ABSTRACT
Proceedings of the European Seminars in Respiratory Medicine course, Inhalation therapy in the next decade: Determinants of adherence to treatment in asthma and COPD, held in Taormina, Italy, on 3-4 March, 2017.
Subject(s)
Asthma/drug therapy , Medication Adherence/statistics & numerical data , Pulmonary Disease, Chronic Obstructive/drug therapy , Respiratory Therapy/instrumentation , Asthma/epidemiology , Asthma/mortality , Cost-Benefit Analysis , Female , History, 20th Century , History, 21st Century , Humans , Italy/epidemiology , Male , Medication Adherence/psychology , Mortality , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/mortality , Pulmonary Medicine/history , Pulmonary Medicine/organization & administration , Respiratory Therapy/methodsABSTRACT
Proceedings of the European Seminars in Respiratory Medicine course, Long-Term Integrated Care of COPD Patients held in Stresa, Italy, on 16-17 June, 2016.
Subject(s)
Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Pulmonary Medicine/organization & administration , Adult , Delivery of Health Care, Integrated/methods , Europe/epidemiology , Exercise , Female , Humans , Incidence , Interdisciplinary Research/methods , Italy/epidemiology , Male , Middle Aged , Mortality , Prevalence , Pulmonary Disease, Chronic Obstructive/classification , Pulmonary Disease, Chronic Obstructive/physiopathology , Self-Management/statistics & numerical dataABSTRACT
BACKGROUND: Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. METHODS: We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0-2 and lag 3-5 in both single and multi-pollutant models, adjusted for daily weather variables. RESULTS: An increase in ozone (O(3)) levels at lag 3-5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0-2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO(2)), CO, nitrate dioxide (NO(2)), and particulate matter (PM(10) and PM(2.5)). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0-2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association. CONCLUSIONS: Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.