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Spatiotemporal analysis of air pollution and asthma patient visits in Taipei, Taiwan
Ta-Chien Chan, Mei-Lien Chen, I-Feng Lin, Cheng-Hua Lee, Po-Huang Chiang, Da-Wei Wang, Jen-Hsiang Chuang
International Journal of Health Geographics , 2009, DOI: 10.1186/1476-072x-8-26
Abstract: We analyzed daily outpatient and emergency visit data from the Taiwan Bureau of National Health Insurance and air pollution data from the Taiwan Environmental Protection Administration during 2000–2002. In general, children (aged 0–15 years) had the highest number of total asthma visits. Seasonal changes of PM10, NO2, O3 and SO2 were evident. However, SO2 showed a positive correlation with the dew point (r = 0.17, p < 0.01) and temperature (r = 0.22, p < 0.01). Among the four pollutants studied, the elevation of NO2 concentration had the highest impact on asthma outpatient visits on the day that a 10% increase of concentration caused the asthma outpatient visit rate to increase by 0.30% (95% CI: 0.16%~0.45%) in the four pollutant model. For emergency visits, the elevation of PM10 concentration, which occurred two days before the visits, had the most significant influence on this type of patient visit with an increase of 0.14% (95% CI: 0.01%~0.28%) in the four pollutants model. The impact on the emergency visit rate was non-significant two days following exposure to the other three air pollutants.This preliminary study demonstrates the feasibility of an integrated spatial and temporal approach to assess the impact of air pollution on asthma patient visits. The results of this study provide a better understanding of the correlation of air pollution with asthma patient visits and demonstrate that NO2 and PM10 might have a positive impact on outpatient and emergency settings respectively. Future research is required to validate robust spatiotemporal patterns and trends.Asthma remains a major health issue for children in Taiwan [1,2]. Taipei City is a highly urbanized area with crowded population density (9,720 people/km2) [3] and intensive motorcycle and sedan density (motorcycles: 3,927 vehicles/km2; sedan: 2,672 vehicles/km2) [4]. Due to this heavy traffic condition, the estimated child asthma prevalence in Taipei City is 13% and the trend is becoming increasingly mor
Air pollution and emergency admissions for cardiorespiratory diseases in Lisbon (Portugal)
Alves, Célia A.;Scotto, Manuel G.;Freitas, Maria do Carmo;
Química Nova , 2010, DOI: 10.1590/S0100-40422010000200020
Abstract: daily records of hospital admissions due to cardiorespiratory diseases and levels of pm10, so2, co, no, no2, and o3 were collected from 1999-2004 to evaluate the relationship between air pollution and morbidity in lisbon. generalised additive poisson regression models were adopted, controlling for temperature, humidity, and both short and long-term seasonality. significant positive associations, lagged by 1 or 2 days, were found between markers of traffic-related pollution (co and no2) and cardiocirculatory diseases in all age groups. increased childhood emergency admissions for respiratory illness were significantly correlated with the 1-day lagged so2 levels coming from industrial activities.
Analyzing Spatial Patterns of Cardiorespiratory Diseases in the Federal District, Brazil  [PDF]
Weeberb Requia, Henrique Roig
Health (Health) , 2015, DOI: 10.4236/health.2015.710143
Abstract: Cardiorespiratory diseases are a serious public health problem worldwide. Identification of spatial patterns in health events is an efficient tool to guide public policies in environmental health. However, only few studies have considered spatial pattern analysis which is considered the evaluation of spatial autocorrelation, degree of autocorrelation and dependence behavior in terms of distances. Therefore, the objective of this study is to propose a set of procedures to evaluate the spatial patterns of cardiorespiratory diseases in the Federal District, Brazil. Specifically, our proposal will be based on four questions: a) is the spatial distribution of all patients clustered, random or dispersed? b) what is the degree of clustering for either high values or low values of patients? c) what is the spatial dependence behavior? d) considering the spatial variation, at what distance does the type of distribution (cluster, random or disperse) begin to change? We chose four methods to answer these questions Global Moran’s I (question “a”); Getis-Ord General G (question “b”); semivariogram analysis (question “c”); and multi-distance spatial cluster-K-function (question “d”). Our results suggest that there is a different behavior for people up to 5 years old (cluster, p < 0.01), especially in distances below 2.5 km. For people above 59 years old, cluster is significant just in short distances (<200 m). For other age groups, the spatial distribution is basically random. Our study showed that it was possible to capture evidences of health disparities in the Federal District.
