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Ozone and fine particulate matter association with CVD and COPD emergency room visits in Harris County, Texas: Spatiotemporal analysis.

机译：德克萨斯州哈里斯县的臭氧和细颗粒物与CVD和COPD急诊室的联系：时空分析。

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摘要

This study represents a secondary analysis of the merging of emergency room visits and daily ozone and PM2.5. Although the adverse health effects of ozone and fine particulate matter have been documented in the literature, evidence regarding the health risks of these two pollutants in Harris County, Texas, is limited. Harris County (Houston) has sufficiently unique characteristics that analysis of these relationships in this setting and with the ozone and industry issues in Houston is informative. The objective of this study was to investigate the association between the joint exposure to ozone and fine particulate matter, and emergency room diagnoses of chronic obstructive pulmonary disease and cardiovascular disease in Harris County, Texas, from 2004 to 2009, with zero and one day lags.;The study variables were daily emergency room visits for Harris County, Texas, from 2004 to 2009, temperature, relative humidity, east wind component, north wind component, ozone, and fine particulate matter. Information about each patient's age, race, and gender was also included. The two dichotomous outcomes were emergency room visits diagnoses for chronic obstructive pulmonary disease and cardiovascular disease. Estimates of ozone and PM2.5 were interpolated using kriging, in which estimates of the two pollutants were predicted from monitoring data for every case residence zip code for every day of the six years, over 3 million estimates (one of each pollutant for each case in the database).;Logistic regressions were conducted to estimate odds ratios of the two outcomes. Three analyses were conducted: one for all records, another for visits during the four months of April and September of 2005 and 2009, and a third one for visits from zip codes that are close to PM2.5 monitoring stations (east area of Harris County). The last two analyses were designed to investigate special temporal and spatial characteristics of the associations.;The dataset included all ER visits surveyed by Safety Net from 2004 to 2009, exceeding 3 million visits for all causes. There were 95,765 COPD and 96,596 CVD cases during this six year period. A 1-mug/m3 increase in PM2.5 on the same day was associated with a 1.0% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses, a 0.4% increase in the odds of cardiovascular disease emergency room diagnoses, and a 0.2% increase in the odds of cardiovascular disease emergency room diagnoses on the following day. A 1-ppb increase in ozone was associated with a 0.1% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses on the same day. These four percentages add up to 1.7% of ER visits. That is, over the period of six years, one unit increase for both ozone and PM2.5 (joint increase), resulted in about 55,286 (3,252,102 * 0.017) extra ER visits for CVD or COPD, or 9,214 extra ER visits per year.;After adjustment for age, race, gender, day of the week, temperature, relative humidity, east wind component, north wind component, and wind speed, there were statistically significant associations between emergency room chronic obstructive pulmonary disease diagnosis in Harris County, Texas, with joint exposure to ozone and fine particulate matter for the same day; and between emergency room cardiovascular disease diagnosis and exposure to PM2.5 of the same day and the previous day.;Despite the small association between the two air pollutants and the health outcomes, this study points to important findings. Namely, the need to identify reasons for the increase of CVD and COPD ER visits over the course of the project, the statistical association between humidity (or whatever other variables for which it may serve as a surrogate) and CVD and COPD cases, and the confirmatory finding that males and blacks have higher odds for the two outcomes, as consistent with other studies.;An important finding of this research suggests that the number and distribution of PM2.5 monitors in Harris County - although not evenly spaced geographically---are adequate to detect significant association between exposure and the two outcomes. In addition, this study points to other potential factors that contribute to the rising incidence rates of CVD and COPD ER visits in Harris County such as population increases, patient history, life style, and other pollutants. Finally, results of validation, using a subset of the data demonstrate the robustness of the models.
机译：这项研究代表了急诊室就诊与每日臭氧和PM2.5合并的二次分析。尽管在文献中已经记录了臭氧和细颗粒物对健康的不利影响，但是有关这两种污染物在德克萨斯州哈里斯县的健康风险的证据有限。哈里斯县（休斯敦）具有足够独特的特征，因此在这种情况下以及与休斯敦的臭氧和工业问题相关的分析非常有益。本研究的目的是调查2004年至2009年德克萨斯州哈里斯县联合暴露于臭氧和细小颗粒物以及急诊室对慢性阻塞性肺疾病和心血管疾病的诊断之间的关联，其中零滞后和一日滞后研究变量为2004年至2009年德克萨斯州哈里斯县的每日急诊室就诊次数，温度，相对湿度，东风成分，北风成分，臭氧和细颗粒物。还包括有关每个患者的年龄，种族和性别的信息。两分结果是急诊就诊诊断为慢性阻塞性肺疾病和心血管疾病。使用克里格插值法对臭氧和PM2.5的估算值进行插值，其中根据六年来每天的每个住所邮政编码的监测数据预测了两种污染物的估算值，超过了300万个估算值（每种情况每种污染物中的一种）在数据库中）。进行逻辑回归以估计两个结果的比值比。进行了三项分析：一项是所有记录，另一项是在2005年4月，9月和2009年的四个月中进行访问，第三项是对接近PM2.5监测站（哈里斯县东部地区）的邮政编码进行访问。 ）。最后两个分析旨在调查协会的特殊时空特征。数据集包括2004年至2009年安全网调查的所有ER访问，所有原因的访问均超过300万次。在这六年中，共有95,765例COPD和96,596例CVD。同一天PM2.5增加1杯/立方米，与慢性阻塞性肺疾病急诊室诊断的几率增加1.0％，心血管疾病急诊室诊断的几率增加0.4％和第二天，急诊室诊断出心血管疾病的几率增加了0.2％。臭氧每增加1ppb，与同一天发生慢性阻塞性肺病急诊室诊断的几率增加0.1％有关。这四个百分比占急诊室就诊总数的1.7％。也就是说，在六年的时间里，臭氧和PM2.5的单位增加（联合增加），使CVD或COPD的急诊就诊次数增加了约55,286（3,252,102 * 0.017），或者每年多了9,214急诊就诊。调整了年龄，种族，性别，星期几，温度，相对湿度，东风分量，北风分量和风速后，德克萨斯州哈里斯县急诊室慢性阻塞性肺疾病的诊断之间存在统计学上的显着关联，同一天同时接触臭氧和细颗粒物；尽管两种空气污染物与健康结果之间的联系很小，但这项研究指出了重要的发现。即，需要确定在项目过程中CVD和COPD ER访问量增加的原因，湿度（或其他可能替代的其他变量）与CVD和COPD情况之间的统计关联，以及证实性的发现，男性和黑人在这两种结果上的几率更高，与其他研究一致。这项研究的重要发现表明，哈里斯县PM2.5监测器的数量和分布-尽管地理分布不均-足以检测暴露与两种结果之间的显着关联。此外，这项研究还指出了导致哈里斯县CVD和COPD ER就诊发病率上升的其他潜在因素，例如人口增加，患者病史，生活方式和其他污染物。最后，使用数据子集的验证结果证明了模型的鲁棒性。

著录项

  • 作者

    Anderson, Faye.;

  • 作者单位

    The University of Texas School of Public Health.;

  • 授予单位 The University of Texas School of Public Health.;
  • 学科 Environmental Health.;Atmospheric Sciences.
  • 学位 Ph.D.
  • 年度 2012
  • 页码 181 p.
  • 总页数 181
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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