| Background:With the increase of human activities and the development of social industrialization, living enviroment has changed a lot. The relationship between enrioment and human health has aroused growing concerns.nasal cavity as the first part of the human respiratory pathway, directly perceived changes in the external environment. There were research reported that air pollution may lead to produce a series of pathophysiological changes in nasal mucosa and eventually cause diseases. In ENT diagnosis and treatment process, epistaxis emergency has associated with climate changes and air pollutants levels. Recently some studies have attempted to use meteorological factors and ambient air pollution as indicators to predict epistaxis.Objective:This study intends to comprehensively investigate and analysis the relationship of meteorological factors and ambient air pollution with the frequency of epistaxis emergency, which may be critical for epistaxis prevention as well as treatment.Methods:The study was collected statistics of epistaxis emergency in the Eye Ear Nose and Throat Hospital of Fudan University in Shanghai, China, from the time of January 2009 to December 2011 (1,095 days), which including a total of 1049 cases after screening. Meteorological data (daily mean, maximal, and minimal temperature; relative humidity and barometric pressure) were obtained from the database of Shanghai Meteorological Bureau. Daily air pollution data, including PMi0, SO2, and NO2, were obtained from Shanghai Environmental Monitoring Center (SEMC), the government agency in charge of collection of air pollution data in Shanghai. A time-series design was adopted to analyze the short-term effects of meteorological factors and air pollution on daily epistaxis emergency. We used generalized additive Poisson regression models (GAM) to analyze these data.Results:According to the diagram of GAM, There was a negative correlation between temperature and the frequency of epistaxis emergency, while barometric pressure and diurnal temperature range (DTR) had a positive correlation with epistaxis; The relative humidity had inverted U-shaped trend, therefore at the turning point 65%,the data would be divided into two parts for analysis. Ambient air pollution PM10, SO2 and NO2 had a positive correlation with epistaxis emergency. From the Lag effect analysis, temperature had a short and immediate effect on epistaxis emergency. An decline of l℃ of temperature corresponded to 1.48%[95% confidence interval(CI):-2.15,-0.81] increase of epistaxis emergency. Barometric pressure and DTR also had immediate effect. An increase of 1 pa of barometric pressure corresponded to 1.18%(95%Cl:0.50,1.87) increase of epistaxis emergency; An increase of 1℃ of DTR corresponded to 2.86%(95%Cl:0.54,5.18) increase of epistaxis emergency. When the relative humidity was below 65%, there was no significance of statistics to conduct the effect of epistaxis emergency. On the other hand, at the point of high moisture condition (greater than 65% relative humidity) had a long-time protection on epistaxis emergency. The most effective point appeared LagO3, which meant that an increase of one unit of relative humidity corresponded to 1.82%(95%CI:-2.71,-0.93) decline of epistaxis emergency. The single-day lag effect of PM10 appeared early and persisted a short time, while the multi-day lag effect of PM10 appeared early but persisted a long time and also had obvious accumulated effect. An increase of 10μg/m3 concentration of PM10 corresponded to 5.30%(95%CI:1.67,8.93) increase of epistaxis emergency. The effect of NO2 and SO2 were weak, which could not proceed statistical inference.Conclusions:There was a negative correlation between temperature and the frequency of epistaxis emergency, while barometric pressure and diurnal temperature range had a positive correlation with epistaxis.All these three meteorological factors had a short influence on epistaxis emergency. High moisture condition (greater than 65% relative humidity) had a long-time protection on epistaxis emergency. The single-day lag effect of PM10 appeared early and persisted a short time, while the multi-day lag effect of PM10 appeared early but persisted a long time and also had obvious accumulated effect.The effect of NO2 and SO2 were weak, which could not proceed statistical inference. |
PDF Full Text Request