Abstract
Spontaneous pneumothorax (SP) involves the spontaneous appearance of air in the pleural space. Atmospheric pressure, temperature change, and seasonal factors may precipitate SP, but its association with air pollution remains unclear. Therefore, we conducted this nationwide, retrospective population-based study to evaluate the risk of SP in Taiwanese children exposed to air pollution. We collected data on SP incidence from the Longitudinal Health Insurance Database; the Taiwan Air Quality-Monitoring Database provided daily concentrations of nitric oxide (NO), nitrogen dioxide (NO2), and hydrocarbons in 2000–2012. SP risk was evaluated for four quartiles (Q1, Q2, Q3, Q4). The NO adjusted hazard ratios (aHRs) for Q2, Q3, and Q4 compared to Q1 were 1.11 (95% confidence interval (CI): 0.77–1.61), 1.24 (95% CI: 0.88–1.76), and 1.66 (95% CI: 1.17–2.34), respectively. The NO2 aHRs for Q2, Q3, and Q4 were 1.12 (95% CI: 0.77–1.64), 1.31 (95% CI: 0.0.90–1.90), and 1.51 (95% CI: 1.04–2.19), respectively. Hydrocarbons aHRs for Q2, Q3, and Q4 were 0.87 (95% CI: 0.64–1.18), 1.16 (95% CI: 0.90–1.49), and 1.40 (95% CI: 1.06–1.85), respectively. Increased exposure to NO, NO2, and hydrocarbons is associated with increased SP risk in Taiwanese children.
Highlights
Long-term ambient air pollution is associated with an increased risk of respiratory, cardiovascular and cerebrovascular diseases [1,2]
Respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma may be exacerbated by air pollution; air pollution may increase morbidity and mortality associated with respiratory diseases [3]
We conducted a population-based cohort study using the file on children that is part of the database of citizens enrolled in the Taiwan National Health Insurance (NHI) program [13] and the Taiwan Air Quality-Monitoring Database (TAQMD), which is released by the Taiwan Environmental Protection Agency
Summary
Long-term ambient air pollution is associated with an increased risk of respiratory, cardiovascular and cerebrovascular diseases [1,2]. Respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma may be exacerbated by air pollution; air pollution may increase morbidity and mortality associated with respiratory diseases [3]. Han et al found that air pollution exposure, especially pollution containing particulate matter (PM), increased hospital visits due to SP [11]; a recent study by
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