Emergency department admission and hospitalization for COPD exacerbation and particulate matter short-term exposure in Brescia, a highly polluted town in northern Italy

Laura Pini, Jordan Giordani, Giulia Gardini, Carlo Concoreggi, Alessandro Pini, Elisa Perger, Enrico Vizzardi, Danilo Di Bona, Carlo Cappelli, Manuela Ciarfaglia, Claudio Tantucci

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Short-term exposure to high Particulate Matter (PM) concentrations worsens several respiratory conditions. Objectives: We evaluated the relationship between short-term exposure to Particulate Matter and fine Particulate Matter (PM10 – PM2.5) and Emergency Department (ED) admissions and hospitalizations for COPD exacerbation observed at the University Hospital, Spedali Civili of Brescia, a city with some of the highest yearly levels of air pollution in Italy. Methods: We collected data from patients admitted to the ED with a COPD exacerbation diagnosis, starting from January 2014 to January 2016. Daily PM levels were collected from the Environmental Protection Regional Agency (ARPA). We performed a time-series analysis using the Poisson regression model with single and multiple day-lag. Results were expressed as Relative Risk (RR) and Excess of Relative Risk (ER) for COPD exacerbation-related ED admissions and hospitalizations, over a 10μg/m3 increase in PM concentration. Results: We collected data from 431 COPD patients. Both PM10 and PM2.5 were significantly associated with the risk of COPD exacerbation-related ED admission and hospitalization. Each increase of 10μg/m3 of PM10 and PM2.5 corresponded respectively to a RR for ED admissions of 1.06 and 1.08 at lag0-1; 1.06 and 1.09 at lag0-5 (p < 0.05). Similar results for COPD Exacerbation-related hospitalizations were found, with a RR of 1.07 and 1.10 at lag0-1 and 1.07 and 1.11 at lag0-5 for each increase of 10μg/m3 PM10 and PM2.5, respectively. Conclusions: Our findings show that in a highly polluted city of Northern Italy, short-term increase in exposure to PM10-PM2.5 is associated with a higher risk of ED admission and hospitalization due to COPD exacerbation with a greater incidence during the winter season.

Original languageEnglish
Article number106334
JournalRespiratory Medicine
Volume179
DOIs
Publication statusPublished - Apr 2021

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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