BackgroundThe health effects of biological aerosols on the respiratory system are unclear. The purpose of this study was to clarify the association of airborne particle, protein, and endotoxin with emergency department visits for asthma in Kyoto City, Japan.MethodsWe collected data on emergency department visits at a hospital in Kyoto from September 2014 to May 2016. Fine (aerodynamic diameter ≤ 2.5 μm) and coarse (≥ 2.5 μm) particles were collected in Kyoto, and protein and endotoxin levels were analyzed. The association of the levels of particles, protein, endotoxin, and meteorological factors (temperature, relative humidity, wind speed, and air pressure) with emergency department visits for asthma was estimated.ResultsThere were 1 to 15 emergency department visits for asthma per week, and the numbers of visits increased in the autumn and spring, namely many weeks in September, October, and April. Weekly concentration of protein in fine particles was markedly higher than that in coarse particles, and protein concentration in fine particles was high in spring months. Weekly endotoxin concentrations in fine and coarse particles were high in autumn months, including September 2014 and 2015. Even after adjusting for meteorological factors, the concentrations of coarse particles and endotoxin in both particles were significant factors on emergency department visits for asthma.ConclusionsOur results suggest that atmospheric coarse particles and endotoxin are significantly associated with an increased risk of asthma exacerbation.Electronic supplementary materialThe online version of this article (10.1186/s12199-018-0731-2) contains supplementary material, which is available to authorized users.

To determine the levels of endotoxin, which is a major component of outer membrane of Gram-negative bacteria, and protein in the atmosphere in Sasebo, Japan, we measured these biological materials in fine (aerodynamic diameter ≤2.5 µm) and coarse (≥2. ). However, the monthly protein concentrations were higher in fine particles than in coarse particles. Compared to the endotoxin concentrations, the fluctuations in the monthly protein concentrations were smaller in both coarse and fine particles. To our knowledge, this study is the first to report long-term atmospheric concentrations of endotoxin and protein in Japan. Since the endotoxin concentrations in coarse particles were positively associated with the concentrations of Na and Cl , it suggests the involvement of Gram-negative bacteria from seawater to the endotoxin levels in the atmosphere. For fine particles, the protein concentrations were positively associated with the concentrations of particles, NO 3 and SO 4 2 . These results suggest that combustion of organic materials, such as biomass burning, may be a contributor to atmospheric protein during this study period.

Drought has exacerbated morbidity and mortality worldwide. Here, a time series study was conducted in northern Bangladesh to evaluate the impact of drought on selected causes of mortality during 2007–2017. Rainfall and temperature data from six meteorological stations were used to analyze drought and non-drought periods and to categorize mild, moderate, severe, and extreme drought based on the 3-month and 12-month Standardized Precipitation Index (SPI) and Standardized Precipitation Evaporation Index (SPEI). A generalized linear model with Poisson regression with log link, a negative binomial with log link, and a zero-inflated Poisson model were used to determine associations between drought severity and mortality. The SPI and SPEI produced slightly different analysis results. Compared with the SPEI, the SPI showed a stronger and more sensitive correlation with mortality. The relative risk for respiratory disease mortality was high, and Saidpur was the most vulnerable area. Health care expenditure was negatively associated with mortality. High temperatures during the drought period were associated with suicide-related mortality in Rajshahi. The impact of drought on mortality differed with small changes in climate. The findings of this study improve our understanding of the differences between the two most used drought indicators and the impact of drought on mortality.

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Atopic dermatitis (AD) is the foremost non-fatal skin-related disease that affects all age groups. Despite the growing prevalence of AD in low- and middle-income countries, its physiological consequences remain overlooked in countries like Bangladesh. Therefore, we aim to assess and characterize the influence of AD on the health-related quality of life (HRQoL) in Bangladeshi patients. A cross-sectional study comprising 184 eligible adults (83 men and 101 women; mean age, 33.46 ± 15.44 years) was conducted at the dermatology outpatient department of Shaheed Suhrawardy Medical College Hospital (a tertiary hospital in Dhaka, Bangladesh). AD was determined using the UK Working Party criteria. A structured questionnaire, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were administered to obtain information on patient characteristics, AD severity, and HRQoL. The mean DLQI score for the entire sample was 11.29 ± 5.27 (range, 1–26), and 51.60% reported the disease greatly affected their lives. Bivariate analysis revealed significant differences in self-rated health measures of DLQI scores in terms of self-reported AD severity, overall health, and the EASI. In multivariable regression models adjusted for patient characteristics, the self-perceived severe AD group reported significantly higher DLQI scores (coefficient = 2.72; 95% confidence interval (CI) = 0.38–5.05; p = 0.022) than the mild group. Concurrently, we observed a substantial increase in the DLQI scores among patients with moderate and severe EASI scores (coefficient = 1.96, 95% CI = 0.08–3.92, p < 0.05 and coefficient = 4.35, 95% CI = 1.98–6.72, p < 0.001, respectively) than in those with mild EASI scores, suggesting that HRQoL was markedly influenced by greater AD severity. These findings highlight the need for a more patient-centric approach to the management of AD in order to alleviate patient suffering and, thereby, improve HRQoL.