| アブストラクト | Several studies have noted that the existence of comorbidities lead to an increase in the risk of premature mortality and morbidity. Most of the studies examining the effects of air pollution on comorbidity visits were from Northern American countries, with scarce literature from Asia. This study contributes to existing, yet limited understanding of air pollution-comorbidity by examining the effects of daily air pollutants on outpatient single morbidity and comorbid cardiorespiratory visits in Japan. A total of 1,452,505 outpatient cardiorespiratory visits were recorded among the 21 Japanese cities from 2013 to 2016. Daily outpatient cardiorespiratory visit data were obtained from a health insurance claims database managed by the Japan Medical Data Center Co., Ltd. (JMDC). A time-stratified case crossover analysis coupled with Generalized Additive Mixed Model was used to analyze the association of daily air pollutants (particulate matter 2.5 mum or less in diameter, ozone and nitrogen dioxide) on daily single (respiratory and cardiovascular) and comorbidity health outcomes. We further examined single and cumulative effects for 0-3 and 0-14 lag periods. Ozone, NO2, and PM2.5 were positively associated with cardiorespiratory visits in either shorter or longer lags, with more apparent comorbidity associations with NO2 exposure. A 10-unit increase in NO2, after adjusting for ozone, was associated with a 2.24% (95% CI: 1.34-3.15) and 6.49% (95% CI: 5.00-8.01) increase in comorbidity visit at Lag 0 (of Lag 0-3) and cumulative lag 0-3, respectively. Our results contribute to existing evidence suggesting that short-term and extended exposure to air pollution elicit health risks on cardiovascular, respiratory and comorbid clinic visits. Exposure to NO2, in particular, was associated with increase in the risk of single and comorbidity cardiorespiratory visits. Results can be potentially utilized for both individual health (e.g. risk population health management) and health facility management (e.g. health visit influx determination). |
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| ジャーナル名 | The Science of the total environment |
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| 投稿日 | 2020/5/7 |
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| 投稿者 | Seposo, Xerxes; Ueda, Kayo; Sugata, Seiji; Yoshino, Ayako; Takami, Akinori |
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| 組織名 | School of Tropical Medicine and Global Health, Nagasaki University, Japan.;Electronic address: seposo.xerxestesoro@nagasaki-u.ac.jp.;Environmental Health Division, Department of Environmental Engineering, Graduate;School of Engineering, Kyoto University, Japan; Environmental Health Sciences,;Department of Global Ecology, Graduate School of Global Environmental Studies,;Kyoto University, Japan.;Center for Regional Environmental Research, National Institute for Environmental;Studies, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32371210/ |
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