Dataset Information

Short-Term Joint Effects of PM₁₀, NO₂ and SO₂ on Cardio-Respiratory Disease Hospital Admissions in Cape Town, South Africa.

ABSTRACT:

Background/aim

In sub-Sahara Africa, few studies have investigated the short-term association between hospital admissions and ambient air pollution. Therefore, this study explored the association between multiple air pollutants and hospital admissions in Cape Town, South Africa.

Methods

Generalized additive quasi-Poisson models were used within a distributed lag linear modelling framework to estimate the cumulative effects of PM₁₀, NO₂, and SO₂ up to a lag of 21 days. We further conducted multi-pollutant models and stratified our analysis by age group, sex, and season.

Results

The overall relative risk (95% confidence interval (CI)) for PM₁₀, NO₂, and SO₂ at lag 0-1 for hospital admissions due to respiratory disease (RD) were 1.9% (0.5-3.2%), 2.3% (0.6-4%), and 1.1% (-0.2-2.4%), respectively. For cardiovascular disease (CVD), these values were 2.1% (0.6-3.5%), 1% (-0.8-2.8%), and -0.3% (-1.6-1.1%), respectively, per inter-quartile range increase of 12 µg/m³ for PM₁₀, 7.3 µg/m³ for NO₂, and 3.6 µg/m³ for SO₂. The overall cumulative risks for RD per IQR increase in PM₁₀ and NO₂ for children were 2% (0.2-3.9%) and 3.1% (0.7-5.6%), respectively.

Conclusion

We found robust associations of daily respiratory disease hospital admissions with daily PM₁₀ and NO₂ concentrations. Associations were strongest among children and warm season for RD.

SUBMITTER: Adebayo-Ojo TC

PROVIDER: S-EPMC8744938 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Pulmonary endarterectomy (PEA) is the only definitive and potentially curative therapy for chronic thromboembolic pulmonary hypertension (CTEPH), associated with impressive improvements in symptoms and haemodynamics. However, it is only offered at a few centres in South Africa. The characteristics and outcomes of patients undergoing PEA in Cape Town have not been reported previously. To assess the difference in World Health Organization functional class (WHO-FC) before and at least 6 weeks after surgery. We interrogated the adult cardiothoracic surgery database at the University of Cape Town between December 2005 and April 2021 for patients undergoing PEA at Groote Schuur Hospital and a private hospital. A total of 32 patients underwent PEA, of whom 8 were excluded from the final analysis owing to incomplete data or a histological diagnosis other than CTEPH. The work-up of these patients for surgery was variable: all had a computed tomography pulmonary angiogram, 7 (29%) had a ventilation/perfusion scan, 5 (21%) underwent right heart catheterisation, and none had a pulmonary angiogram. The perioperative mortality was 4/24 (17%): 1 patient (4%) had a cardiac arrest on induction of anaesthesia, 2 patients (8%) died of postoperative pulmonary haemorrhage, and 1 patient (4%) died of septic complications in the intensive care unit. Among the survivors, the median (interquartile range) improvement in WHO-FC was 2 (1 - 3) classes (p=0.0004); 10/16 patients (63%) returned to a normal baseline (WHO-FC I). Even in a low-volume centre, PEA is associated with significant improvements in WHO-FC and a return to a normal baseline in survivors. What the study adds. South African patients undergoing pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) have a marked improvement in functional status, with many returning to a normal functional baseline. However, the small number of patients included in this study indicates that PEA is probably underutilised. Pre- and postoperative assessment is inconsistent, despite availability of established guidelines.Implications of the findings. More patients should be referred to specialist centres for assessment for this potentially curative procedure. Use of guidelines to standardise investigations and monitoring of patients with CTEPH may improve patient selection for surgery.

Dataset Information

Short-Term Joint Effects of PM₁₀, NO₂ and SO₂ on Cardio-Respiratory Disease Hospital Admissions in Cape Town, South Africa.

Background/aim

Methods

Results

Conclusion

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Short-Term Joint Effects of PM10, NO2 and SO2 on Cardio-Respiratory Disease Hospital Admissions in Cape Town, South Africa.

Background/aim

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OmicsDI is part of the ELIXIR infrastructure

Tweets

Short-Term Joint Effects of PM₁₀, NO₂ and SO₂ on Cardio-Respiratory Disease Hospital Admissions in Cape Town, South Africa.