Estimate the effects of environmental determining factors on childhood asthma hospital admissions in Lisbon, Portugal: a time series modelling study

Rodrigues, Mónica; Natário, Isabel; Martins, Maria do Rosário Oliveira

doi:10.1007/s00704-020-03415-w

Cited by 8 publications

(10 citation statements)

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“…The effects of daily temperature on mortality in Lisbon Metropolitan Area (LMA) were estimated separately for winter (December–March) and summer (June–September) months and for each age group (0–64 years; 65–74 years; 75–84 years; and 85+ years). A semiparametric quasi-Poisson regression model accounting for overdispersion was used to investigate the temperature–mortality relationship, using distributed lag non-linear models (DLNM) [ 1 – 3 , 27 , 45 – 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…The specific model was chosen on the grounds of model fit criteria, modified Akaike information criteria for models with over dispersed data, Quasi-AIC [ 2 , 27 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

“…Extreme heat or cold events with greater magnitude and intensity may contribute to higher morbidity or mortality due to heat- and cold-related illnesses [ 20 – 23 ]. These illnesses are expected to be more severe among the most defenseless populations [ 24 – 27 ]. The elderly are often at higher risk due to limited mobility, susceptibility to infectious diseases, reduced caloric intake, and social isolation [ 18 , 22 , 24 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Modelling of Temperature-Attributable Mortality among the Elderly in Lisbon Metropolitan Area, Portugal: A Contribution to Local Strategy for Effective Prevention Plans

Rodrigues

Santana

2021

J Urban Health

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Epidemiological studies on the impact of determining environmental factors on human health have proved that temperature extremes and variability constitute mortality risk factors. However, few studies focus specifically on susceptible individuals living in Portuguese urban areas. This study aimed to estimate and assess the health burden of temperature-attributable mortality among age groups (0–64 years; 65–74 years; 75–84 years; and 85+ years) in Lisbon Metropolitan Area, from 1986–2015. Non-linear and delayed exposure–lag–response relationships between temperature and mortality were fitted with a distributed lag non-linear model (DLNM). In general, the adverse effects of cold and hot temperatures on mortality were greater in the older age groups, presenting a higher risk during the winter season. We found that, for all ages, 10.7% (95% CI: 9.3–12.1%) deaths were attributed to cold temperatures in the winter, and mostly due to moderately cold temperatures, 7.0% (95% CI: 6.2–7.8%), against extremely cold temperatures, 1.4% (95% CI: 0.9–1.8%). When stratified by age, people aged 85+ years were more burdened by cold temperatures (13.8%, 95% CI: 11.5–16.0%). However, for all ages, 5.6% of deaths (95% CI: 2.7–8.4%) can be attributed to hot temperatures. It was observed that the proportion of deaths attributed to exposure to extreme heat is higher than moderate heat. As with cold temperatures, people aged 85+ years are the most vulnerable age group to heat, 8.4% (95% CI: 3.9%, 2.7%), and mostly due to extreme heat, 1.3% (95% CI: 0.8–1.8%). These results provide new evidence on the health burdens associated with alert thresholds, and they can be used in early warning systems and adaptation plans. Supplementary Information The online version contains supplementary material available at 10.1007/s11524-021-00536-z.

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Section: Discussionmentioning

confidence: 99%

“…The specific model was chosen on the grounds of model fit criteria, modified Akaike information criteria for models with over dispersed data, Quasi-AIC [ 2 , 27 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Modelling of Temperature-Attributable Mortality among the Elderly in Lisbon Metropolitan Area, Portugal: A Contribution to Local Strategy for Effective Prevention Plans

Rodrigues

Santana

2021

J Urban Health

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“…10 However, in most studies investigating the impact of O 3 on asthma exacerbation, the target population is children with asthma. [11][12][13][14] The effect of O 3 on asthma in adulthood remains unclear.…”

