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Assessment of Effects of Air Pollution on Daily Outpatient Visits using the Air Quality Index

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      Abstract

      BackgroundThe air quality index (AQI) is widely used to characterize the quality of ambient air. Chinese cities officially report the AQI on a daily basis. To assess the possible effects of air pollution on daily outpatient visits, we examined the association between AQI and the daily outpatient count.MethodsDaily data on outpatient visits to each clinical department were collected from the Z county hospital of Datong City, China. The collection period was between 5 April and 30 June, 2012. Daily AQI data and meteorological information were simultaneously recorded. We compared outpatient counts between the index days and comparison days, and calculated Pearson’s product moment correlation coefficient between outpatient counts and AQI levels. ResultsThe average AQI level for index days was significantly higher than that for comparison days. No significant difference was observed in temperature or relative humidity between index days and comparison days. The outpatient counts for pediatrics were significantly higher on index days than on comparison days, and no significant difference was noted in other clinical departments. The outpatient counts for pediatrics positively correlated with the AQI level, and no correlation was noted in other clinical departments.ConclusionThe present study assessed the association between daily outpatient visits and air pollution using AQI. The results obtained suggest that air pollution could increase the outpatient count for pediatrics.

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        Ozone has been associated with various adverse health effects, including increased rates of hospital admissions and exacerbation of respiratory illnesses. Although numerous time-series studies have estimated associations between day-to-day variation in ozone levels and mortality counts, results have been inconclusive. To investigate whether short-term (daily and weekly) exposure to ambient ozone is associated with mortality in the United States. Using analytical methods and databases developed for the National Morbidity, Mortality, and Air Pollution Study, we estimated a national average relative rate of mortality associated with short-term exposure to ambient ozone for 95 large US urban communities from 1987-2000. We used distributed-lag models for estimating community-specific relative rates of mortality adjusted for time-varying confounders (particulate matter, weather, seasonality, and long-term trends) and hierarchical models for combining relative rates across communities to estimate a national average relative rate, taking into account spatial heterogeneity. Daily counts of total non-injury-related mortality and cardiovascular and respiratory mortality in 95 large US communities during a 14-year period. A 10-ppb increase in the previous week's ozone was associated with a 0.52% increase in daily mortality (95% posterior interval [PI], 0.27%-0.77%) and a 0.64% increase in cardiovascular and respiratory mortality (95% PI, 0.31%-0.98%). Effect estimates for aggregate ozone during the previous week were larger than for models considering only a single day's exposure. Results were robust to adjustment for particulate matter, weather, seasonality, and long-term trends. These results indicate a statistically significant association between short-term changes in ozone and mortality on average for 95 large US urban communities, which include about 40% of the total US population. The findings indicate that this widespread pollutant adversely affects public health.
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          Pulmonary effects of inhaled ultrafine particles.

          Recent epidemiological studies have shown an association between increased particulate urban air pollution and adverse health effects on susceptible parts of the population, in particular the elderly with pre-existing respiratory and cardiovascular diseases. Urban particles consist of three modes: ultrafine particles, accumulation mode particles (which together form the fine particle mode) and coarse mode particles. Ultrafine particles (those of < 0.1 micron diameter) contribute very little to the overall mass, but are very high in number, which in episodic events can reach several hundred thousand/cm3 in the urban air. The hypothesis that ultrafine particles are causally involved in adverse responses seen in sensitive humans is based on several studies summarized in this brief review. Studies on rodents demonstrate that ultrafine particles administered to the lung cause a greater inflammatory response than do larger particles, per given mass. Surface properties (surface chemistry) appear to play an important role in ultrafine particle toxicity. Contributing to the effects of ultrafine particles is their very high size-specific deposition when inhaled as singlet ultrafine particles rather than as aggregated particles. It appears also that ultrafine particles, after deposition in the lung, largely escape alveolar macrophage surveillance and gain access to the pulmonary interstitium. Inhaled low doses of carbonaceous ultrafine particles can cause mild pulmonary inflammation in rodents after exposure for 6 h. Old age and a compromised/sensitized respiratory tract in rodents can increase their susceptibility to the inflammatory effects of ultrafine particles significantly, and it appears that the aged organism is at a higher risk of oxidative stress induced lung injury from these particles, compared with the young organism. Results also show that ultrafine particle effects can be significantly enhanced by a gaseous co-pollutant such as ozone. The studies performed so far support the ultrafine particle hypothesis. Additional studies are necessary to evaluate mechanistic pathways of responses.
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            Author and article information

            Affiliations
            *Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
            †Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
            ‡Cancer Center, Tottori University Hospital, Yonago 683-8504, Japan
            §Department of Nursing Care Environment and Mental Health, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
            Author notes
            Corresponding author: Haosheng Mu
            Journal
            Yonago Acta Med
            Yonago Acta Med
            YAm
            Yonago Acta Medica
            Tottori University Faculty of Medicine
            0513-5710
            1346-8049
            26 December 2014
            December 2014
            : 57
            : 4
            : 133-136
            4404523
            yam-57-133
            2014 Yonago Acta medica
            Categories
            Original Article
            Custom metadata
            AQI, air quality index

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