tetano
Editor, Senior Moderator
Environ Health
. 2022 Nov 8;21(1):107.
doi: 10.1186/s12940-022-00928-x.
Neighborhood environmental factors linked to hospitalizations of older people for viral lower respiratory tract infections in Spain: a case-crossover study
Alejandro Álvaro-Meca[SUP] 1 2 [/SUP], Daniel Sepúlveda-Crespo[SUP] 2 3 [/SUP], Rosa Resino[SUP] 4 [/SUP], Pablo Ryan[SUP] 2 5 6 7 [/SUP], Isidoro Martínez[SUP] 2 3 [/SUP], Salvador Resino[SUP] 8 9 [/SUP]
Affiliations
Abstract
Background: Lower respiratory tract viral infection (LRTI) is a significant cause of morbidity-mortality in older people worldwide. We analyzed the association between short-term exposure to environmental factors (climatic factors and outdoor air pollution) and hospital admissions with a viral LRTI diagnosis in older adults.
Methods: We conducted a bidirectional case-crossover study in 6367 patients over 65 years of age with viral LRTI and residential zip code in the Spanish Minimum Basic Data Set. Spain's State Meteorological Agency was the source of environmental data. Associations were assessed using conditional logistic regression. P-values were corrected for false discovery rate (q-values).
Results: Almost all were hospital emergency admissions (98.13%), 18.64% were admitted to the intensive care unit (ICU), and 7.44% died. The most frequent clinical discharge diagnosis was influenza (90.25%). LRTI hospital admissions were more frequent when there were lower values of temperature and O[SUB]3[/SUB] and higher values of relative humidity and NO[SUB]2[/SUB]. The regression analysis adjusted by temperatures and relative humidity showed higher concentrations at the hospital admission for NO[SUB]2[/SUB] [compared to the lag time of 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)] and O[SUB]3[/SUB] [compared to the lag time of 3-days (q-value< 0.001), 1-week (q-value< 0.001), and 2-weeks (q-value< 0.001)] were related to a higher odds of hospital admissions due to viral LRTI. Moreover, higher concentrations of PM[SUB]10[/SUB] at the lag time of 1-week (q-value = 0.023) and 2-weeks (q-value = 0.002), and CO at the lag time of 3-days (q-value = 0.023), 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)], compared to the day of hospitalization, were related to a higher chances of hospital admissions with viral LRTI.
Conclusion: Unfavorable environmental factors (low temperatures, high relative humidity, and high concentrations of NO[SUB]2[/SUB], O[SUB]3[/SUB], PM[SUB]10[/SUB], and CO) increased the odds of hospital admissions with viral LRTI among older people, indicating they are potentially vulnerable to these environmental factors.
Keywords: Air pollution; ICD-9-CM; Lower respiratory tract infection; Older people; Respiratory virus; Temperature.
. 2022 Nov 8;21(1):107.
doi: 10.1186/s12940-022-00928-x.
Neighborhood environmental factors linked to hospitalizations of older people for viral lower respiratory tract infections in Spain: a case-crossover study
Alejandro Álvaro-Meca[SUP] 1 2 [/SUP], Daniel Sepúlveda-Crespo[SUP] 2 3 [/SUP], Rosa Resino[SUP] 4 [/SUP], Pablo Ryan[SUP] 2 5 6 7 [/SUP], Isidoro Martínez[SUP] 2 3 [/SUP], Salvador Resino[SUP] 8 9 [/SUP]
Affiliations
- PMID: 36348411
- DOI: 10.1186/s12940-022-00928-x
Abstract
Background: Lower respiratory tract viral infection (LRTI) is a significant cause of morbidity-mortality in older people worldwide. We analyzed the association between short-term exposure to environmental factors (climatic factors and outdoor air pollution) and hospital admissions with a viral LRTI diagnosis in older adults.
Methods: We conducted a bidirectional case-crossover study in 6367 patients over 65 years of age with viral LRTI and residential zip code in the Spanish Minimum Basic Data Set. Spain's State Meteorological Agency was the source of environmental data. Associations were assessed using conditional logistic regression. P-values were corrected for false discovery rate (q-values).
Results: Almost all were hospital emergency admissions (98.13%), 18.64% were admitted to the intensive care unit (ICU), and 7.44% died. The most frequent clinical discharge diagnosis was influenza (90.25%). LRTI hospital admissions were more frequent when there were lower values of temperature and O[SUB]3[/SUB] and higher values of relative humidity and NO[SUB]2[/SUB]. The regression analysis adjusted by temperatures and relative humidity showed higher concentrations at the hospital admission for NO[SUB]2[/SUB] [compared to the lag time of 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)] and O[SUB]3[/SUB] [compared to the lag time of 3-days (q-value< 0.001), 1-week (q-value< 0.001), and 2-weeks (q-value< 0.001)] were related to a higher odds of hospital admissions due to viral LRTI. Moreover, higher concentrations of PM[SUB]10[/SUB] at the lag time of 1-week (q-value = 0.023) and 2-weeks (q-value = 0.002), and CO at the lag time of 3-days (q-value = 0.023), 1-week (q-value< 0.001) and 2-weeks (q-value< 0.001)], compared to the day of hospitalization, were related to a higher chances of hospital admissions with viral LRTI.
Conclusion: Unfavorable environmental factors (low temperatures, high relative humidity, and high concentrations of NO[SUB]2[/SUB], O[SUB]3[/SUB], PM[SUB]10[/SUB], and CO) increased the odds of hospital admissions with viral LRTI among older people, indicating they are potentially vulnerable to these environmental factors.
Keywords: Air pollution; ICD-9-CM; Lower respiratory tract infection; Older people; Respiratory virus; Temperature.