Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, USA.
University of Colorado School of Medicine, Aurora, CO, USA.
Yale J Biol Med. 2023 Jun 30;96(2):159-169. doi: 10.59249/KYDF6093. eCollection 2023 Jun.
Exposure to environmental variables including declining air quality and increasing temperatures can exert detrimental effects on human health including acute exacerbations of chronic diseases. We aim to investigate the association between these exposures and acute health outcomes in a rural community in Colorado. Meteorological and adult emergency department visit data were retrospectively collected (2013-2017); for asthma outcomes, additional data were available (2003-2017). Daily environmental exposure data included PM, maximum daily temperature (MDT), and mean humidity and precipitation. Total daily counts of emergency department (ED) diagnoses for myocardial infarction, congestive heart failure, urolithiasis, and exacerbation of chronic obstructive pulmonary disease (COPD) and asthma, were calculated during the study period. Time series models using generalized estimating equations were fit for each disease and included all four environmental factors. Between 2013 and 2017, asthma and COPD exacerbation accounted for 30.8% and 25.4% of all ED visits (n=5,113), respectively. We found that for every 5˚C increase in MDT, the rate of urolithiasis visits increased by 13% (95% CI: 2%, 26%) and for every 10μg/m increase in 3-day moving average PM, the rate of urolithiasis visits increased by 7% (95% CI: 1%, 13%). The magnitude of association between 3-day moving average PM and rate of urolithiasis visits increased with increasing MDT. The rate of asthma exacerbation significantly increased as 3-day, 7-day, and 21-day moving average PM increased. This retrospective study on ED visits is one of the first to investigate the impact of several environmental exposures on adverse health outcomes in a rural community. Research into mitigating the negative impacts of these environmental exposures on health outcomes is needed.
暴露于环境变量，包括空气质量下降和温度升高，可能对人类健康产生有害影响，包括慢性疾病的急性加重。我们旨在调查科罗拉多州一个农村社区中这些暴露与急性健康结果之间的关联。回顾性收集了气象和成人急诊就诊数据（2013-2017 年）；对于哮喘结果，还提供了额外的数据（2003-2017 年）。每日环境暴露数据包括 PM、日最大温度（MDT）、平均湿度和降水量。在研究期间，计算了急诊部（ED）诊断为心肌梗死、充血性心力衰竭、尿路结石和慢性阻塞性肺疾病（COPD）和哮喘加重的每日总就诊次数。使用广义估计方程的时间序列模型适用于每种疾病，并包括所有四个环境因素。2013 年至 2017 年间，哮喘和 COPD 加重分别占所有 ED 就诊的 30.8%和 25.4%（n=5113）。我们发现，MDT 每升高 5°C，尿路结石就诊率增加 13%（95%CI：2%，26%），3 天移动平均 PM 每增加 10μg/m，尿路结石就诊率增加 7%（95%CI：1%，13%）。3 天移动平均 PM 与尿路结石就诊率之间的关联程度随着 MDT 的增加而增加。随着 3 天、7 天和 21 天移动平均 PM 的增加，哮喘加重的发生率显著增加。这项关于 ED 就诊的回顾性研究是首次调查几种环境暴露对农村社区不良健康结果的影响的研究之一。需要研究减轻这些环境暴露对健康结果的负面影响的措施。