Section: Open Accessmentioning

confidence: 99%

“…Sacks et al , using a time-stratified case-crossover study in North Carolina, also reported a positive association between O 3 and asthma-associated emergency department visits in children (5–17 years of age) 10. However, in most studies investigating the impact of O 3 on asthma exacerbation, the target population is children with asthma 11–14. The effect of O 3 on asthma in adulthood remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Relationship between exposure to ozone and exacerbation requiring hospital admission among patients with asthma: a case-control study in central Taiwan

et al. 2022

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ObjectiveThe convergence of asthma and air pollutants in ageing populations is currently a growing health issue worldwide, and hence there is an essential need to investigate the association between exposure to air pollution, particularly ozone (O3), and exacerbation requiring admission in patients with asthma.SettingA case-control study at a tertiary referral hospital in central Taiwan.ParticipantsWe used an asthma cohort, which included 11 400 patients with asthma, for the period 2006–2018 at Taichung Veterans General Hospital.Primary and secondary outcome measuresWe identified patients who had admitted for exacerbation as cases and selected patients with asthma without exacerbation, matching (1:4) the cases for age, gender and season of exacerbation, as controls. Data on hourly level of air pollutants were obtained from the Taiwan Environmental Protection Administration. We used conditional logistic regression and calculated adjusted ORs (adjORs) with 95% CIs.ResultsWe enrolled 11 400 participants with asthma, and 4.4% (501) of them had been admitted for exacerbation. Participants with asthma with exacerbation requiring hospitalisation were exposed to a higher level of O3 8-hour daily maximum (adjOR 1.009, 95% CI 1.001 to 1.016) and were more likely to have high Charlson Comorbidity Index (CCI ≥3; adjOR 2.198, 95% CI 1.729 to 2.794) and asthma-chronic obstructive pulmonary disease overlap (adjOR 4.542, 95% CI 3.376 to 6.611) compared with those without exacerbation. The aforementioned associations between exacerbation of asthma requiring hospitalisation and exposure to O3 were similar when defined by either O3 1-hour daily maximum or O3 24-hour average. Moreover, the O3 relevant exacerbation of asthma mainly existed in those aged older than 65 years and patients with medical comorbidities, including gastrointestinal diseases, cardiovascular diseases, neurological diseases, diabetes and renal disease.ConclusionsOur findings highlight the need for vigilance of exposure to O3 among elderly with asthma, particularly those with medical comorbidities. Further studies are warranted to investigate the underlying mechanisms.

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Short-term exposure to particulate matter and effects on emergency hospital admissions for Alzheimer’s disease and Parkinson’s disease: an ecological study from an aged European metropolis

Franco¹,

Gordo²,

Costa³

et al. 2023

Air Qual Atmos Health

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Alzheimer’s disease (AD) and Parkinson’s disease (PD) are important neurodegenerative disorders, especially in an aging population context that prevails in high-developed countries and Europe in particular. It is known that exposure to particulate matter (PM) leads to the production and deposition of aggregate clusters of proteins, which are linked to neurological disorders and impediments. Nonetheless, only a few works study the short-term exposure to PM and its association with hospital admissions or mortality due to AD or PD. This study assesses the association between exposure to PM and emergency hospital admissions for AD and PD in an aging metropole, serving as a case study for most European big cities. Daily emergency hospital admissions due to AD and PD data were obtained for the 2012 to 2015 period and multivariate Poisson regression models were used to evaluate the association between PM and admissions while controlling for the day of the week, seasonality, and environmental factors. Furthermore, lagged observations were assessed. Results show that an increase in exposure to PM2.5 resulted in a percentage increase in emergency hospital admissions due to AD and PD. Also, age was an effect modifier for PD admissions. Additionally, greater effects were felt at shorter lags for AD and delayed/longer lags for PD. This study found a relationship between short-term exposure to PM and AD and PD hospital admissions in an urban context, drawing attention to the importance of air pollution for urban health, especially in areas with an aged population structure.

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Estimate the effects of environmental determining factors on childhood asthma hospital admissions in Lisbon, Portugal: a time series modelling study

Cited by 8 publications

References 62 publications

Modelling of Temperature-Attributable Mortality among the Elderly in Lisbon Metropolitan Area, Portugal: A Contribution to Local Strategy for Effective Prevention Plans

Modelling of Temperature-Attributable Mortality among the Elderly in Lisbon Metropolitan Area, Portugal: A Contribution to Local Strategy for Effective Prevention Plans

Relationship between exposure to ozone and exacerbation requiring hospital admission among patients with asthma: a case-control study in central Taiwan

Short-term exposure to particulate matter and effects on emergency hospital admissions for Alzheimer’s disease and Parkinson’s disease: an ecological study from an aged European metropolis

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