Association between short-term air pollution exposure and traumatic intracranial hemorrhage: pilot evidence from Taiwan

Frontiers in Neurology

Neurology

Bayu Satria Wiratama¹  Chin-Wang Hsu²  Wen-Cheng Huang³  Kuo-Hsing Liao⁴  Carlos Lam⁵  Chia-Chieh Wu⁵  Wen-Ta Chiu⁶  Ta-Chien Chan⁷  Hsiao-Chi Chuang⁸ 

[1] Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia;Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;Center for Education in Medical Simulation, Taipei Medical University, Taipei, Taiwan;Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Department of Neurosurgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;Division of Critical Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;Department of Neurotraumatology and Intensive Care, Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan;Division of Neurosurgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan;AHMC Health System, Alhambra, CA, United States;Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan;Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan;Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;

关键词: air pollution;    fine particulate matter;    geographic information system;    road traffic accident;    traumatic intracranial hemorrhage;    short-term exposure;   

DOI  :  10.3389/fneur.2023.1087767

 received in 2022-11-02, accepted in 2023-04-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionThe detrimental effects of air pollution on the brain are well established. However, few studies have examined the effect of air pollution on traumatic brain injury (TBI). This pilot study evaluated the association between short-term air pollution exposure and traumatic intracranial hemorrhage (TIH).MethodsHospital data of patients with TBI following road traffic accidents were retrospectively collected from the electronic medical records at five trauma centers in Taiwan between 1 January and 31 December 2017. TIH was employed as an outcome measure. All road accident locations were geocoded, and air quality data were collected from the nearest monitoring stations. Air pollutants were entered into five multivariable models. A sensitivity analysis was performed on patients who are vulnerable to suffering TBI after road accidents, including motorcyclists, bicyclists, and pedestrians.ResultsAmong 730 patients with TBI, 327 had TIH. The ages of ≥65 [odds ratio (OR), 3.24; 95% confidence interval (CI), 1.85–5.70], 45–64 (OR, 2.61; 95% CI, 1.64–4.15), and 25–44 (OR, 1.79; 95% CI, 1.13–2.84) years were identified as significant risk factors in the multivariable analysis. In the best-fit multivariable model, exposure to higher concentrations of particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) was associated with an elevated TIH risk (OR, 1.50; 95% CI, 1.17–1.94). The concentration of nitrogen oxides (NOX) did not increase the risk of TIH (OR, 0.45; 95% CI, 0.32–0.61). After categorizing the air pollution concentration according to quartile, the trend tests in the multivariate model showed that the concentrations of PM2.5 and NOX were significant (p = 0.017 and p < 0.001, respectively). There was a negative borderline significant association between temperature and TIH risk (OR, 0.75; 95% CI, 0.56–1.00, p = 0.05). Notably, the single-vehicle crash was a significant risk factor (OR, 2.11; 95% CI, 1.30–3.42) for TIH.DiscussionHigh PM2.5 concentrations and low temperatures are risk factors for TIH in patients with TBI. High NOX concentrations are associated with a lower TIH risk.

【 授权许可】

Unknown   
Copyright © 2023 Liao, Chan, Wu, Huang, Hsu, Chuang, Wiratama, Chiu and Lam.