Dataset Information

Ambient ozone concentrations and the risk of perforated and nonperforated appendicitis: a multicity case-crossover study.

ABSTRACT:

Background

Environmental determinants of appendicitis are poorly understood. Past work suggests that air pollution may increase the risk of appendicitis.

Objectives

We investigated whether ambient ground-level ozone (O3) concentrations were associated with appendicitis and whether these associations varied between perforated and nonperforated appendicitis.

Methods

We based this time-stratified case-crossover study on 35,811 patients hospitalized with appendicitis from 2004 to 2008 in 12 Canadian cities. Data from a national network of fixed-site monitors were used to calculate daily maximum O3 concentrations for each city. Conditional logistic regression was used to estimate city-specific odds ratios (ORs) relative to an interquartile range (IQR) increase in O3 adjusted for temperature and relative humidity. A random-effects meta-analysis was used to derive a pooled risk estimate. Stratified analyses were used to estimate associations separately for perforated and nonperforated appendicitis.

Results

Overall, a 16-ppb increase in the 7-day cumulative average daily maximum O3 concentration was associated with all appendicitis cases across the 12 cities (pooled OR = 1.07; 95% CI: 1.02, 1.13). The association was stronger among patients presenting with perforated appendicitis for the 7-day average (pooled OR = 1.22; 95% CI: 1.09, 1.36) when compared with the corresponding estimate for nonperforated appendicitis [7-day average (pooled OR = 1.02, 95% CI: 0.95, 1.09)]. Heterogeneity was not statistically significant across cities for either perforated or nonperforated appendicitis (p > 0.20).

Conclusions

Higher levels of ambient O3 exposure may increase the risk of perforated appendicitis.

SUBMITTER: Kaplan GG

PROVIDER: S-EPMC3734492 | biostudies-literature | 2013 Aug

REPOSITORIES: biostudies-literature

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Publications

Ambient ozone concentrations and the risk of perforated and nonperforated appendicitis: a multicity case-crossover study.

Kaplan Gilaad G GG Tanyingoh Divine D Dixon Elijah E Johnson Markey M Wheeler Amanda J AJ Myers Robert P RP Bertazzon Stefania S Saini Vineet V Madsen Karen K Ghosh Subrata S Villeneuve Paul J PJ

Environmental health perspectives 20130711 8

<h4>Background</h4>Environmental determinants of appendicitis are poorly understood. Past work suggests that air pollution may increase the risk of appendicitis.<h4>Objectives</h4>We investigated whether ambient ground-level ozone (O3) concentrations were associated with appendicitis and whether these associations varied between perforated and nonperforated appendicitis.<h4>Methods</h4>We based this time-stratified case-crossover study on 35,811 patients hospitalized with appendicitis from 2004 ...[more]

PMID: 23842601

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Dataset Information

Ambient ozone concentrations and the risk of perforated and nonperforated appendicitis: a multicity case-crossover study.

Background

Objectives

Methods

Results

Conclusions

Publications

Ambient ozone concentrations and the risk of perforated and nonperforated appendicitis: a multicity case-crossover study.

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