人为因素、气象因素与特定病因急诊入院率之间的关联。

IF 4.3 2区 医学 Q2 ENVIRONMENTAL SCIENCES Geohealth Pub Date : 2024-09-04 DOI:10.1029/2024GH001061
Pranav Tewari, Baihui Xu, Ma Pei, Kelvin Bryan Tan, John Abisheganaden, Steve Hung-Lam Yim, Borame Lee Dickens, Jue Tao Lim
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引用次数: 0

摘要

不可预测的急诊科(ED)入院人数给医疗系统带来了挑战,导致资源分配效率低下。本研究分析了空气污染物、气象因素与 2014 年至 2018 年 12 个类别的 2,655,861 例特定病因急诊入院人数之间的关联。研究采用广义相加模型评估了每种暴露的非线性关联,得出了发病率比(IRR),而人口可归因分数(PAF)计算了每种暴露对特定病因急诊入院人数的贡献。IRRs 显示,在降雨量增加(13.21-16.97 毫米)期间,呼吸道感染(IRR:1.06,95% CI:1.01-1.11)以及传染病和寄生虫病(IRR:1.09,95% CI:1.03-1.15)的急诊入院风险增加。风速大于 12.73 公里/小时时,呼吸道感染(IRR:1.12,95% CI:1.03-1.21)和口腔疾病(IRR:1.58,95% CI:1.31-1.91)的急诊入院风险相应增加。较高浓度的空气污染物与心血管疾病(PM10 的 IRR:1.16,95% CI:1.05-1.27)和呼吸道感染相关的急诊入院风险升高有关(CO 的 IRR:2.78,95% CI:1.69-4.56)。风速 >12.5 公里/小时预计会导致 10%的呼吸道感染急诊入院率,而平均气温 >28°C 则会导致泌尿生殖系统疾病和消化系统疾病的 PAF 上升达 5%。PM10 浓度 >60 μg/m3 对心血管疾病(PAF:10%)、消化系统疾病(PAF:15%)和肌肉骨骼疾病(PAF:10%)的急诊入院率影响很大。二氧化碳浓度大于 0.6 ppm 时,呼吸道感染(PAF:20%)和糖尿病(PAF:20%)的急诊入院率较高。这项研究强调了气象变量的保护作用和空气污染物暴露对急诊室收治类别的有害影响。
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Associations Between Anthropogenic Factors, Meteorological Factors, and Cause-Specific Emergency Department Admissions

Unpredictable emergency department (ED) admissions challenge healthcare systems, causing resource allocation inefficiencies. This study analyses associations between air pollutants, meteorological factors, and 2,655,861 cause-specific ED admissions from 2014 to 2018 across 12 categories. Generalized additive models were used to assess non-linear associations for each exposure, yielding Incidence Rate Ratios (IRR), while the population attributable fraction (PAF) calculated each exposure's contribution to cause-specific ED admissions. IRRs revealed increased risks of ED admissions for respiratory infections (IRR: 1.06, 95% CI: 1.01–1.11) and infectious and parasitic diseases (IRR: 1.09, 95% CI: 1.03–1.15) during increased rainfall (13.21–16.97 mm). Wind speeds >12.73 km/hr corresponded to increased risks of ED admissions for respiratory infections (IRR: 1.12, 95% CI: 1.03–1.21) and oral diseases (IRR: 1.58, 95% CI: 1.31–1.91). Higher concentrations of air pollutants were associated with elevated risks of cardiovascular disease (IRR: 1.16, 95% CI: 1.05–1.27 for PM10) and respiratory infection-related ED admissions (IRR: 2.78, 95% CI: 1.69–4.56 for CO). Wind speeds >12.5 km/hr were predicted to contribute toward 10% of respiratory infection ED admissions, while mean temperatures >28°C corresponded to increases in the PAF up to 5% for genitourinary disorders and digestive diseases. PM10 concentrations >60 μg/m3 were highly attributable toward cardiovascular disease (PAF: 10%), digestive disease (PAF: 15%) and musculoskeletal disease (PAF: 10%) ED admissions. CO concentrations >0.6 ppm were highly attributable to respiratory infections (PAF: 20%) and diabetes mellitus (PAF: 20%) ED admissions. This study underscores protective effects of meteorological variables and deleterious impacts of air pollutant exposures across the ED admission categories considered.

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来源期刊
Geohealth
Geohealth Environmental Science-Pollution
CiteScore
6.80
自引率
6.20%
发文量
124
审稿时长
19 weeks
期刊介绍: GeoHealth will publish original research, reviews, policy discussions, and commentaries that cover the growing science on the interface among the Earth, atmospheric, oceans and environmental sciences, ecology, and the agricultural and health sciences. The journal will cover a wide variety of global and local issues including the impacts of climate change on human, agricultural, and ecosystem health, air and water pollution, environmental persistence of herbicides and pesticides, radiation and health, geomedicine, and the health effects of disasters. Many of these topics and others are of critical importance in the developing world and all require bringing together leading research across multiple disciplines.
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