Szyszkowicz Mieczysław, Lukina Anna, Dinu Tatiana
Environmental Health Science & Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada.
Water and Air Quality Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada.
Int J Environ Res Public Health. 2022 May 5;19(9):5603. doi: 10.3390/ijerph19095603.
This study focused on investigating possible associations between exposure to urban air pollution and the number of emergency department (ED) visits for various health outcomes. The outcomes were grouped into four chapters of the International Classification of Diseases Tenth Revision (ICD-10) system (i.e., Chapter II-IV: "Neoplasms", "Diseases of the blood", "Endocrine, nutritional and metabolic diseases", and XVIII: "Symptoms, signs and abnormal clinical and laboratory findings"). The data were collected for the city of Toronto, Canada, (2004-2015, 4292 days). Four gaseous air pollutants (carbon monoxide (CO), nitrogen dioxide (NO), ground level ozone (O), and sulfur dioxide (SO)) and fine particulate matter (PM), and two calculated air quality health indexes (AQHI) based on Toronto were used. The statistical models were constructed by applying the conditional Poisson regression. The exposure was assessed over a maximum of 15 days (time lags 0-14 days). An analysis was performed with the following strata: sex, age, and seasons. Relative risks (RR) and their 95% confidence intervals (95%CI) were estimated for an increase in concentration by a one interquartile range (IQR). For the AQHI (composed of NO, O, and PM), IQR = 1, the estimations for lag 1 and all patients, are RR = 1.023 (95%CI: 1.008, 1.038), 1.026 (1.012, 1.040), 1.013 (1.003, 1.024), and 1.007 (1.003, 1.010) for Chapters II-IV and XVIII, respectively. The results show that in the four large, analyzed health groups, the impact of air quality mainly occurs over a short period (from current day to a maximum of 3 days after exposure).
本研究聚焦于调查城市空气污染暴露与因各种健康结果前往急诊科（ED）就诊次数之间可能存在的关联。这些结果被归入《国际疾病分类第十次修订本》（ICD - 10）系统的四个章节（即第二章至第四章：“肿瘤”“血液疾病”“内分泌、营养和代谢疾病”，以及第十八章：“症状、体征和临床及实验室异常发现”）。数据收集自加拿大多伦多市（2004 - 2015年，共4292天）。使用了四种气态空气污染物（一氧化碳（CO）、二氧化氮（NO）、地面臭氧（O）和二氧化硫（SO））、细颗粒物（PM），以及基于多伦多计算得出的两种空气质量健康指数（AQHI）。通过应用条件泊松回归构建统计模型。暴露评估最长为15天（时间滞后0 - 14天）。按性别、年龄和季节进行分层分析。估计浓度每增加一个四分位数间距（IQR）时的相对风险（RR）及其95%置信区间（95%CI）。对于由NO、O和PM组成的AQHI，IQR = 1，滞后1天且针对所有患者的估计值，第二章至第四章以及第十八章的RR分别为1.023（95%CI：1.008，1.038）、1.026（1.012，1.040）、1.013（1.003，1.024）和1.007（1.003，1.010）。结果表明，在分析的四个大型健康组中，空气质量的影响主要发生在短时间内（从当前日期到暴露后最多3天）。
