Li Yun Hao, Tong Tan Jing, Hwa Ooi Poh, Jiang Fang, Kan Haidong, Leung Wai K
Department of Medicine School of Clinical Medicine Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China.
School of Public Health Key Lab of Public Health Safety of the Ministry of Education NHC Key Lab of Health Technology Assessment IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health Fudan University Shanghai China.
Geohealth. 2024 Nov 1;8(11):e2024GH001086. doi: 10.1029/2024GH001086. eCollection 2024 Nov.
The relationship between exposure to ambient air pollutants and emergency attendance for upper gastrointestinal bleeding (UGIB) remains inconclusive. This study examines the association between short-term exposure to various ambient pollutants and the risk of UGIB emergency attendance. Data on daily UGIB emergency attendance, ambient pollutants, and meteorological conditions in Hong Kong were collected from 2017 to 2022. A time-series study using a distributed lag non-linear model to analyze the data, considering lag days. Stratified analysis was performed based on sex, seasons, and the COVID-19 pandemic period. The burden was quantified using attributable fraction (AF) and number (AN). The study included 31,577 UGIB emergency records. Exposure to high levels of PM significantly increased the risk of UGIB emergency attendance from lag day 3 (RR: 1.012) to day 6 (RR: 1.008). High NO exposure also posed a significant risk from lag day 0 (RR: 1.026) to day 2 (RR: 1.014), and from lag day 5 (RR: 1.013) to day 7 (RR: 1.024). However, there was no association between UGIB and high O levels. The attributable burden of high-concentration NO exposure was higher compared to those of PM. Males and elderly individuals (≥65 years) faced a higher risk of UGIB emergencies, particularly during cold seasons. Our study suggests that both PM and NO exposure are associated with an increased risk of emergency attendance for UGIB. Ambient pollutant exposure has a stronger effect on UGIB in males and the elderly, particularly during cold seasons.
暴露于环境空气污染物与上消化道出血（UGIB）的急诊就诊之间的关系尚无定论。本研究探讨短期暴露于各种环境污染物与UGIB急诊就诊风险之间的关联。收集了2017年至2022年香港每日UGIB急诊就诊、环境污染物和气象条件的数据。采用分布滞后非线性模型进行时间序列研究以分析数据，并考虑滞后天数。根据性别、季节和COVID-19大流行期间进行分层分析。使用归因分数（AF）和归因数（AN）对负担进行量化。该研究纳入了31577条UGIB急诊记录。暴露于高水平的细颗粒物（PM）显著增加了从滞后第3天（相对危险度：1.012）到第6天（相对危险度：1.008）的UGIB急诊就诊风险。高浓度一氧化氮（NO）暴露在滞后第0天（相对危险度：1.026）到第2天（相对危险度：1.014）以及从滞后第5天（相对危险度：1.013）到第7天（相对危险度：1.024）也构成显著风险。然而，UGIB与高浓度臭氧（O）水平之间并无关联。与PM相比，高浓度NO暴露的归因负担更高。男性和老年人（≥65岁）面临更高的UGIB急诊风险，尤其是在寒冷季节。我们的研究表明，暴露于PM和NO均与UGIB急诊就诊风险增加有关。环境污染物暴露对男性和老年人的UGIB影响更强，尤其是在寒冷季节。
