Urban air pollution and meteorological factors affect emergency department visits of elderly patients with chronic obstructive pulmonary disease in Taiwan. (May 2017)

• Record Type: Journal Article
• Authors: Ding, Pei-Hsiou; Wang, Gen-Shuh; Guo, Yue-Leon; Chang, Shuenn-Chin; Wan, Gwo-Hwa
• Is Part Of: Environmental pollution. Volume 224(2017)
• Page Start: 751
• Page End: 758
• Publication Date: 2017-05
• Subjects: Urbanization -- Air pollution -- Meteorological factor -- COPD -- Emergency department visits; ED emergency department -- COPD chronic obstructive pulmonary disease -- PM10 particulate matter in 10 μm diameter -- PM2.5 particulate matter in 2.5 μm diameter -- O3 ozone -- SO2 sulfate dioxide -- NO2 nitrate dioxide -- RH relative humidity -- TEPA Taiwan Environmental Protection Administration -- NHI National Health Insurance -- WHO World Health Organization -- ICD international classification of diseases -- IQR interquartile range -- OR odds ratio; Pollution -- Periodicals; Pollution -- Environmental aspects -- Periodicals; Environmental Pollution -- Periodicals; Pollution -- Périodiques; Pollution -- Aspect de l'environnement -- Périodiques; Pollution -- Effets physiologiques -- Périodiques; Pollution; Pollution -- Environmental aspects; Periodicals; Electronic journals; 363.73
• DOI: 10.1016/j.envpol.2016.12.035
• Languages: English
• ISSNs: 0269-7491

Abstract

Abstract: Both air pollution and meteorological factors in metropolitan areas increased emergency department (ED) visits from people with chronic obstructive pulmonary disease (COPD). Few studies investigated the associations between air pollution, meteorological factors, and COPD-related health disorders in Asian countries. This study aimed to investigate the relationship between the environmental factors and COPD-associated ED visits of susceptible elderly population in the largest Taiwanese metropolitan area (Taipei area, including Taipei city and New Taipei city) between 2000 and 2013. Data of air pollutant concentrations (PM10, PM2.5, O3, SO2, NO2 and CO), meteorological factors (daily temperature, relative humidity and air pressure), and daily COPD-associated ED visits were collected from Taiwan Environmental Protection Administration air monitoring stations, Central Weather Bureau stations, and the Taiwan National Health Insurance database in Taipei area. We used a case-crossover study design and conditional logistic regression models with odds ratios (ORs), and 95% confidence intervals (CIs) for evaluating the associations between the environmental factors and COPD-associated ED visits. Analyses showed that PM2.5, O3, and SO2 had significantly greater lag effects (the lag was 4 days for PM2.5, and 5 days for O3 and SO2 ) on COPD-associated ED visits of the elderly population (65–79 years old). In warmer days, a significantly greater effect on elderly COPD-associated ED visits was estimated for PM2.5 with coexistence of O3 . Additionally, either O3 or SO2 combined with other air pollutants increased the risk of elderly COPD-associated ED visits in the days of high relative humidity and air pressure difference, respectively. This study showed that joint effect of urban air pollution and meteorological factors contributed to the COPD-associated ED visits of the susceptible elderly population in the largest metropolitan area in Taiwan. Government authorities should review existing air pollution policies, and strengthen health education propaganda to ensure the health of the susceptible elderly population. Graphical abstract: Highlights: Few studies investigated the relationship between air pollution, meteorological factors, and COPD ED visits in Asia. PM2.5, O3, and SO2 had greater lag effects on COPD ED visits of the elderly population in Taipei area. PM2.5 and O3 had a significantly greater impact on elderly COPD-associated ED visits on hot days. Strong impact existed between O3, SO2 and elderly COPD ED visits on days with higher RH and air pressure. Joint effect of urban air pollution and meteorological factors was observed on elderly COPD ED visits in Taiwan. Abstract : PM2.5, O3, and SO2 had greater lag effects on elderly (65–79 years old) COPD ED visits in Taipei area, especially in days with hot, high relative humidity and air pressure differences.