, Taiwan
Yu-Ni Ho: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, Taiwan
Ming-Ta Tsai: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, Taiwan
Chih-Min Tsai: College of Medicine, Chang Gung University, Guishan District, Taoyuan City 333, Taiwan
Po-Chun Chuang: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, Taiwan
Fu-Jen Cheng: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, Taiwan

IJERPH, 2021, vol. 18, issue 9, 1-12

Abstract: Background: PM 2.5 exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM 2.5 constitutes. This study evaluated the effects of increased short-term exposure to PM 2.5 constituents on chronic obstructive pulmonary disease (COPD)-related emergency department (ED) visits and determined the susceptible groups. Methods: This retrospective observational study performed in a medical center from 2007 to 2010, and enrolled non-trauma patients aged >20 years who visited the emergency department (ED) and were diagnosed as COPD. Concentrations of PM 2.5 , PM 10 , and the four PM 2.5 components, including organic carbon (OC), elemental carbon (EC), nitrate (NO 3 ? ), and sulfate (SO 4 2? ), were collected by three PM supersites in Kaohsiung City. We used an alternative design of the Poisson time series regression models called a time-stratified and case-crossover design to analyze the data. Results: Per interquartile range (IQR) increment in PM 2.5 level on lag 2 were associated with increments of 6.6% (95% confidence interval (CI), 0.5–13.0%) in risk of COPD exacerbation. An IQR increase in elemental carbon (EC) was significantly associated with an increment of 3.0% (95% CI, 0.1–5.9%) in risk of COPD exacerbation on lag 0. Meanwhile, an IQR increase in sulfate, nitrate, and OC levels was not significantly associated with COPD. Patients were more sensitive to the harmful effects of EC on COPD during the warm season (interaction p = 0.019). The risk of COPD exacerbation after exposure to PM 2.5 was higher in individuals who are currently smoking, with malignancy, or during cold season, but the differences did not achieve statistical significance. Conclusion: PM 2.5 and EC may play an important role in COPD events in Kaohsiung, Taiwan. Patients were more susceptible to the adverse effects of EC on COPD on warm days.

Keywords: air pollution; chronic obstructive pulmonary disease (COPD); constituents; emergency department; particulate matter (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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