Asian Dust Storm Elevates Children’s Respiratory Health Risks: A Spatiotemporal Analysis of Children’s Clinic Visits across Taipei (Taiwan)  [PDF]
Hwa-Lung Yu, Lung-Chang Chien, Chiang-Hsing Yang
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0041317
Abstract: Concerns have been raised about the adverse impact of Asian dust storms (ADS) on human health; however, few studies have examined the effect of these events on children’s health. Using databases from the Taiwan National Health Insurance and Taiwan Environmental Protection Agency, this study investigates the documented daily visits of children to respiratory clinics during and after ADS that occurred from 1997 to 2007 among 12 districts across Taipei City by applying a Bayesian structural additive regressive model controlled for spatial and temporal patterns. This study finds that the significantly impact of elevated children’s respiratory clinic visits happened after ADS. Five of the seven lagged days had increasing percentages of relative rate, which was consecutively elevated from a 2-day to a 5-day lag by 0.63%~2.19% for preschool children (i.e., 0~6 years of age) and 0.72%~3.17% for school children (i.e., 7~14 years of age). The spatial pattern of clinic visits indicated that geographical heterogeneity was possibly associated with the clinic’s location and accessibility. Moreover, day-of-week effects were elevated on Monday, Friday, and Saturday. We concluded that ADS may significantly increase the risks of respiratory diseases consecutively in the week after exposure, especially in school children.
Mortality Rates Due to Occupational Accidents and Diseases Between 2000-2005 in Turkey
Nazan Yard?m,Zekiye ?ipil,Ceyhan Vardar,Salih Mollahalilo?lu
Dicle Medical Journal , 2007,
Abstract: Each year, considerable amount of people lose their life or become disabled due to work accidents or occupational diseases which may be prevented or are to be prevented legally.Estimating mortality rates of work accidents and occupational diseases for 2000-2005; reviewing current situation related to work Health and safety and, making proposals on the issue. Number of work accidents, occupational diseases, number of deaths, and total number of deaths in district and province centers were obtained. In terms of deaths in the rural area, other years were estimated based on the estimations in the National Burden of Disease Study. 73,923 work accidents occurred in 2005; 1096 people in total lost their lives; 1072 people in the accidents at work, and 24 people due to an occupational disease. Mortality rates, proportional mortality rates, and fatality rates of work accidents and occupational diseases increased in 2005. There are still many things to achieve on Occupational Health and Safety. It is important to have comprehensive policies aiming at minimizing and preventing accidents and injuries related to a work or occurring during a work.
