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Ambient Air Pollutant Exposures and Hospitalization for Kawasaki Disease in Taiwan: A Case-Crossover Study (2000-2010).
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- Author(s): Chau-Ren Jung1,2; Wei-Ting Chen3; Yu-Ting Lin1,2; Bing-Fang Hwang1
- Source:
Environmental Health Perspectives. Apr2017, Vol. 125 Issue 4, p670-676. 7p. 4 Charts, 3 Graphs.- Subject Terms:
*Air pollution; *Environmental exposure; Baroclinicity; Confidence intervals; Crossover trials; Hospital care; Hospitals; Case studies; Mucocutaneous lymph node syndrome; Probability theory; Research funding; Statistics; Logistic regression analysis; Data analysis; Data analysis software; Descriptive statistics; Odds ratio - Source:
- Additional Information
- Subject Terms:
- Abstract: BACKGROUND: Kawasaki disease (KD) is an acute and multi-systemic vasculitis that occurs predominantly in infants and young children. Although the etiological agent of KD remains unclear, limited studies have reported that windborne environmental factors may trigger KD. OBJECTIVES: We conducted a time-stratified case-crossover study to assess the associations between air pollutants and KD in Taiwan. METHODS: We identified children < 5 years old with a diagnosis of KD from the Longitudinal Health Insurance Database 2000 (LHID2000) between 2000 and 2010. We obtained data regarding carbon monoxide (CO), nitrogen dioxide (NO[sub 2]), ozone (O[sub 3]), particulate matter with aerodynamic diameter < 10μm (PM[sub 10]), and sulfate dioxide (SO[sub 2]) from 70 monitoring stations and used inverse distance weighting to calculate average daily exposures for the residential postal code of each case. We performed conditional logistic regression to estimate associations between KD and each air pollutant according to interquartile range (IQR) increases and quartiles of exposure on the day of hospitalization versus 3-4 reference days during the same month for each case. Additionally, we estimated associations with single-day exposures lagged 1-2 days. RESULTS: We identified 695 KD hospital admissions during the study period. An IQR increase (28.73 ppb) of O[sub 3] was positively associated with KD after adjusting for temperature, humidity, northward wind, and eastward wind [adjusted odds ratio = 1.21; 95% confidence interval (CI): 1.01, 1.44]. There were no significant associations between KD and CO, NO[sub 2], PM[sub 10], or SO[sub 2]. The association with O[sub 3] was limited to exposure on the day of hospitalization and to exposure during the summer months (June-August). CONCLUSIONS: Our results provide new evidence that exposure to O[sub 3] may increase the risk of KD in children. However, further investigation is needed to confirm the association and identify a potential biological mechanism. CITATION: Jung CR, Chen WT, Lin YT, Hwang BF. 2017. Ambient air pollutant exposures and hospitalization for Kawasaki disease in Taiwan: a case-crossover study (2000-2010). Environ Health Perspect 125:670-676; http://dx.doi.org/10.1289/EHP137 [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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