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Health Services Utilization in Asthma Exacerbations and PM10 Levels in Rural Colorado.
Ann Am Thorac Soc. 2018 08; 15(8):947-954.AA

Abstract

RATIONALE

The San Luis Valley in rural Colorado often has elevated levels of ambient particulate matter. To date little is known about the impact of ambient particulate matter levels and medical care utilization due to asthma exacerbation in rural communities.

OBJECTIVES

We investigated the impact of ambient particulate matter concentrations on emergency/urgent visits and hospitalizations for asthma in a rural community.

METHODS

Daily ambient particulate matter concentrations from an air quality monitor in the San Luis Valley (2003-2012) were obtained from the state health department. Deidentified data for emergency/urgent visits with a diagnosis code for asthma were collected from the local health care system organization. A generalized linear model using splines and employing generalized estimating equations for correlated measures over time was used to examine the association between daily counts of emergency/urgent visits for asthma and 3- to 5-day averaged ambient particulate matter concentrations.

RESULTS

For each 15-μg/m3 increase in 3-day averaged ambient particulate matter, there was an associated 3.1% increase in hospital counts for all patients with asthma (95% confidence interval, 0.3-5.9%; P = 0.03). When the 3-day average exceeded 50 μg/m3, asthma hospital visits increased by 16.8% (P = 0.03), and when it exceeded 100 μg/m3, visits increased by 65.8% (P = 0.002). In children, the odds of one asthma event requiring an emergency/urgent care visit increased 5.0% with each 15-μg/m3 increase in 3-day averaged ambient particulate matter (P = 0.22).

CONCLUSIONS

We observed associations between ambient air levels of particulate matter with a diameter less than 10 μm and emergency/urgent care visits and hospitalization counts in a rural U.S. community prone to dust storms and Environmental Protection Agency exceedances.

Authors+Show Affiliations

1 University of Colorado, Denver, Colorado; and.2 National Jewish Health, Denver, Colorado.1 University of Colorado, Denver, Colorado; and.1 University of Colorado, Denver, Colorado; and. 2 National Jewish Health, Denver, Colorado.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29979621

Citation

James, Katherine A., et al. "Health Services Utilization in Asthma Exacerbations and PM10 Levels in Rural Colorado." Annals of the American Thoracic Society, vol. 15, no. 8, 2018, pp. 947-954.
James KA, Strand M, Hamer MK, et al. Health Services Utilization in Asthma Exacerbations and PM10 Levels in Rural Colorado. Ann Am Thorac Soc. 2018;15(8):947-954.
James, K. A., Strand, M., Hamer, M. K., & Cicutto, L. (2018). Health Services Utilization in Asthma Exacerbations and PM10 Levels in Rural Colorado. Annals of the American Thoracic Society, 15(8), 947-954. https://doi.org/10.1513/AnnalsATS.201804-273OC
James KA, et al. Health Services Utilization in Asthma Exacerbations and PM10 Levels in Rural Colorado. Ann Am Thorac Soc. 2018;15(8):947-954. PubMed PMID: 29979621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health Services Utilization in Asthma Exacerbations and PM10 Levels in Rural Colorado. AU - James,Katherine A, AU - Strand,Matthew, AU - Hamer,Mika K, AU - Cicutto,Lisa, PY - 2018/7/7/pubmed PY - 2019/11/22/medline PY - 2018/7/7/entrez KW - ambient particulate matter KW - asthma KW - children KW - exacerbations KW - rural SP - 947 EP - 954 JF - Annals of the American Thoracic Society JO - Ann Am Thorac Soc VL - 15 IS - 8 N2 - RATIONALE: The San Luis Valley in rural Colorado often has elevated levels of ambient particulate matter. To date little is known about the impact of ambient particulate matter levels and medical care utilization due to asthma exacerbation in rural communities. OBJECTIVES: We investigated the impact of ambient particulate matter concentrations on emergency/urgent visits and hospitalizations for asthma in a rural community. METHODS: Daily ambient particulate matter concentrations from an air quality monitor in the San Luis Valley (2003-2012) were obtained from the state health department. Deidentified data for emergency/urgent visits with a diagnosis code for asthma were collected from the local health care system organization. A generalized linear model using splines and employing generalized estimating equations for correlated measures over time was used to examine the association between daily counts of emergency/urgent visits for asthma and 3- to 5-day averaged ambient particulate matter concentrations. RESULTS: For each 15-μg/m3 increase in 3-day averaged ambient particulate matter, there was an associated 3.1% increase in hospital counts for all patients with asthma (95% confidence interval, 0.3-5.9%; P = 0.03). When the 3-day average exceeded 50 μg/m3, asthma hospital visits increased by 16.8% (P = 0.03), and when it exceeded 100 μg/m3, visits increased by 65.8% (P = 0.002). In children, the odds of one asthma event requiring an emergency/urgent care visit increased 5.0% with each 15-μg/m3 increase in 3-day averaged ambient particulate matter (P = 0.22). CONCLUSIONS: We observed associations between ambient air levels of particulate matter with a diameter less than 10 μm and emergency/urgent care visits and hospitalization counts in a rural U.S. community prone to dust storms and Environmental Protection Agency exceedances. SN - 2325-6621 UR - https://www.unboundmedicine.com/medline/citation/29979621/Health_Services_Utilization_in_Asthma_Exacerbations_and_PM10_Levels_in_Rural_Colorado_ L2 - https://www.atsjournals.org/doi/10.1513/AnnalsATS.201804-273OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -