Ambient particulate matter and frequency of outpatient visits for chronic rhinosinusitis in the United States.

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-10-30 DOI:10.1002/alr.23477
Hong-Ho Yang, David Grimm, Esther Velasquez, Peter H Hwang
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Abstract

Background: Emerging evidence has underscored the harmful effects of air pollution on the upper airway. We investigated the relationship between ambient particulate matter (PM) level and the frequency of outpatient visits for chronic rhinosinusitis (CRS).

Methods: We conducted an ecological cohort study of US adults enrolled in The Merative MarketScan outpatient database from 2007 to 2020. For each geographical subunit (core-based statistical area [CBSA]), we calculated the annual rate of CRS-related outpatient visits per 1000 well-patient checkup visits (CRS-OV). Using data from the Environmental Protection Agency's Air Quality System, we mapped the rolling statistical average of daily PM2.5 and PM10 over the preceding year onto each CBSA × year combination. We employed multivariable negative binomial regression modeling to estimate the association between PM levels and subsequent CRS-OV.

Results: Across 3933 observations (CBSA × year combinations), encompassing ∼4 billion visits, the median CRS-OV was 164 (interquartile range 110-267). The mean PM2.5 level was 8.9 µg/m3 (SD 2.6) and the mean PM10 level was 20.2 µg/m3 (SD 7.2). Adjusting for patient demographics and respiratory comorbidities, a compounded rise in subsequent CRS-OV was observed with increasing PM levels. Each µg/m3 rise in PM2.5 independently predicted a 10% increase in CRS-OV (adjusted incidence rate ratio [aIRR]) 1.10, 95% confidence interval [CI] 1.08-1.13) and each µg/m3 rise in PM10 independently predicted a 3% increase in CRS-OV (aIRR 1.03, 95% CI 1.02-1.04).

Conclusion: Elevated ambient PM2.5 and PM10 levels are associated with a subsequent compounded increase in the frequency of CRS-OV, with PM2.5 predicting a more pronounced rise compared to PM10.

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美国环境颗粒物与慢性鼻炎门诊就诊频率。
背景:新的证据强调了空气污染对上呼吸道的有害影响。我们研究了环境颗粒物(PM)水平与慢性鼻炎(CRS)门诊就诊频率之间的关系:我们对 2007 年至 2020 年期间加入 Merative MarketScan 门诊数据库的美国成年人进行了一项生态队列研究。对于每个地理分区(核心统计区 [CBSA]),我们计算了每 1000 名健康体检者中 CRS 相关门诊的年就诊率(CRS-OV)。利用环境保护署空气质量系统的数据,我们将前一年的每日 PM2.5 和 PM10 的滚动统计平均值映射到每个 CBSA × 年份组合上。我们采用多变量负二项回归模型来估计 PM 水平与随后的 CRS-OV 之间的关联:结果:在3933个观测值(CBSA × 年份组合)中,包含了40亿人次,CRS-OV的中位数为164(四分位距为110-267)。PM2.5的平均水平为8.9微克/立方米(标准差为2.6),PM10的平均水平为20.2微克/立方米(标准差为7.2)。根据患者的人口统计学特征和呼吸系统合并症进行调整后发现,随着 PM 水平的升高,随后的 CRS-OV 呈复合上升趋势。PM2.5每升高1微克/立方米,可独立预测CRS-OV增加10%(调整后发病率比[aIRR]为1.10,95%置信区间[CI]为1.08-1.13),PM10每升高1微克/立方米,可独立预测CRS-OV增加3%(aIRR为1.03,95%置信区间[CI]为1.02-1.04):结论:环境中 PM2.5 和 PM10 水平的升高与随后 CRS-OV 发生频率的复合增加有关,与 PM10 相比,PM2.5 预测的上升更为明显。
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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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