The Association Between Air Pollution and Hospitalization of Patients With Idiopathic Pulmonary Fibrosis in Chile: A Daily Time Series Analysis
- DOI
- Language of the publication
- English
- Date
- 2020-02-21
- Type
- Article
- Author(s)
- Dales, Robert
- Blanco-Vidal, Claudia
- Cakmak, Sabit
- Publisher
- Elsevier
Abstract
Background Idiopathic pulmonary fibrosis (IPF) causes progressive dyspnea, hypoxemia, and death within a few years. Little is known about the effect of air pollution on disease exacerbations. Research Question Are acute increases in air pollution a risk factor for hospitalization of patients with a primary diagnosis of IPF. Study Design and Methods Hospital admissions for IPF are coded J84.1 by the International Classification of Disease, 10th Revision. Using ambient air pollution and climate data from seven air monitoring stations distributed in the seven urban centers in Santiago, Chile, along with daily patient hospitalization data from 2001 to 2012, a linear association between daily ambient air pollution and daily J84.1 hospital admissions was tested using generalized linear models. Results Average pollutant levels for all regions were as follows: carbon monoxide was 0.96 ppm, ozone was 64 ppb, nitrogen dioxide (NO2) was 43 ppb, sulfur dioxide was 9 ppb, particulate matter < 2.5 μm in diameter was 29 μg/m3 and particulate matter < 10 μm in diameter (PM10) was 67 μg/m3. For the combined Santiago area, relative risk estimates of J84.1 hospitalizations for all pollutants (except ozone), adjusted for age, sex, and weather were statistically significant. In the two-pollutant models, the significance of NO2 and PM10 persisted despite adjustments for each of the other measured pollutants. Interpretation Our findings suggest that acute increases in air pollution are a risk factor for hospitalization of patients with a primary diagnosis of IPF.
Plain language summary
"Health Canada is responsible for the assessment and management of health risks to Canadians associated with exposure to air pollutants in the environment. In this study, Health Canada assessed the risk associated with air pollutants and Idiopathic interstitial lung diseases (IILDs). IILD, characterized by inflammation and thickening/scarring of the fluid filled interconnected spaces in the lung, can cause difficulty breathing, low oxygen in the blood or even death within a few years, but its association with air pollution is not well known. Using ambient air pollution (Ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide and particulate matter) and climate data from seven air monitoring stations distributed in the seven urban centres in Santiago, Chile, along with daily patient hospitalization data from 2001 to 2012, an association between ambient air pollution and daily hospital admissions for IILD was tested. Our findings suggest that short term increases in air pollution may be one risk factor in the worsening of IILD symptoms requiring hospitalization. Given that air pollution exposure is modifiable, findings from this study and those of others suggest that reducing exposure may possibly reduce hospitalizations for IILD. Exposure can be reduced through new cleaner methods of energy generation, and public education to reduce personal exposure."
Subject
- Health,
- Health and safety