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Emergency department admission and hospitalization for COPD exacerbation and particulate matter short-term exposure in Brescia, a highly polluted town in northern Italy - 17/03/21

Doi : 10.1016/j.rmed.2021.106334 
Laura Pini a, b, , Jordan Giordani b, Giulia Gardini b, Carlo Concoreggi c, Alessandro Pini d, Elisa Perger e, Enrico Vizzardi f, Danilo Di Bona g, Carlo Cappelli b, Manuela Ciarfaglia b, Claudio Tantucci a, b
a Respiratory Medicine Unit, Spedali Civili, Brescia, Italy 
b Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy 
c Emergency Department, ASST - Spedali Civili di Brescia, Brescia, Italy 
d Epicentre, Departement de épidemiologie D'Intervention et Formation, Paris, France 
e Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy 
f Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy 
g Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari, Italy 

Corresponding author. Clinical & Experimental Sciences Department, University of Brescia, Respiratory Medicine Unit, Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, Italy.Clinical & Experimental Sciences DepartmentUniversity of BresciaRespiratory Medicine UnitSpedali Civili di Brescia, Piazzale Spedali Civili 1BresciaItaly

Abstract

Background

Short-term exposure to high Particulate Matter (PM) concentrations worsens several respiratory conditions.

Objectives

We evaluated the relationship between short-term exposure to Particulate Matter and fine Particulate Matter (PM10 – PM2.5) and Emergency Department (ED) admissions and hospitalizations for COPD exacerbation observed at the University Hospital, Spedali Civili of Brescia, a city with some of the highest yearly levels of air pollution in Italy.

Methods

We collected data from patients admitted to the ED with a COPD exacerbation diagnosis, starting from January 2014 to January 2016. Daily PM levels were collected from the Environmental Protection Regional Agency (ARPA). We performed a time-series analysis using the Poisson regression model with single and multiple day-lag. Results were expressed as Relative Risk (RR) and Excess of Relative Risk (ER) for COPD exacerbation-related ED admissions and hospitalizations, over a 10μg/m3 increase in PM concentration.

Results

We collected data from 431 COPD patients. Both PM10 and PM2.5 were significantly associated with the risk of COPD exacerbation-related ED admission and hospitalization. Each increase of 10μg/m3 of PM10 and PM2.5 corresponded respectively to a RR for ED admissions of 1.06 and 1.08 at lag0-1; 1.06 and 1.09 at lag0-5 (p < 0.05). Similar results for COPD Exacerbation-related hospitalizations were found, with a RR of 1.07 and 1.10 at lag0-1 and 1.07 and 1.11 at lag0-5 for each increase of 10μg/m3 PM10 and PM2.5, respectively.

Conclusions

Our findings show that in a highly polluted city of Northern Italy, short-term increase in exposure to PM10-PM2.5 is associated with a higher risk of ED admission and hospitalization due to COPD exacerbation with a greater incidence during the winter season.

Le texte complet de cet article est disponible en PDF.

Highlights

Short-term exposure to Particulate Matter worsens several respiratory conditions.
Exposure to PM10-PM2.5 relates with higher ED admissions for COPD exacerbation.
Exposure to PM10-PM2.5 relates with higher hospitalizations for COPD exacerbation.
The incidence of admission and hospitalization is greater during the winter season.

Le texte complet de cet article est disponible en PDF.

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Vol 179

Article 106334- avril 2021 Retour au numéro
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