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; Fu Jen Cheng

doi:10.3390/ijerph18094400

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
, Fu Jen Cheng^*

^*Corresponding author for this work

School of Medicine

Chang Gung University

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

14 Scopus citations

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, PM₁₀, and the four PM_2.5 components, including organic carbon (OC), elemental carbon (EC), nitrate (NO₃⁻), and sulfate (SO₄²⁻), 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.

Original language	English
Article number	4400
Journal	International Journal of Environmental Research and Public Health
Volume	18
Issue number	9
DOIs	https://doi.org/10.3390/ijerph18094400
State	Published - 01 05 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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
Chronic obstructive pulmonary disease (COPD)
Constituents
Emergency department
Particulate matter

Access to Document

10.3390/ijerph18094400

Cite this

Huang, Y. T., Chen, C. C., Ho, Y. N., Tsai, M. T., Tsai, C. M., Chuang, P. C., & Cheng, F. J. (2021). 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. International Journal of Environmental Research and Public Health, 18(9), Article 4400. https://doi.org/10.3390/ijerph18094400

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title = "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",

abstract = "Background: PM2.5 exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM2.5 constitutes. This study evaluated the effects of increased short-term exposure to PM2.5 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 PM2.5, PM10, and the four PM2.5 components, including organic carbon (OC), elemental carbon (EC), nitrate (NO3−), and sulfate (SO42−), 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 PM2.5 level on lag 2 were associated with increments of 6.6\% (95\% confidence interval (CI), 0.5{\textendash}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{\textendash}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 PM2.5 was higher in individuals who are currently smoking, with malignancy, or during cold season, but the differences did not achieve statistical significance. Conclusion: PM2.5 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",

author = "Huang, \{Yii Ting\} and Chen, \{Chien Chih\} and Ho, \{Yu Ni\} and Tsai, \{Ming Ta\} and Tsai, \{Chih Min\} and Chuang, \{Po Chun\} and Cheng, \{Fu Jen\}",

note = "Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

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month = may,

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doi = "10.3390/ijerph18094400",

language = "英语",

volume = "18",

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Huang, YT, Chen, CC, Ho, YN, Tsai, MT, Tsai, CM, Chuang, PC & Cheng, FJ 2021, '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', International Journal of Environmental Research and Public Health, vol. 18, no. 9, 4400. https://doi.org/10.3390/ijerph18094400

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. / Huang, Yii Ting; Chen, Chien Chih; Ho, Yu Ni et al.
In: International Journal of Environmental Research and Public Health, Vol. 18, No. 9, 4400, 01.05.2021.

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

TY - JOUR

T1 - Short-term effects of particulate matter and its constituents on emergency room visits for chronic obstructive pulmonary disease

T2 - A time-stratified case-crossover study in an urban area

AU - Huang, Yii Ting

AU - Chen, Chien Chih

AU - Ho, Yu Ni

AU - Tsai, Ming Ta

AU - Tsai, Chih Min

AU - Chuang, Po Chun

AU - Cheng, Fu Jen

PY - 2021/5/1

Y1 - 2021/5/1

N2 - Background: PM2.5 exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM2.5 constitutes. This study evaluated the effects of increased short-term exposure to PM2.5 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 PM2.5, PM10, and the four PM2.5 components, including organic carbon (OC), elemental carbon (EC), nitrate (NO3−), and sulfate (SO42−), 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 PM2.5 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 PM2.5 was higher in individuals who are currently smoking, with malignancy, or during cold season, but the differences did not achieve statistical significance. Conclusion: PM2.5 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.

AB - Background: PM2.5 exposure is associated with pulmonary and airway inflammation, and the health impact might vary by PM2.5 constitutes. This study evaluated the effects of increased short-term exposure to PM2.5 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 PM2.5, PM10, and the four PM2.5 components, including organic carbon (OC), elemental carbon (EC), nitrate (NO3−), and sulfate (SO42−), 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 PM2.5 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 PM2.5 was higher in individuals who are currently smoking, with malignancy, or during cold season, but the differences did not achieve statistical significance. Conclusion: PM2.5 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.

KW - Air pollution

KW - Chronic obstructive pulmonary disease (COPD)

KW - Constituents

KW - Emergency department

KW - Particulate matter

UR - https://www.scopus.com/pages/publications/85104445146

U2 - 10.3390/ijerph18094400

DO - 10.3390/ijerph18094400

M3 - 文章

C2 - 33919089

AN - SCOPUS:85104445146

SN - 1661-7827

VL - 18

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 9

M1 - 4400

ER -

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

Abstract

Bibliographical note

UN SDGs

Keywords

Access to Document

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