Association between particulate matter exposure and short-term prognosis in patients with pneumonia

Chien Chih Chen; Jyun Bin Huang; Shih Yu Cheng; Kuan Han Wu; Fu Jen Cheng

doi:10.4209/aaqr.2019.06.0293

Association between particulate matter exposure and short-term prognosis in patients with pneumonia

Chien Chih Chen
, Jyun Bin Huang
, Shih Yu Cheng
, Kuan Han Wu
, Fu Jen Cheng^*

^*Corresponding author for this work

School of Medicine

Chang Gung University
Chang Gung Memorial Hospital

Research output: Contribution to journal › Journal Article › peer-review

12 Scopus citations

Abstract

Particulate matter (PM) and other air pollutants are reportedly associated with both lung and systemic inflammation; however, an association between air pollutants and pneumonia outcomes has not been well established. Therefore, we evaluated the effect of air pollutants on the short-term outcomes of emergency department patients with pneumonia. We collected data on PM_2.5 (aerodynamic diameter < 2.5 µm), PM₁₀ (aerodynamic diameter < 10 µm), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and ozone from 11 air-quality monitoring stations in Kaohsiung City between January 1, 2008, and December 31, 2013. Medical records were extracted for non-trauma patients aged > 17 years who had visited the emergency department with a principal diagnosis of pneumonia. In-hospital mortality and the association of air pollutant exposure with the need for invasive respiratory and/or vasopressor support (IRVS) within 72 h were evaluated. Interquartile range (IQR) increments of PM_2.5 and PM₁₀ were associated with an increased IRVS risk with odds ratios (ORs) of 1.211 (95% confidence interval [CI], 1.031–1.419) and 1.194 (95% CI, 1.020–1.394) on lag 1, respectively, and per-IQR increments of NO₂ were associated with an increased IRVS risk with an OR of 1.146 (95% CI, 1.004–1.308) on lag 2. IQR increments of PM_2.5 and NO₂ were associated with an increased in-hospital mortality risk with ORs of 1.202 (95% CI, 1.100–1.429) and 1.175 (95% CI, 1.014–1.360), respectively. During the warm season, IQR increments of PM_2.5, PM₁₀, and NO₂ corresponded with an increased IRVS risk, with ORs of 1.333 (95% CI, 1.078–1.644), 1.348 (95% CI, 1.090–1.665), and 1.321 (95% CI, 1.101– 1.585), respectively. For patients with pneumonia, PM_2.5, PM₁₀, and NO₂ exposures were risk factors for a poor prognosis. Exposure effects appeared to be greater during the warm season. Regulations focused on PM_2.5, PM₁₀, and NO₂ levels should be considered to improve patient outcomes.

Original language	English
Pages (from-to)	89-96
Number of pages	8
Journal	Aerosol and Air Quality Research
Volume	20
Issue number	1
DOIs	https://doi.org/10.4209/aaqr.2019.06.0293
State	Published - 01 2020

Bibliographical note

Publisher Copyright:
© Taiwan Association for Aerosol Research.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 11 Sustainable Cities and Communities

Keywords

Air pollution
Emergency department
Particulate matter
Prognosis

Access to Document

10.4209/aaqr.2019.06.0293

Cite this

@article{ba4c086098e7497b8d554e5850c52088,

title = "Association between particulate matter exposure and short-term prognosis in patients with pneumonia",

abstract = "Particulate matter (PM) and other air pollutants are reportedly associated with both lung and systemic inflammation; however, an association between air pollutants and pneumonia outcomes has not been well established. Therefore, we evaluated the effect of air pollutants on the short-term outcomes of emergency department patients with pneumonia. We collected data on PM2.5 (aerodynamic diameter < 2.5 µm), PM10 (aerodynamic diameter < 10 µm), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone from 11 air-quality monitoring stations in Kaohsiung City between January 1, 2008, and December 31, 2013. Medical records were extracted for non-trauma patients aged > 17 years who had visited the emergency department with a principal diagnosis of pneumonia. In-hospital mortality and the association of air pollutant exposure with the need for invasive respiratory and/or vasopressor support (IRVS) within 72 h were evaluated. Interquartile range (IQR) increments of PM2.5 and PM10 were associated with an increased IRVS risk with odds ratios (ORs) of 1.211 (95\% confidence interval [CI], 1.031–1.419) and 1.194 (95\% CI, 1.020–1.394) on lag 1, respectively, and per-IQR increments of NO2 were associated with an increased IRVS risk with an OR of 1.146 (95\% CI, 1.004–1.308) on lag 2. IQR increments of PM2.5 and NO2 were associated with an increased in-hospital mortality risk with ORs of 1.202 (95\% CI, 1.100–1.429) and 1.175 (95\% CI, 1.014–1.360), respectively. During the warm season, IQR increments of PM2.5, PM10, and NO2 corresponded with an increased IRVS risk, with ORs of 1.333 (95\% CI, 1.078–1.644), 1.348 (95\% CI, 1.090–1.665), and 1.321 (95\% CI, 1.101– 1.585), respectively. For patients with pneumonia, PM2.5, PM10, and NO2 exposures were risk factors for a poor prognosis. Exposure effects appeared to be greater during the warm season. Regulations focused on PM2.5, PM10, and NO2 levels should be considered to improve patient outcomes.",

keywords = "Air pollution, Emergency department, Particulate matter, Prognosis",

author = "Chen, \{Chien Chih\} and Huang, \{Jyun Bin\} and Cheng, \{Shih Yu\} and Wu, \{Kuan Han\} and Cheng, \{Fu Jen\}",

note = "Publisher Copyright: {\textcopyright} Taiwan Association for Aerosol Research.",

year = "2020",

month = jan,

doi = "10.4209/aaqr.2019.06.0293",

language = "英语",

volume = "20",

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T1 - Association between particulate matter exposure and short-term prognosis in patients with pneumonia

