Air pollution and hospital admissions for congestive heart failure: are there potentially sensitive groups?

Recent studies have shown that air pollution is a risk factor for hospitalization for congestive heart failure (CHF). However, there is limited evidence to suggest what subpopulations are at greater risk from air pollution. This study was undertaken to examine the modifying effect of specific secondary diagnosis (including hypertension, diabetes, dysrhythmia, and chronic obstructive pulmonary disease) on the relationship between hospital admissions for CHF and ambient air pollutants. Hospital admissions for CHF and ambient air pollution data for Taipei were obtained for the period from 1996 to 2005. The relative risk of hospital admission was estimated using a case-crossover approach. None of the secondary diagnosis we examined (hypertension, diabetes, dysrhythmia, and chronic obstructive pulmonary disease (COPD)) showed much evidence of effect modification.     

北京市寒潮天气对居民心脑血管疾病死亡影响的病例交叉研究

目的研究寒潮天气对北京市居民心脑血管疾病日死亡人数的影响。方法北京市居民死亡资料来自北京市疾病预防控制中心,气象资料来自北京城市气象研究所。运用病例交叉的设计思想,采用单向回顾性1∶1对照和双向对称性1∶2对照设计,分析北京市1998年1月1日—2000年6月30日期间6次寒潮天气与北京市城8区居民每日心血管疾病、急性心肌梗死和脑血管疾病死亡的关系。病例选取为冬季所有心脑血管疾病死亡病例,选取死亡发生前第7天和发生后第7天作为对照(或者死亡前、后第14天作为对照)。结果研究时间段内共出现6次寒潮,日最低气温下降明显且伴随有湿度下降和气压上升的第3次寒潮期间3种死因的双向对称性对照设计的滞后期均为0d,居民每日心血管疾病、急性心肌梗死、脑血管疾病死亡的OR值分别为1.500(95%CI:1.032～2.181),1.913(95%CI:1.066～3.432)、1.679(95%CI:1.139～2.474)。其他5次寒潮对心脑血管病人的死亡未见明显影响。结论研究期间北京地区的绝大多数寒潮天气未对居民心脑血管疾病的死亡产生明显影响;但是温度降幅大且伴随高气压的寒潮可能会造成心脑血管疾病死亡风险升高,值得关注。     

大气可吸入颗粒物对脑血管疾病死亡影响的病例交叉研究

目的 <\b>分析北京市可吸入颗粒物(PM_{10<\sub>)浓度与暴露人群脑血管疾病死亡的相关性,探索PM10<\sub>对人群脑血管疾病死亡的影响.方法 <\b>收集2004-2008年北京市某城区气象因素、大气污染物(PM10<\sub>、SO2<\sub>、NO2<\sub>)水平以及人群脑血管疾病死亡数据,采用双向对称性病例交叉设计和条件logistic回归模型,分析大气中PM10<\sub>水平与脑血管疾病之间的关系.结果 <\b>调整气象因素(日平均气温和日平均相对湿度)后,单污染物模型PM10<\sub>的滞后效应不明显.调整SO2<\sub>、NO2<\sub>和SO2<\sub>+NO2<\sub>后的多污染物模型,PM10<\sub>对人群脑血管疾病的效应OR值比单污染物模型大且差异有统计学意义(P＜0.05).分层分析显示,大气PM10<\sub>浓度对女性、≥65岁的脑血管疾病和冬季脑血管疾病病例效应差异有统计学意义(P＜0.05),而对男性和≥65岁的脑血管疾病病例效应无统计学意义(P＞0.05).结论 <\b>调整其他大气污染物和气象因素后,PM10<\sub>浓度与脑血管疾病死亡呈正相关.PM10<\sub>浓度升高会导致女性、≥65岁和冬季脑血管疾病死亡增加.}     

金属制造业职业伤害危险因素的病例交叉研究

目的 探讨金属制造业职业伤害的瞬时危险因素.方法 采用配对病例交叉研究的方法,研究对象为广东省中山市4个职业伤害定点医院收治的来自金属制造业的由机械压力导致的职业意外伤害患者208人,采集伤害发生前30 min内危险因素的暴露情况,伤害发生前一天同一时段12种急性危险因素的暴露情况.结果 采用条件logistic回归分析,结果显示,更换工作岗位(OR =20.76,95％ CI=2.04～210.53),突然加班(OR =10.11,95％ CI=2.57～39.75)是职业伤害的危险因素(P＜0.01),而其他危险因素没有统计学意义.结论 更换工作岗位和突然加班是职业伤害的危险因素.     

Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD

Background

The protective effect of hormonal contraception may offer a potential intervention against bacterial vaginosis (BV).

Study Design

Three hundred thirty reproductive-age women enrolled in a contraceptive program from April 2005 to October 2006 at two sexually transmitted diseases clinics in Baltimore, MD. Participants were supplied with hormonal contraceptives of their choice and followed prospectively. BV was diagnosed by Amsel's criteria. Results from population-level analysis were compared to a case-crossover analysis.

Results

BV was diagnosed in 189 (13.0%) of the visits among 133 (40.3%) women. In the population-level analysis, the use of progestin-only and combined contraception was associated with a decreased risk of BV compared to intervals of no hormonal contraceptive use [adjusted odds ratio (AOR): 0.42 (95% CI: 0.20-0.88) and AOR: 0.66 (95% CI: 0.39-1.10), respectively]. The case-crossover analysis demonstrated a similar trend in findings.

Conclusion

Hormonal contraception was associated with a decreased risk of BV in an STD clinic cohort.     

特发性室速短期暴露危险因素的病例交叉研究

5%CI∶1.44～3.50).结论 强体力活动、生气、悲伤、激动、感染是IVT的危险因素.病例交叉研究能有效地识别,并揭示其作用强度.     

日最高气温与医院心脑血管疾病急诊人次关系的病例交叉研究

目的 探讨北京市某区日最高气温与某医院心脑血管疾病急诊人次(ICD10:100～199)的关系,研究日最高气温对心脑血管疾病的影响.方法 收集2004-2006年北京市海淀区某三级甲等医院急诊科心脑血管疾病资料及相关的气象资料和大气污染物资料,采用季节分层的病例交叉设计分析不同季节日最高气温变化对心脑血管疾病的影响.结果 多气象因素模型结果显示,春、夏季日最高气温每升高1℃,心脑血管疾病急诊人次分别增加17.3%(OR=1.173,95%CI:1.149～1.197)和4.2%(OR:1.042,95%CI:1.011～1.074);而秋季13最高气温每升高1℃,心脑血管疾病急诊人次反而下降25%(OR:0.750,95%CI:0.727～0.773),关联有统计学意义(P<0.05);冬季日最高气温每升高1℃,心脑血管疾病急诊人次下降2.1%(OR=0.979,95%CI:0.956-1.004),但关联无统计学意义(P>0.05).结论 春、夏季日最高气温升高可以导致心脑血管疾病急诊增加.提示春季和夏季,日最高气温的增加可能是心脑血管疾病发病的一个危险性因素;而秋季和冬季,日最高气温的增加反而作为一种保护性因素,能够减少心脑血管疾病的发生.

Abstract：

Objective To explore the association between the daily maximum temperature and hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10:100～199) in different seasons in Beijing, China Methods The data of the daily hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10: 100～199) from a Level-3A hospital in Haidian district in Beijing during 2004-2006 and the corresponding meteorological, air pollution data were collected. The seasonal-stratified case-crossover design and Logistic multiple regression model was used for the data analysis. Results After adjusting the influence of relative humidity, wind speed and atmospheric pressure, for It increase in daily maximum temperature, the corresponding increase in the hospital emergency visits of the diseases was 17.3%(OR=1.173,95%CI: 1.149～1.197) and 4.2% (OR=1.042,95%CI: 1.011～1.074) in spring and summer of the years, respectively (P<0.05); contrarily, those decreased by 25% in autumn(OR =0.750,95% CI: 0.727～0.773); no significant association was seen in winter (P>0.05). Conclusion The increase of daily maximum temperature may be a risk factor for daily hospital emergency visits for cardiovascular and cerebrovascular diseases in spring and summer, however, it may be a preventive factor in autumn. The effects of air temperature on health should not be the same in seasons.     

