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加拿大蒙特利尔的空气污染与因头痛前往急诊科的每日就诊情况

Air pollution and daily emergency department visits for headache in Montreal, Canada.

作者信息

Szyszkowicz Mieczyslaw

机构信息

Air Health Effects Division, Health Canada, Ottawa, Ontario, Canada.

出版信息

Headache. 2008 Mar;48(3):417-23. doi: 10.1111/j.1526-4610.2007.00808.x.

DOI:10.1111/j.1526-4610.2007.00808.x
PMID:18302702
Abstract

BACKGROUND

Many studies have indicated that weather can trigger headache. Here we propose a new methodological approach to assess the relationship between weather, ambient air pollution, and emergency department (ED) visits for this condition.

OBJECTIVE

To examine the associations between ED visits for headache and selected meteorological and air pollution factors.

DESIGN AND METHODS

A hierarchical clusters design was used to study 10,497 ED visits for headache (ICD-9: 784) that occurred at a Montreal hospital between 1997 and 2002. The generalized linear mixed models technique was applied to create Poisson models for the clustered counts of visits for headache.

RESULTS

Statistically significant positive associations were observed between the number of ED visits for headache and the atmospheric pressure for all and for female visits for 1-day and 2-day lagged exposures. The percentage increase in daily ED female visits was 4.1% (95% CI: 2.0, 6.2), 3.4% (95% CI: 1.4, 5.6), and 2.2% (95% CI: 1.4, 5.6) for current day, 1-day and 2-day lagged exposure to SO(2), respectively, for an increase of an interquartile range (IQR) of 2.4 ppb. The percentage increase was also statistically significant for current day and 1-day lagged exposure to NO(2) and CO for all and for female visits.

CONCLUSIONS

Presented findings provide support for the hypothesis that ED visits for headache are correlated to weather conditions and ambient air pollution - to atmospheric pressure and exposure to SO(2), NO(2), CO, and PM(2.5). An increase in levels of these factors is associated with an increase in the number of ED visits for headache.

摘要

背景

许多研究表明天气可引发头痛。在此,我们提出一种新的方法来评估天气、环境空气污染与因该病症前往急诊科(ED)就诊之间的关系。

目的

研究因头痛前往急诊科就诊与选定的气象和空气污染因素之间的关联。

设计与方法

采用分层聚类设计,研究了1997年至2002年期间在蒙特利尔一家医院发生的10497例因头痛(国际疾病分类第九版:784)前往急诊科就诊的病例。应用广义线性混合模型技术为头痛就诊病例的聚类计数创建泊松模型。

结果

在所有病例以及女性病例中,观察到因头痛前往急诊科就诊的次数与大气压力之间存在统计学上显著的正相关,且在滞后1天和2天暴露时也存在这种相关性。对于当前日、滞后1天和2天暴露于二氧化硫(SO₂)的情况,女性每日前往急诊科就诊人数的百分比增加分别为4.1%(95%可信区间:2.0,6.2)、3.4%(95%可信区间:1.4,5.6)和2.2%(95%可信区间:1.4,5.6),二氧化硫增加四分位数间距(IQR)为2.4 ppb。对于所有病例以及女性病例,当前日和滞后1天暴露于二氧化氮(NO₂)和一氧化碳(CO)时,百分比增加也具有统计学显著性。

结论

本研究结果支持以下假设:因头痛前往急诊科就诊与天气状况和环境空气污染相关——与大气压力以及暴露于SO₂、NO₂、CO和细颗粒物(PM₂.₅)相关。这些因素水平的增加与因头痛前往急诊科就诊的次数增加相关。

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