Patterns of medical care utilization according to environmental factors in asthma and chronic obstructive pulmonary disease patients

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.

Variación geográfica en la prevalencia de asma en niños mexicanos durante la pandemia de la COVID-19

“…Otros estudios han demostrado que la exposición a contaminante aéreos durante el embarazo se asocia con mayor probabilidad de asma en los niños; [10][11] pero en el lado opuesto, tal parece que la exposición a contaminantes aéreos contribuye más consistentemente a un incremento en la utilización de los servicios médicos de los pacientes con asma. [12][13][14] Una circunstancia que va emparejada con las condiciones geográficas y climáticas, y su posible influencia en la prevalencia de asma es la exposición a aeroalérgenos; los climas húmedos y cálidos favorecen el desarrollo de los ácaros del polvo casero, la exposición a sus alérgenos y sensibilización alérgica en sujetos genéticamente predispuestos, lo que puede provocar síntomas respiratorios. 15 En México, la península de Yucatán se caracteriza por un clima húmedo y cálido que favorece la sensibilización alérgica a los ácaros del polvo casero; 7 este factor puede explicar parcialmente por qué la prevalencia de asma fue mayor en la región Sureste, pero no advierte por qué resultó ser igualmente mayor en la región Noroeste, donde el clima es seco y cálido.…”

Air pollution and hospital admissions for critical illness in emergency department: a tertiary-center research in Changsha, China, 2016–2020

“…Abbreviations: RR, relative risk; PM 2.5 , particulate matter with an aerodynamic diameter ≤ 2.5 μm; PM 10 , particulate matter with an aerodynamic diameter ≤ 10 μm; SO 2 , sulfur dioxide; NO 2 , nitrogen dioxide; CO, carbon monoxide; O 3 , ozone susceptible to air pollutants due to the higher prevalence of chronic diseases and degradation of organ function. In addition, the physiological processes including disturbance in thermoregulation and homeostasis change were some other possible reasons (Jo et al 2021.…”

“…A research from France illuminated that there was no significant difference between spontaneous pneumothorax and short-term exposure of air pollutants, which included PM 10 , NO 2 , and O 3 (Marx et al 2020). Another research from Israel with 641 conjunctivitis patients found that no significant association was observed between conjunctivitis and air pollution (Khalaila et al 2021).…”

Extreme temperature and storm exacerbations of pediatric asthma: evidence and prevention strategies

“…Xu et al found a statistically significant association between DTR and pediatric asthma, with the greatest effect for lag 0-9 d, during which a 31% [95% CI: 11%, 58%] increase of EDAs occurred per 5 • C increment of DTR [2]. A study in Korea from 2007-2013 demonstrated that among children aged 0-9 years, a larger daily temperature difference was associated with both increased hospitalizations (incidence rate ratio [IRR] = 4.159 [3.449, 5.018]) and emergency department use (IRR = 3.405 [3.294, 3.518]) for asthma [5]. Despite an established epidemiologic association of large DTR with asthma exacerbations, the wide range of exposure to exacerbation time frames and lack of inclusion of variables (e.g.…”