Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis
Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs) have not been fully determined. We sought to quantify the associations between short-term exposure...
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| Veröffentlicht in: | PloS one 2015-09, Vol.10 (9), p.e0138146 |
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| creator | Zheng, Xue-yan Ding, Hong Jiang, Li-na Chen, Shao-wei Zheng, Jin-ping Qiu, Min Zhou, Ying-xue Chen, Qing Guan, Wei-jie |
| description | Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs) have not been fully determined.
We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter ≤10 μm (PM10) and PM2.5] and the asthma-related emergency room visits (ERV) and hospitalizations.
Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed.
After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI), 1.009 (1.006, 1.011); I2 = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I2 = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO2: RR(95%CI), 1.018 (1.014, 1.022); I2 = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO2: RR(95%CI), 1.011 (1.007, 1.015); I2 = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM10: RR(95%CI), 1.010 (1.008, 1.013); I2 = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM2.5: RR(95%CI), 1.023 (1.015, 1.031); I2 = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater.
Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden. |
| doi_str_mv | 10.1371/journal.pone.0138146 |
| format | Article |
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We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter ≤10 μm (PM10) and PM2.5] and the asthma-related emergency room visits (ERV) and hospitalizations.
Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed.
After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI), 1.009 (1.006, 1.011); I2 = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I2 = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO2: RR(95%CI), 1.018 (1.014, 1.022); I2 = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO2: RR(95%CI), 1.011 (1.007, 1.015); I2 = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM10: RR(95%CI), 1.010 (1.008, 1.013); I2 = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM2.5: RR(95%CI), 1.023 (1.015, 1.031); I2 = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater.
Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0138146</identifier><identifier>PMID: 26382947</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Air Pollutants - analysis ; Air pollution ; Air Pollution - analysis ; Ambulatory Care - statistics & numerical data ; Analysis ; Asthma ; Asthma - epidemiology ; Asthma - therapy ; Carbon monoxide ; Care and treatment ; Child ; Children ; Confidence intervals ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital - statistics & numerical data ; Environmental aspects ; Environmental Exposure - analysis ; Environmental Exposure - statistics & numerical data ; Environmental risk ; Exposure ; Geriatrics ; Health care ; Hospital admission and discharge ; Hospitalization ; Humans ; Male ; Males ; Management ; Medical care utilization ; Medical ethics ; Meta-analysis ; Nitrogen dioxide ; Older people ; Outdoor air quality ; Ozone ; Particulate emissions ; Particulate matter ; Particulate Matter - analysis ; Patient Admission - statistics & numerical data ; Pollutants ; Risk assessment ; Risk factors ; Seasons ; Sensitivity ; Sensitivity analysis ; Subgroups ; Sulfur ; Sulfur compounds ; Sulfur dioxide ; Systematic review ; Time Factors ; Warm seasons</subject><ispartof>PloS one, 2015-09, Vol.10 (9), p.e0138146</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Zheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Zheng et al 2015 Zheng et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-f58b917bf1cab8bad8f20f490897ec6a1c15c26b7eaf4d2172594675ea7aec613</citedby><cites>FETCH-LOGICAL-c758t-f58b917bf1cab8bad8f20f490897ec6a1c15c26b7eaf4d2172594675ea7aec613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575194/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575194/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26382947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Nawrot, Tim S.</contributor><creatorcontrib>Zheng, Xue-yan</creatorcontrib><creatorcontrib>Ding, Hong</creatorcontrib><creatorcontrib>Jiang, Li-na</creatorcontrib><creatorcontrib>Chen, Shao-wei</creatorcontrib><creatorcontrib>Zheng, Jin-ping</creatorcontrib><creatorcontrib>Qiu, Min</creatorcontrib><creatorcontrib>Zhou, Ying-xue</creatorcontrib><creatorcontrib>Chen, Qing</creatorcontrib><creatorcontrib>Guan, Wei-jie</creatorcontrib><title>Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs) have not been fully determined.
We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter ≤10 μm (PM10) and PM2.5] and the asthma-related emergency room visits (ERV) and hospitalizations.
Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed.
After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI), 1.009 (1.006, 1.011); I2 = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I2 = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO2: RR(95%CI), 1.018 (1.014, 1.022); I2 = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO2: RR(95%CI), 1.011 (1.007, 1.015); I2 = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM10: RR(95%CI), 1.010 (1.008, 1.013); I2 = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM2.5: RR(95%CI), 1.023 (1.015, 1.031); I2 = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater.
Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.</description><subject>Aged</subject><subject>Air Pollutants - analysis</subject><subject>Air pollution</subject><subject>Air Pollution - analysis</subject><subject>Ambulatory Care - statistics & numerical data</subject><subject>Analysis</subject><subject>Asthma</subject><subject>Asthma - epidemiology</subject><subject>Asthma - therapy</subject><subject>Carbon monoxide</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Children</subject><subject>Confidence intervals</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency Service, Hospital - statistics & numerical data</subject><subject>Environmental aspects</subject><subject>Environmental Exposure - analysis</subject><subject>Environmental Exposure - statistics & numerical data</subject><subject>Environmental risk</subject><subject>Exposure</subject><subject>Geriatrics</subject><subject>Health care</subject><subject>Hospital admission and discharge</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>Males</subject><subject>Management</subject><subject>Medical care utilization</subject><subject>Medical ethics</subject><subject>Meta-analysis</subject><subject>Nitrogen dioxide</subject><subject>Older people</subject><subject>Outdoor air quality</subject><subject>Ozone</subject><subject>Particulate emissions</subject><subject>Particulate matter</subject><subject>Particulate Matter - analysis</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Pollutants</subject><subject>Risk assessment</subject><subject>Risk factors</subject><subject>Seasons</subject><subject>Sensitivity</subject><subject>Sensitivity analysis</subject><subject>Subgroups</subject><subject>Sulfur</subject><subject>Sulfur compounds</subject><subject>Sulfur dioxide</subject><subject>Systematic review</subject><subject>Time Factors</subject><subject>Warm seasons</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1Fv0zAQxyMEYmPwDRBYQkLiocVO4jjmASmaBqs0NNSOvVqOc2ldJXHJORv9KHxb3C2bWgkklAdH9u__v_P5LopeMzpliWAf127oO91MN66DKWVJztLsSXTMZBJPspgmT_f-j6IXiGtKeZJn2fPoKM6SPJapOI5-F4jOWO2t60gJ_hagI4XtyXfXNIPXnUeiu4oU6FetJmct9EvozJbMnWvJtUU7AucON9brhhRVaxGDHRLbkSvbAllAbwHJwg9VWD-Rgiy26KENUQ2Zw42F2zuPb-D1pAiX2qLFl9GzWjcIr8b1JPrx5ezq9Hxycfl1dlpcTIzguZ_UPC8lE2XNjC7zUld5HdM6lTSXAkymmWHcxFkpQNdpFTMRc5lmgoMWOpyz5CR6e--7aRyqsaqoAkipSHkcB2J2T1ROr9Wmt63ut8ppq-42XL9Uug9XaUCVTJokCbpchGgStOQ6Ax6yYjSV2c7r8xhtKFuoDHS-182B6eFJZ1dq6W5UygVnMg0G70aD3v0cAP0_Uh6ppQ5Z2a52wcyEhzGqSGNJuZR85zX9CxW-ClprQl_VNuwfCD4cCALj4Zdf6gFRzRbz_2cvrw_Z93vsCnTjV-hC_-3a6BBM70HTO8Qe6sfKMap2Y_FQDbUbCzWORZC92a_6o-hhDpI_gJ0J-w</recordid><startdate>20150918</startdate><enddate>20150918</enddate><creator>Zheng, Xue-yan</creator><creator>Ding, Hong</creator><creator>Jiang, Li-na</creator><creator>Chen, Shao-wei</creator><creator>Zheng, Jin-ping</creator><creator>Qiu, Min</creator><creator>Zhou, Ying-xue</creator><creator>Chen, Qing</creator><creator>Guan, Wei-jie</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150918</creationdate><title>Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis</title><author>Zheng, Xue-yan ; Ding, Hong ; Jiang, Li-na ; Chen, Shao-wei ; Zheng, Jin-ping ; Qiu, Min ; Zhou, Ying-xue ; Chen, Qing ; Guan, Wei-jie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-f58b917bf1cab8bad8f20f490897ec6a1c15c26b7eaf4d2172594675ea7aec613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Air Pollutants - 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We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter ≤10 μm (PM10) and PM2.5] and the asthma-related emergency room visits (ERV) and hospitalizations.
Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed.
After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI), 1.009 (1.006, 1.011); I2 = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I2 = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO2: RR(95%CI), 1.018 (1.014, 1.022); I2 = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO2: RR(95%CI), 1.011 (1.007, 1.015); I2 = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM10: RR(95%CI), 1.010 (1.008, 1.013); I2 = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM2.5: RR(95%CI), 1.023 (1.015, 1.031); I2 = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater.
Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26382947</pmid><doi>10.1371/journal.pone.0138146</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-09, Vol.10 (9), p.e0138146 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1720074522 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Aged Air Pollutants - analysis Air pollution Air Pollution - analysis Ambulatory Care - statistics & numerical data Analysis Asthma Asthma - epidemiology Asthma - therapy Carbon monoxide Care and treatment Child Children Confidence intervals Emergency medical care Emergency medical services Emergency Service, Hospital - statistics & numerical data Environmental aspects Environmental Exposure - analysis Environmental Exposure - statistics & numerical data Environmental risk Exposure Geriatrics Health care Hospital admission and discharge Hospitalization Humans Male Males Management Medical care utilization Medical ethics Meta-analysis Nitrogen dioxide Older people Outdoor air quality Ozone Particulate emissions Particulate matter Particulate Matter - analysis Patient Admission - statistics & numerical data Pollutants Risk assessment Risk factors Seasons Sensitivity Sensitivity analysis Subgroups Sulfur Sulfur compounds Sulfur dioxide Systematic review Time Factors Warm seasons |
| title | Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis |
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