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环境空气污染、天气与因头痛而进行的每日急诊就诊

Ambient air pollution, weather and daily emergency department visits for headache.

作者信息

Vodonos Alina, Novack Victor, Zlotnik Yair, Ifergane Gal

机构信息

Public Health Department, Faculty for Health Sciences, Ben-Gurion University of the Negev, Israel Clinical Research Center, Soroka University Medical Center, Israel

Clinical Research Center, Soroka University Medical Center, Israel.

出版信息

Cephalalgia. 2015 Oct;35(12):1085-91. doi: 10.1177/0333102415570300. Epub 2015 Feb 4.

Abstract

BACKGROUND

Headache is a common condition, and a common complaint leading patients to emergency departments (ED). There have been a number of studies of the effect of environmental factors on headache, such as weather and air pollutants.

METHODS

This retrospective cohort study included data on daily ED visits with a chief complaint of headache in Soroka University Medical Center (SUMC) during 2002-2012. Data on weather and air pollutants were obtained from monitor station in Be'er-Sheva. To estimate the short-term effects of air pollution and temperature on number of daily headache ED visits, we applied generalized linear mixed models (GLMM).

RESULTS

A total of 22,021 ED visits were included in the analysis. An increase in 5℃ in temperature was associated with an increase in ED visits, relative risk (RR) = 1.042, (95% CI 1.009; 1.076). RR for headache was associated with an increase in 10 units of nitrogen dioxide (NO2), RR = 1.110 (95% CI 1.057; 1.167), with a higher effect for older patients.

DISCUSSION

The current findings give evidence of an association between air pollution, weather and ED visits for headache, especially for NO2. Short-term increases in air pollution exposure may trigger headache by increasing pulmonary and systemic inflammation, increasing blood coagulability or altering endothelial function.

摘要

背景

头痛是一种常见病症,也是导致患者前往急诊科就诊的常见主诉。已有多项关于环境因素对头痛影响的研究,如天气和空气污染物。

方法

这项回顾性队列研究纳入了2002年至2012年期间索罗卡大学医学中心(SUMC)以头痛为主诉的每日急诊科就诊数据。天气和空气污染物数据来自贝尔谢巴的监测站。为了评估空气污染和温度对每日头痛急诊科就诊人数的短期影响,我们应用了广义线性混合模型(GLMM)。

结果

分析共纳入22,021次急诊科就诊。温度升高5℃与急诊科就诊人数增加相关,相对风险(RR)=1.042,(95%置信区间1.009;1.076)。头痛的RR与二氧化氮(NO2)增加10个单位相关,RR = 1.110(95%置信区间1.057;1.167),对老年患者的影响更大。

讨论

目前的研究结果证明了空气污染、天气与头痛急诊科就诊之间存在关联,尤其是与NO2有关。短期暴露于空气污染中可能通过增加肺部和全身炎症、增加血液凝固性或改变内皮功能来引发头痛。

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