Patterns of medical care utilization according to environmental factors in asthma and chronic obstructive pulmonary disease patients
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Background/Aims: Weather and air pollution are associated with the exacerbation of respiratory diseases. We investigated patterns of medical care use according to meteorological factors and air pollution in patients with asthma or chronic obstructive pulmonary disease (COPD). Methods: We analyzed the medical care utilization patterns of patients with asthma or COPD registered in the Korea Health Insurance Review and Assessment database for the period 2007 to 2013. The patterns were divided into hospitalization and emergency department (ED) use. Results: The medical care use of patients with asthma or COPD increased when the mean temperature and relative humidity were lower, and the temperature difference and atmospheric pressure were greater. Medical care use increased with the concentrations of particulate matter and ozone. Among age groups, sensitivity to pollutants was greatest in patients aged ≥ 65 years. The effect of being elderly was greater for asthma than for COPD, with a higher hospitalization rate. ED utilization affected by environmental factors was significantly greater for females and hospitalization was significantly more common for males. Conclusions: Meteorological factors and air pollutants were shown to contribute to increased medical care utilization by patients with asthma and COPD, particularly elderly patients. The overall effect was greater for COPD, but the effect in elderly patients was greater for asthma. In addition, the patterns of change in medical care use due to environmental factors differed according to sex.
Abstract
Background/Aims: Weather and air pollution are associated with the exacerbation of respiratory diseases. We investigated patterns of medical care use according to meteorological factors and air pollution in patients with asthma or chronic obstructive pulmonary disease (COPD). Methods: We analyzed the medical care utilization patterns of patients with asthma or COPD registered in the Korea Health Insurance Review and Assessment database for the period 2007 to 2013. The patterns were divided into hospitalization and emergency department (ED) use. Results: The medical care use of patients with asthma or COPD increased when the mean temperature and relative humidity were lower, and the temperature difference and atmospheric pressure were greater. Medical care use increased with the concentrations of particulate matter and ozone. Among age groups, sensitivity to pollutants was greatest in patients aged ≥ 65 years. The effect of being elderly was greater for asthma than for COPD, with a higher hospitalization rate. ED utilization affected by environmental factors was significantly greater for females and hospitalization was significantly more common for males. Conclusions: Meteorological factors and air pollutants were shown to contribute to increased medical care utilization by patients with asthma and COPD, particularly elderly patients. The overall effect was greater for COPD, but the effect in elderly patients was greater for asthma. In addition, the patterns of change in medical care use due to environmental factors differed according to sex.
참고문헌 (39)
- Mannucci PM, "Effects on health of air pollution : a narrative review", Intern Emerg Med, 10, pp.657~662 (2015)
- Guilbert TW, "Asthma that is not well-controlled is associated with increased healthcare utilization and decreased quality of life", J Asthma, 48, pp.126~132 (2011)
- Malig BJ, "Coarse particles and respiratory emergency department visits in California", Am J Epidemiol, 178, pp.58~69 (2013)
- Silverman RA, "Age-related association of fine particles and ozone with severe acute asthma in New York City", J Allergy Clin Immunol, 125, pp.367~373 (2010)
- Lam HC, "The shortterm association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong : a time-series study", Thorax, 71, pp.1097~1109 (2016)
- Mar TF, "Relationship between visits to emergency departments for asthma and ozone exposure in greater Seattle, Washington", Ann Allergy Asthma Immunol, 103, pp.474~479 (2009)
- Ko FW, "Temporal relationship between air pollutants and hospital admissions for chronic obstructive pulmonary disease in Hong Kong", Thorax, 62, pp.780~785 (2007)
- Rossi OV, "Association of severe asthma attacks with weather, pollen, and air pollutants", Thorax, 48, pp.244~248 (1993)