AU - Chen, Chien Chih

AU - Huang, Jyun Bin

AU - Cheng, Shih Yu

AU - Wu, Kuan Han

AU - Cheng, Fu Jen

PY - 2020/1

Y1 - 2020/1

N2 - Particulate matter (PM) and other air pollutants are reportedly associated with both lung and systemic inflammation; however, an association between air pollutants and pneumonia outcomes has not been well established. Therefore, we evaluated the effect of air pollutants on the short-term outcomes of emergency department patients with pneumonia. We collected data on PM2.5 (aerodynamic diameter < 2.5 µm), PM10 (aerodynamic diameter < 10 µm), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone from 11 air-quality monitoring stations in Kaohsiung City between January 1, 2008, and December 31, 2013. Medical records were extracted for non-trauma patients aged > 17 years who had visited the emergency department with a principal diagnosis of pneumonia. In-hospital mortality and the association of air pollutant exposure with the need for invasive respiratory and/or vasopressor support (IRVS) within 72 h were evaluated. Interquartile range (IQR) increments of PM2.5 and PM10 were associated with an increased IRVS risk with odds ratios (ORs) of 1.211 (95% confidence interval [CI], 1.031–1.419) and 1.194 (95% CI, 1.020–1.394) on lag 1, respectively, and per-IQR increments of NO2 were associated with an increased IRVS risk with an OR of 1.146 (95% CI, 1.004–1.308) on lag 2. IQR increments of PM2.5 and NO2 were associated with an increased in-hospital mortality risk with ORs of 1.202 (95% CI, 1.100–1.429) and 1.175 (95% CI, 1.014–1.360), respectively. During the warm season, IQR increments of PM2.5, PM10, and NO2 corresponded with an increased IRVS risk, with ORs of 1.333 (95% CI, 1.078–1.644), 1.348 (95% CI, 1.090–1.665), and 1.321 (95% CI, 1.101– 1.585), respectively. For patients with pneumonia, PM2.5, PM10, and NO2 exposures were risk factors for a poor prognosis. Exposure effects appeared to be greater during the warm season. Regulations focused on PM2.5, PM10, and NO2 levels should be considered to improve patient outcomes.

AB - Particulate matter (PM) and other air pollutants are reportedly associated with both lung and systemic inflammation; however, an association between air pollutants and pneumonia outcomes has not been well established. Therefore, we evaluated the effect of air pollutants on the short-term outcomes of emergency department patients with pneumonia. We collected data on PM2.5 (aerodynamic diameter < 2.5 µm), PM10 (aerodynamic diameter < 10 µm), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone from 11 air-quality monitoring stations in Kaohsiung City between January 1, 2008, and December 31, 2013. Medical records were extracted for non-trauma patients aged > 17 years who had visited the emergency department with a principal diagnosis of pneumonia. In-hospital mortality and the association of air pollutant exposure with the need for invasive respiratory and/or vasopressor support (IRVS) within 72 h were evaluated. Interquartile range (IQR) increments of PM2.5 and PM10 were associated with an increased IRVS risk with odds ratios (ORs) of 1.211 (95% confidence interval [CI], 1.031–1.419) and 1.194 (95% CI, 1.020–1.394) on lag 1, respectively, and per-IQR increments of NO2 were associated with an increased IRVS risk with an OR of 1.146 (95% CI, 1.004–1.308) on lag 2. IQR increments of PM2.5 and NO2 were associated with an increased in-hospital mortality risk with ORs of 1.202 (95% CI, 1.100–1.429) and 1.175 (95% CI, 1.014–1.360), respectively. During the warm season, IQR increments of PM2.5, PM10, and NO2 corresponded with an increased IRVS risk, with ORs of 1.333 (95% CI, 1.078–1.644), 1.348 (95% CI, 1.090–1.665), and 1.321 (95% CI, 1.101– 1.585), respectively. For patients with pneumonia, PM2.5, PM10, and NO2 exposures were risk factors for a poor prognosis. Exposure effects appeared to be greater during the warm season. Regulations focused on PM2.5, PM10, and NO2 levels should be considered to improve patient outcomes.

KW - Air pollution

KW - Emergency department

KW - Particulate matter

KW - Prognosis

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DO - 10.4209/aaqr.2019.06.0293

M3 - 文章

AN - SCOPUS:85078247602

SN - 1680-8584

VL - 20

SP - 89

EP - 96

JO - Aerosol and Air Quality Research

JF - Aerosol and Air Quality Research

IS - 1

ER -

Association between particulate matter exposure and short-term prognosis in patients with pneumonia

Abstract

Bibliographical note

UN SDGs

Keywords

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