Upper gastrointestinal bleeding due to peptic ulcer disease is not associated with air pollution: a case-crossover study

BMC Gastroenterology

Gilaad G. Kaplan¹  Subrata Ghosh¹  Eddy Lang³  Kerri Novak¹  Sander Veldhuyzen van Zanten⁵  Karen Madsen⁵  Robert Hilsden¹  Markey Johnson²  David M. Stieb⁶  Paul J. Villeneuve⁴  Divine Tanyingoh¹  Hong Yang¹  Samuel Quan¹ 

[1] Departments of Medicine and Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Room 6D56, Calgary T2N-4N1, AB, Canada;Air Health Science Division, Health Canada, Ottawa K1A 0K9, Ontario, Canada;Departments of Emergency Medicine, University of Calgary, Calgary T2N-4N1, Alberta, Canada;Department of Health Sciences, Carleton University, Ottawa, Ottawa K1S 5B6, Ontario, Canada;Department of Medicine, University of Alberta, Edmonton T6G-2R7, Alberta, Canada;Population Studies Division, Health Canada, Vancouver V6C 1A1, British Columbia, Canada

关键词: Nitrogen dioxide;    Particulate matter;    Upper gastrointestinal bleeding;    Peptic ulcer disease;    Air pollution;   

Others  :  1234379
DOI  :  10.1186/s12876-015-0363-6

 received in 2015-06-03, accepted in 2015-10-01,  发布年份 2015

【 摘 要 】

Background

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).

Methods

A 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 (PM ₁₀and PM _2.5 ) 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.

Results

No 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.

Conclusion

Our findings suggest that short-term elevations in the level of ambient air pollutants does not increase the incidence of UGIB secondary to PUD.

【 授权许可】

   
2015 Quan et al.

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