Social care and changes in occupational accidents and diseases - the situation in Eastern Europe in general and for skin diseases in particular
Kathrin R von Hirschberg, Bj?rn K?hler, Albert Nienhaus
Journal of Occupational Medicine and Toxicology , 2009, DOI: 10.1186/1745-6673-4-28
Abstract: The available data from the European Union (MISSOC and MISSCEEC Studies on the Social Protection Systems), the database "Social Security Worldwide" (SSW) of the International Social Security Association (ISSA), the International Labour Office Database (LABORSTA), the World Health Organization (WHO) and the annual statistical reports of the different countries were analysed with respect to changes in occupational accidents and occupational diseases. To find missing data, 128 ministries and authorities in the 22 countries in eastern Europe were researched and 165 persons contacted.The social insurance systems were very different in the different countries and some were better established than others. Moreover, not all data were available. For these reasons, detailed comparison was not always possible. The occupational accident rates are decreasing in more than half the countries. In contrast, the fatal accident rates have increased in half the countries. The number of newly registered occupational diseases is decreasing in more than half the countries. The rates for occupational skin diseases in 2006 were particularly high in the Czech Republic, Poland and Slovakia. In half the countries (four out of eight), the number of occupational skin diseases is decreasing. A reliable analysis of any correlation between EU membership and the rates of occupational accidents and occupational diseases was not possible, because of missing current data.Comparison of the social insurance systems and changes in occupational accidents and occupational diseases in 22 countries in eastern Europe makes it clear that further effort is needed to develop registration and notification procedures. Only then will it be possible to analyse changes, to map successes and problems and perhaps to initiate necessary improvements. Standardisation of the documents must also be improved, to allow international comparisons between the systems.As a consequence of the disintegration of the state systems and
Assessment of Cardiorespiratory Fitness without Exercise in Elderly Men with Chronic Cardiovascular and Metabolic Diseases  [PDF]
Geraldo A. Maranh?o Neto,Antonio P. de Leon,Vitor A. Lira,Paulo T. V. Farinatti
Journal of Aging Research , 2012, DOI: 10.1155/2012/518045
Abstract: Low cardiorespiratory (CRF) is associated with health problems in elderly people, especially cardiovascular and metabolic disease. However, physical limitations in this population frequently preclude the application of aerobic tests. We developed a model to estimate CRF without aerobic testing in older men with chronic cardiovascular and metabolic diseases. Subjects aged from 60 to 91 years were randomly assigned into validation ( ?? = 6 7 ) and cross-validation ( ?? = 2 9 ) groups. A hierarchical linear regression model included age, self-reported fitness, and handgrip strength normalized to body weight ( ?? 2 = 0 . 7 9 ; SEE?=?1.1 METs). The PRESS (predicted residual sum of squares) statistics revealed minimal shrinkage in relation to the original model and that predicted by the model and actual CRF correlated well in the cross-validation group ( ?? = 0 . 8 5 ). The area under curve (AUC) values suggested a good accuracy of the model to detect disability in the validation (0.876, 95% CI: 0.793–0.959) and cross-validation groups (0.826, 95% CI: 0.677–0.975). Our findings suggest that CRF can be reliably estimated without exercise test in unhealthy elderly men. 1. Introduction Cardiorespiratory fitness (CRF) maintenance is important for functional independence and physical capacity throughout aging [1, 2]. Substantial declines in the ability to tolerate physical exertion generally predict mobility problems and cardiovascular morbidity and mortality, particularly in the sedentary elderly [3, 4]. Despite the importance of CRF assessment, very low functional capacity and frailty may hinder the use of exercise tests in this population [5, 6]. In this context, nonexercise prediction models become practical alternatives to estimate CRF [7] and may have important applications both in clinical and epidemiological settings. These models are developed by means of regression-based equations that usually include variables of simple and fast assessment, such as anthropometric measures, demographic characteristics, and daily habits [8]. Recently, Mailey et al. [7] cross-validated an equation developed primarily in middle-aged adults by Jurca et al. [9] and suggested that nonexercise models could be used to estimate the CRF of older adults. The sample studied was mainly composed by healthy old women (~60%). However, the prevalence of chronic diseases such as cardiovascular disease and diabetes increases dramatically with age [10], and is associated to lower physical capacity, inactivity, and limitations in the ability to exercise [2]. It would be therefore important
An Outbreak of Varicella among Schoolchildren in Taipei
Chao-Chih Lai, Szu-Ching Chen, Donald Jiang
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-226
