Particulate matter and exacerbations of chronic obstructive pulmonary disease: analysis of emergency department visits in a low-pollution area.

IF 6.3
Félix Del Campo, Tania M Álvaro de Castro, Raúl López-Izquierdo, Fernando Moreno Torrero, Daniel Álvarez, Gonzalo C Gutiérrez-Tobal, Roberto Hornero, Tomás Ruiz Albi
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Abstract

Objective: To evaluate the association between particulate matter concentration (PM10 and PM2.5) and the number of emergency department visits for exacerbation of chronic obstructive pulmonary disease (COPD) in a low-pollution area.

Methods: We conducted an ecological study based on emergency department visits for COPD exacerbations. A generalized additive model was used to estimate the relative risk and attributable fraction (AF), adjusting for weather variables. Pollution levels on the day of the visit and the 5 preceding days were considered to assess potential delayed effects of exposure.

Results: A total of 2,045 patients with 5,233 emergency department visits were included. A total of 79.1% of the patients were men. The mean age was 79.5 years (SD, 10.1). The mean concentration of PM2.5 and PM10 was 11.5 µg/m³ and 17.3 µg/m³, respectively. Both emergency visits and particulate matter concentrations showed a seasonalpattern. A significant association was found with exposure occurring 3 days prior (lag -3), with a 5.8% increase in visits for every 10 µg/m³ increase in PM2.5 (AF 5.45%) and a 3.3% increase for PM10 (AF 3.15%). Men and patients older than 75 years showed greater sensitivity to exposure. The impact of particulate matter was more pronounced during the summer months.

Conclusions: Exposure to PM2.5 and PM10 is associated with an increase in emergency department visits for COPD exacerbations, with a particular impact among men, patients older than 75 years, and during the summer season.

颗粒物与慢性阻塞性肺疾病的恶化:低污染地区急诊科就诊分析
目的:评价某低污染地区慢性阻塞性肺疾病(COPD)急性加重的颗粒物浓度(PM10和PM2.5)与急诊就诊次数的关系。方法:我们进行了一项基于急诊就诊的慢性阻塞性肺病加重的生态学研究。在对天气变量进行调整后,使用广义加性模型来估计相对风险和归因分数(AF)。访问当天和访问前5天的污染水平被用来评估接触的潜在延迟影响。结果:共纳入2045例患者,5233例急诊科就诊。男性占79.1%。平均年龄79.5岁(SD, 10.1)。PM2.5和PM10的平均浓度分别为11.5µg/m³和17.3µg/m³。急诊就诊和颗粒物浓度均呈现季节性模式。发现与暴露前3天(滞后-3)有显著关联,PM2.5每增加10 μ g/m³(AF 5.45%), PM10增加3.3% (AF 3.15%),就诊人数增加5.8%。男性和75岁以上的患者对暴露更敏感。颗粒物的影响在夏季更为明显。结论:暴露于PM2.5和PM10与COPD急性加重的急诊就诊增加有关,尤其是对男性、75岁以上患者和夏季患者的影响。
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