PMID- 29051420
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2305-6304 (Electronic)
IS  - 2305-6304 (Linking)
VI  - 4
IP  - 3
DP  - 2016 Aug 5
TI  - Air Quality and Hospital Outcomes in Emergency Medical Admissions with 
      Respiratory Disease.
LID - 10.3390/toxics4030015 [doi]
LID - 15
AB  - BACKGROUND: The impact of very low levels of air pollutants, particulate matter 
      (PM10) and sulfur dioxide (SO(2)) concentrations, on human health is not well 
      characterized. We examined the outcomes (30-day in-hospital mortality) of 
      emergency hospitalizations of respiratory patients and the level of local 
      pollutants on the day of admission. METHODS: All emergency admissions (82,421 
      episodes in 44,660 patients) were recorded over 13 years (2002-2014) and 
      mortality assessed. The median interquartile ranges (IQR) age was 64.5 (43.9, 
      78.5) years with the proportion of males at 48.5%. Univariate and multivariate 
      logistic regression was used to examine relationships between pollutant 
      concentration (PM10 and SO(2)) and odds ratio (OR) for 30-day in hospital death, 
      after adjustment for acuity. RESULTS: Mortality related to each pollutant 
      variable assessed (as quintiles of increasing atmospheric concentration). For 
      PM10 mortality, the highest two quintiles concentrations were significantly 
      increased (p < 0.001) with univariate ORs of 1.30. For SO(2), the ORs were 1.32, 
      1.39, and 1.46, for the top three quintiles. There was also a strong relationship 
      between the underlying respiratory function; with forced expiratory volume (FEV(1)) 
      in 1 second (FEV(1)) >/= 2.0L at the lowest PM10 quintile, mortality was 6.5% (95% 
      CI: 6.1, 6.9) increasing to 9.5% (95% CI: 9.0, 10.0) at the highest PM10 
      quintile. For patients with FEV(1) < 2.0L, the mortality at the lowest PM10 
      quintile was 9.9% (95% CI: 8.8, 10.9) increasing to 14.2% (95% CI: 12.8, 15.6) at 
      the highest quintile. CONCLUSION: Despite air quality improvement, there was a 
      clear relationship between pollutant concentration and outcomes for respiratory 
      emergency admissions; additionally, the underlying level of pulmonary function 
      was predictive of in-hospital mortality.
FAU - Cournane, Sean
AU  - Cournane S
AUID- ORCID: 0000-0002-8185-968X
AD  - Medical Physics and Bioengineering Department, St James's Hospital, Dublin 8, 
      Ireland. sean.cournane@gmail.com.
FAU - Conway, Richard
AU  - Conway R
AUID- ORCID: 0000-0003-2538-3362
AD  - Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland. 
      drrichardconway@gmail.com.
FAU - Byrne, Declan
AU  - Byrne D
AUID- ORCID: 0000-0002-1836-4043
AD  - Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland. 
      declangbyrne@gmail.com.
FAU - O'Riordan, Deirdre
AU  - O'Riordan D
AD  - Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland. 
      doriordan@stjames.ie.
FAU - Silke, Bernard
AU  - Silke B
AD  - Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland. 
      bernardsilke@physicians.ie.
LA  - eng
PT  - Journal Article
DEP - 20160805
PL  - Switzerland
TA  - Toxics
JT  - Toxics
JID - 101639637
PMC - PMC5606657
OTO - NOTNLM
OT  - air pollution
OT  - emergency medical admission
OT  - particulate matter
OT  - sulphur dioxide
COIS- The authors declare no conflict of interest.
EDAT- 2016/08/05 00:00
MHDA- 2016/08/05 00:01
PMCR- 2016/08/05
CRDT- 2017/10/21 06:00
PHST- 2016/04/15 00:00 [received]
PHST- 2016/07/26 00:00 [revised]
PHST- 2016/07/29 00:00 [accepted]
PHST- 2017/10/21 06:00 [entrez]
PHST- 2016/08/05 00:00 [pubmed]
PHST- 2016/08/05 00:01 [medline]
PHST- 2016/08/05 00:00 [pmc-release]
AID - toxics4030015 [pii]
AID - toxics-04-00015 [pii]
AID - 10.3390/toxics4030015 [doi]
PST - epublish
SO  - Toxics. 2016 Aug 5;4(3):15. doi: 10.3390/toxics4030015.