- Ehara A, "Are high barometric pressure, low humidity and diurnal change of temperature related to the onset of asthmatic symptoms?", Pediatr Int, 42, pp.272~274 (2000)
- 권재우, "Emergency Department Visits for Asthma Exacerbation due to Weather Conditions and Air Pollution in Chuncheon, Korea: A Case-Crossover Analysis", Allergy, Asthma & Immunology Research, 8(6), pp.512~521 (2016), 대한천식알레르기학회
- "Chronic Condition Data Warehouse 2014" (2014)[URL]
- Zhang Y, "Effects of meteorological factors on daily hospital admissions for asthma in adults : a time-series analysis", PLoS One, 9, pp.e102475~ (2014)
- Son JY, "The impact of heat, cold, and heat waves on hospital admissions in eight cities in Korea", Int J Biometeorol, 58, pp.1893~1903 (2014)
- Lin MT, "Association of meteorological factors and air NO2 and O3 concentrations with acute exacerbation of elderly chronic obstructive pulmonary disease", Sci Rep, 8, pp.10192~ (2018)
- Hansel NN, "The effects of air pollution and temperature on COPD", COPD, 13, pp.372~379 (2016)
- Carey MJ, "Asthma and climatic conditions: experience from Bermuda, an isolated island community", Br Med J (Clin Res Ed), 293, pp.843~844 (1986)
- Villeneuve PJ, "Frequency of emergency room visits for childhood asthma in Ottawa, Canada : the role of weather", Int J Biometeorol, 50, pp.48~56 (2005)
- Jo EJ, "Effects of particulate matter on respiratory disease and the impact of meteorological factors in Busan, Korea", Respir Med, 124, pp.79~87 (2017)
- Jo YS, "Epidemiological study of PM2.5 and risk of COPD-related hospital visits in association with particle constituents in Chuncheon, Korea", Int J Chron Obstruct Pulmon Dis, 13, pp.299~307 (2018)
- Papi A, "Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations", Am J Respir Crit Care Med, 173, pp.1114~1121 (2006)
- Monso E, "Bacterial infection in chronic obstructive pulmonary disease. A study of stable and exacerbated outpatients using the protected specimen brush", Am J Respir Crit Care Med, 152, pp.1316~1320 (1995)
- McManus TE, "Respiratory viral infection in exacerbations of COPD", Respir Med, 102, pp.1575~1580 (2008)
- Fagon JY, "Characterization of distal bronchial microflora during acute exacerbation of chronic bronchitis. Use of the protected specimen brush technique in 54 mechanically ventilated patients", Am Rev Respir Dis, 142, pp.1004~1008 (1990)
- Sint T, "Ambient air pollution particles and the acute exacerbation of chronic obstructive pulmonary disease", Inhal Toxicol, 20, pp.25~29 (2008)
- Peacock JL, "Outdoor air pollution and respiratory health in patients with COPD", Thorax, 66, pp.591~596 (2011)
- MacNee W, "Exacerbations of COPD : environmental mechanisms", Chest, 117, pp.390S~397S (2000)
- Seaton A, "Particulate air pollution and acute health effects", Lancet, 345, pp.176~178 (1995)
- Utell MJ, "Acute health effects of ambient air pollution : the ultrafine particle hypothesis", J Aerosol Med, 13, pp.355~359 (2000)
- Anderson HR, "Particulate air pollution and hospital admissions for cardiorespiratory diseases: are the elderly at greater risk?", Eur Respir J, 40(Suppl), pp.39s~46s (2003)
- Duran CG, "A proof-of-concept clinical study examining the NRF2 activator sulforaphane against neutrophilic airway inflammation", Respir Res, 17, pp.89~ (2016)
- Cydulka RK, "Patterns of hospitalization in elderly patients with asthma and chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 156, pp.1807~1812 (1997)
- Milanese M, "Asthma control in elderly asthmatics : an Italian observational study", Respir Med, 108, pp.1091~1099 (2014)
- Menezes AMB, "Increased risk of exacerbation and hospitalization in subjects with an overlap phenotype : COPD-asthma", Chest, 145, pp.297~304 (2014)
- Singh AK, "Sex differences among adults presenting to the emergency department with acute asthma. Multicenter Asthma Research Collaboration Investigators", Arch Intern Med, 159, pp.1237~1243 (1999)
- Hopke PK, "Changes in the hospitalization and ED visit rates for respiratory diseases associated with source-specific PM2.5 in New York State from 2005 to 2016", Environ Res, 181, pp.108912~ (2020)
- de Torres JP, "Gender and COPD in patients attending a pulmonary clinic", Chest, 128, pp.2012~2016 (2005)
- Kessler R, "Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 159, pp.158~164 (1999)
- Kim SY, "Air pollution, socioeconomic position, and emergency hospital visits for asthma in Seoul, Korea", Int Arch Occup Environ Health, 80, pp.701~710 (2007)
- Kim J, "Hourly differences in air pollution on the risk of asthma exacerbation", Environ Pollut, 203, pp.15~21 (2015)