Abstract: An outbreak occurred in an elementary school which located in southern Taipei from April 2007 through May 2007. A retrospect cohort study was performed by using a self-administered questionnaire for parents.Ten out of sixteen varicella cases were vaccinated. Overall vaccine coverage was 71.2%. The common reasons for not receiving varicella vaccine were that varicella vaccine was unavailable because the student didn't live in Taipei (29.4%) or the children could not be vaccinated due to certain illnesses (23.5%). The sensitivity and specificity of self-reported vaccination status was 0.900 (95% CI: 0.864, 0.935) and 0.611 (95% CI: 0.514, 0.701).The vaccine effectiveness was 69.3%-100.0% against any disease severity of varicella. Overall vaccine effectiveness against moderate or severe varicella was 85.5%. Attending cram school was associated with the risk of developing the varicella illness (RR: 13.39; 95% CI: 5.38, 33.31). Unvaccinated students tended to show moderate to severe (>50 lesions) afflictions of the disease (RR: 4.17; 95% CI: 1.15, 15.14).Because of the low vaccination coverage, varicella outbreaks continue to be reported in Taipei. Increasing vaccine coverage and second dose vaccination for increasing vaccine effectiveness may be considered.A live attenuated varicella vaccine was made commercially available in Taiwan in September 1997. It has been included in public vaccination programs in Taipei city and Taichung city/county since 1998 and 1999 respectively [1]. It could be provided by self-paid option in other areas of Taiwan. Varicella disease has been included in the reports of National Notifiable Disease Surveillance System in Taiwan since 1999. A routine varicella vaccination for all children born after 2003 and aged 12 months or older was implemented in Taiwan since 2004. Varicella disease has declined dramatically 5 years after the introduction of vaccine in the United States [2]. Although some studies show complications and significantly decline
Fine temporal structure of cardiorespiratory synchronization  [PDF]
Sungwoo Ahn,Jessica Solfest1,Leonid L Rubchinsky
Quantitative Biology , 2014, DOI: 10.1152/ajpheart.00314.2013
Abstract: Cardiac and respiratory rhythms are known to exhibit a modest degree of phase synchronization, which is affected by age, diseases, and other factors. We study the fine temporal structure of this synchrony in healthy young, healthy elderly, and elderly subjects with coronary artery disease. We employ novel time-series analysis to explore how phases of oscillations go in and out of the phase-locked state at each cycle of oscillations. For the first time we show that cardiorespiratory system is engaged in weakly synchronized dynamics with a very specific temporal patterning of synchrony: the oscillations go out of synchrony frequently, but return to the synchronous state very quickly (usually within just one cycle of oscillations). Properties of synchrony depended on the age and disease status. Healthy subjects exhibited more synchrony at the higher (1:4) frequency-locking ratio between respiratory and cardiac rhythms, while subjects with coronary artery disease exhibited relatively more 1:2 synchrony. However, multiple short desynchronization episodes prevailed regardless of age and disease status. The same average synchrony level could alternatively be achieved with few long desynchronizations, but this was not observed in the data. This implies functional importance of short desynchronizations dynamics. These dynamics suggest that a synchronous state is easy to create if needed, but is also easy to break. Short desynchronizations dynamics may facilitate the mutual coordination of cardiac and respiratory rhythms by creating intermittent synchronous episodes. It may be an efficient background dynamics to promote adaptation of cardiorespiratory coordination to various external and internal factors.
The Obesity Paradox and Cardiorespiratory Fitness
Paul A. McAuley,Nancy S. Smith,Brian T. Emerson,Jonathan N. Myers
Journal of Obesity , 2012, DOI: 10.1155/2012/951582
Abstract: Cardiorespiratory fitness as an explanation for the obesity paradox warrants further examination. We evaluated independent and joint associations of cardiorespiratory fitness and adiposity with all-cause mortality in 811 middle-aged (age, 53.3±7.2 years) male never smokers without documented cardiopulmonary disease or diabetes from the Veterans Exercise Testing Study (VETS). Cardiorespiratory fitness was quantified in metabolic equivalents (METs) using final treadmill speed and grade achieved on a maximal exercise test. Subjects were grouped for analysis by METs: unfit (lowest third) and fit (upper two-thirds); and by body mass index (kg/m2): nonobese (18.5−29.9) and obese (≥30.0). Associations of baseline fitness and adiposity measures with all-cause mortality were determined by Cox proportional hazards analysis adjusted for age, ethnicity, hypertension, hypercholesterolemia, family history of coronary artery disease, and cardiovascular medication use. In multivariate analysis, mortality risk for obese/fit men did not differ significantly from the nonobese/fit reference group. However, compared to the reference group, nonobese and obese unfit men were 2.2 (=0.01) and 1.9 (=0.03) times more likely to die, respectively. Cardiorespiratory fitness altered the obesity paradox such that mortality risk was lower for both obese and nonobese men who were fit.
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