2004-2006年北京夏季最低气温对心脑血管疾病急诊数的影响

目的 探讨北京市夏季最低气温对心脑血管疾病(ICD10:100～199)急诊的影响.方法 收集2004-2006年北京大学某医院急诊科心脑血管疾病急诊资料、北京市环境监测中心大气污染物数据和中国气象科学数据共享服务网的气象资料,应用时间分层的病例交叉设计研究方法进行数据分析.结果 在控制大气污染物SO_2、NO_2、可吸入颗粒物(PM10)影响的情况下,无滞后夏季最低气温对心脑血管疾病总急诊、冠心病急诊、心律失常急诊、心衰急诊和脑血管疾病急诊的影响最大,气温每升高1℃,OR值分别为1.039(95%CI:1.008～1.071),1.077(95%CI:0.987～1.174),1.037(95%CI:0.963～1.116).1.103(95%CI:0.909～1.339)和 1.030(95%CI:0.985～1.077),其中最低气温与总心脑血管疾病急诊的关联有统计学意义(P<0.05).在多因素模型中,考虑到相对湿度因素时,气温每升高1℃对冠心病急诊和脑血管病急诊的OR值分别为1.095(95%CI:1.001～1.075)和1.050(95%CI:1.002～1.100),关联具有统计学意义(P<0.05).结论 夏季最低气温升高可以导致心脑血管疾病总急诊增加,同时相对湿度可能与气温有协同作用,可导致冠心病急诊,脑血管病急诊增加.

Abstract：

Objective To explore the association between the minimum temperature in different seasons and the hospital emergency room visits for cardiocerebrovascular diseases(International Classification of Diseases,tenth vision ICD-10：100-199)in Beijing.China.Methods The data of the daily hospital emergency room visits for cardiocerebrevascular diseases(ICD-10：100-199)from one of Peking university hospitals,the data of relevant ambient air pollution from the Beijing Municipal Environmental Monitoring Center and the data of meteorological index from China meteorological data sharing service system between 2004—2006 were collected The time-stratified case-crossover design was used to analyze the data.Results After adjusting SO_2,NO_2,and PM10.The results showed that each 1℃ increase in the daily minimum temperature in summer was associated with the intraday hospital emergency room visits(OR=1.039,P<0.05)for the total cardiocerebrovascular diseases.In multi-factor model,considering relative humidity,1℃ increase in the daily minimum temperature was associated with the coronary heart disease(OR=1.095,95％CI:1.001—1.075)and the cerebrovascular diseases(OR=1.050,95％CI：1.002—1.100)(P<0.05).Conclusion These outcomes suggest that elevated level of minimum temperature in summer will increase the hospital emergency room visits for the total circulatory diseases,and the relative humidity may enhance the effects of minimum temperature on the hospital emergency room visits of coronary heart disease and cerebrovaseular diseases.     

大气颗粒物污染与脑卒中死亡的病例交叉研究

目的 评价大气颗粒物污染对人群脑卒中死亡的急性效应.方法 采用时间分层的病例交叉设计,分析杭州市2002-2004年间大气可吸入颗粒物(PM10)日平均浓度短期增加与人群每日脑卒中死亡的关系,同时分析其他气态污染物(NO2和SO2)的急性健康效应.结果共纳入9906例脑卒中死亡病例,粗死亡率约为83.54/10万.调整气象因素后,3 d内PM10、SO2和NO2日平均浓度每增加10μg/m3,人群脑卒中死亡则分别增加0.56%(95%CI:0.14%～0.99%)、1.62%(95%CI:0.26%～3.01%)和2.07%(95%CI:0.54%～3.62%).多污染物模型中未见有统计学意义的关联.敏感性分析结果显示进行缺失值填补后,单污染物模型中均有关联效应,多污染物模型中则无统计学意义的关联.结论大气颗粒物污染以及SO2和NO2污染物浓度短期升高均与脑卒中死亡增加存在一定关联.