Emergency department visits for asthma in relation to the Air Quality Health Index: A case-crossover study in Windsor, Canada

Szyszkowicz, Mieczysław; Kousha, Termeh

doi:10.17269/cjph.105.4539

Cited by 36 publications

(25 citation statements)

References 18 publications

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“…This methodology has already been applied in the implementation of the AQHI risk communication tool [7,8,[17][18][19][20][21][22]. In general, the main idea of such methods is to combine exposure levels and estimated coefficients related to health.…”

Section: Discussionmentioning

confidence: 99%

An approach to represent a combined exposure to air pollution

Szyszkowicz¹

2015

Int J Occup Med Environ Health

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Objectives: The objective of this study was to present a technique for estimating the effect of ambient air pollution mix on health outcomes. Material and Methods: We created a technique of indexing air pollution mix as a cause of the increased odds of health problems. As an illustrative example, we analyzed the impact of pollution on the frequency of emergency department (ED) visits due to colitis among young patients (age < 15 years, N = 11 110). Our technique involves 2 steps. First, we considered 6 ambient air pollutants (carbon monoxide, nitrogen dioxide, sulphur dioxide, ozone, and 2 measures of particulate matter) treating each pollutant as a single exposure. Odds ratios (ORs) for ED visits associated with a standard increase (interquartile range -IQR) in the pollutants levels were calculated using the case-crossover technique. The ORs and their 95% confidence intervals (95% CIs) were also found for lagged exposures (for lags 1-9 days). Second, we defined a Health Air Study Index (HASI) to represent the combined impact of the 6 air pollutants. Results: We obtained positive and statistically significant results for individual air pollutants and among them the following estimations: OR = 1.06 (95% CI: 1.02-1.1, NO 2 lag 3, IQR = 12.8 ppb), OR = 1.04 (95% CI: 1.01-1.07, SO 2 lag 4, IQR = 2.3 ppb), OR = 1.04 (95% CI: 1-1.06, PM lag 3, IQR = 6.2 μg/m 3 ). Among the re-calculated ORs with the HASI values as an exposure, the highest estimated value was OR = 1.37 (95% CI: 1.12-1.68, for 1 unit of the HASI, lag 3). Conclusions: The proposed index (HASI) allows to confirm the pattern of associations for lags obtained for individual air pollutants. In the presented example the used index (HASI) indicates the strongest relation with the exposure lagged by 3 days.

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Section: Discussionmentioning

confidence: 99%

An approach to represent a combined exposure to air pollution

Szyszkowicz¹

2015

Int J Occup Med Environ Health

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“…The PSI data can indicate the increased risk of chronic obstructive pulmonary disease, heart disease, asthma, and so on Szyszkowicz & Kousha 2014;Zheng et al 2015). This is particularly true for air pollutants smaller than PM2.5 (PM2.5: fine particles with diameters of 2.5 microns or less), which was found to increase the phenomenon of premature mortality (Lelieveld et al 2015) or cerebral hemorrhage (Huang et al 2017) as well as the number of emergency department visits (Fan et al 2016;Lim et al 2016).…”

Section: Data and Data Sourcementioning

confidence: 99%

Relationship between emergency care utilization, ambient temperature, and the pollution standard index in Taiwan

Tseng

Lan

et al. 2017

International Journal of Environmental Health Research

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This study applied a vector error correction model to investigate the effects of ambient temperature (AT) and air quality index values on emergency care utilization (ECU). The Pollution Standards Index (PSI) and total suspended particulates (TSP) were used for analysis. Data were obtained from the National Health Insurance Research Database of the Ministry of Transportation and Communications and Ministry Environmental of Protection Administration of Taiwan. Data from January of 1998 to December of 2012 (180 months) were analyzed. Study results showed that, regardless of long-term equilibrium or short-term dynamics, a 1 °C increase in AT will decrease ECU, showing that AT strongly affects ECU. There were no significant corrections of long-term equilibrium of PSI and TSP on ECU. Only short-term TSP dynamics caused negative effects in the first ECU phase. Emergency care requires special monitoring of AT and TSP to respond to the increased number of high-risk patients consulting emergency departments.

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“…In human studies of outdoor air pollution, an increased risk for OM has been linked to combinations of persistent organic pollutants, increased levels of carbon monoxide, fine particulate matter (PM2.5), nitrogen oxides, and woodsmoke (Karmaus, Kuehr, & Kruse, ; MacIntyre et al., ; Zemek et al., ). Given that infection, irritation, and allergy of the entire respiratory system, eye, ear, nose, and throat are often linked, additional evidence includes observed associations between air pollution and hospital visits for respiratory (Kousha & Rowe, ; Szyszkowicz & Kousha, ) and nonrespiratory (Kousha & Castner, ; Szyszkowicz, Shutt, Kousha, & Rowe, ) diseases. Thus, it is plausible to hypothesize that increased exposure to air pollution will lead to inflammation, thereby increasing the risk for OM.…”

Section: Otitis Media and Outdoor Air Pollutionmentioning

confidence: 99%