Abstract
BackgroundRecent studies have demonstrated an association between short-term elevations in air pollution and an increased risk of exacerbating gastrointestinal disease. The objective of the study was to evaluate if day-to-day increases in air pollution concentrations were positively associated with upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD).MethodsA time-stratified case-crossover study design was used. Adults presenting to hospitals with their first UGIB secondary to PUD from 2004–2010 were identified using administrative databases from Calgary (n = 1374; discovery cohort) and Edmonton (n = 1159; replication cohort). Daily concentrations of ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, and particulate matter (PM10 and PM2.5) were estimated in these two cities. Conditional logistic regression models were employed, adjusting for temperature and humidity. Odds ratios (OR) with 95 % confidence intervals (CI) were expressed relative to an interquartile range increase in the concentration of each pollutant.ResultsNo statistically significant associations were observed for any of the individual pollutants based on same-day, or 1-day lag effects within the Calgary discovery cohort. When the air pollution exposures were assessed as 3-, 5-, and 7-day averages, some pollutants were inversely associated with UGIB in the discovery cohort; for example, 5-day averages of nitrogen dioxide (OR = 0.68; 95 % CI: 0.53–0.88), and particulate matter <2.5 μm (OR = 0.75; 95 % CI: 0.61–0.90). However, these findings could not be reproduced in the replication cohort.ConclusionOur findings suggest that short-term elevations in the level of ambient air pollutants does not increase the incidence of UGIB secondary to PUD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-015-0363-6) contains supplementary material, which is available to authorized users.
Highlights
Recent studies have demonstrated an association between short-term elevations in air pollution and an increased risk of exacerbating gastrointestinal disease
Pollutant concentrations were not associated with developing upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD) when the exposure period was on the same day or the day prior to being hospitalized
Based on emerging evidence that air pollution is associated with other gastrointestinal disorders [23,24,25,26,27], we hypothesized that acute exposure to air pollution triggered an UGIB secondary to PUD
Summary
Recent studies have demonstrated an association between short-term elevations in air pollution and an increased risk of exacerbating gastrointestinal disease. The objective of the study was to evaluate if day-to-day increases in air pollution concentrations were positively associated with upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD). Upper-gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD) is a serious medical condition that is associated with substantial morbidity, high healthcare costs, and decreased quality of life [1, 2]. Autopsy data showed virtually no cases of death secondary to PUD in the early 1800’s, but by the mid 1800’s PUD became recognized as a major contributor to mortality in Westernized nations like North America and England [12].
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