An outbreak of cardiovascular syndromes requiring urgent medical treatment and i

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Environ Health. 2007 Nov 25;6(1):37 [Epub ahead of print]

 

An outbreak of cardiovascular syndromes requiring urgent medical treatment

and its association with environmental factors: an ecological study.

Turner RM, Muscatello DJ, Zheng W, Willmore A, Arendts G.

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ABSTRACT:

 

BACKGROUND: In April 2005, syndromic surveillance based on statistical

control chart methods in Sydney, Australia, signalled increasing incidence of

urgent emergency department visits for cardiovascular and chest pain syndromes

compared to the preceding twelve months. This paper aimed to determine whether

environmental factors could have been responsible for this 'outbreak'.

 

METHODS: The outcome studied was daily counts of emergency department visits

for cardiovascular or chest pain syndromes that were considered immediately

or imminently life threatening on arrival at hospital. The outbreak had a

mean daily count of 5.7 visits compared with 4.0 in the same months in previous

years sustained for eight weeks. Poisson regression was used to

systematically assess the emergency department visits in relation to available

daily

weather and pollution variables by first finding the best model that explained

short-term variation in the outcome over the period 25 January 2002 to 31 May

2005, and then assessing interactions of all available variables with the

'outbreak' period, April-May 2005. Rate ratios were estimated for an

interquartile

increase in each variable meaning that the ratio measures the relative

increase (or decrease) in the emergency department visits for an interquartile

increase in the weather or pollution variable. The rate ratios for the outbreak

period measure the relative increase (or decrease) in the emergency

department visits for an interquartile increase in the weather or pollution

variable

during the outbreak period only.

 

RESULTS: The best fitting model over the whole study period included minimum

temperature with a rate ratio (RR) of 0.86(95% confidence interval (CI),

0.77-0.96), maximum relative humidity of 1.09(95% CI 1.05-1.14) and minimum

daily particulate matter less than 10 microns (PM10) of 1.05(95% CI,

1.01-1.09).

During the outbreak period, maximum temperature (RR 1.27, 95% CI 1.03-1.57),

solar radiation (RR 1.44, 95% CI, 1.00-2.07) and ozone (RR 1.13, 95% CI

1.01-1.26) were associated with the outcome.

 

CONCLUSIONS: The increase may have been associated with photochemical

pollution. Syndromic surveillance can identify outbreaks of non-communicable

diseases associated with environmental factors.

 

PMID: 18036253 [PubMed - as supplied by publisher]

 

_http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed & cmd=Retrieve & dopt=Abstract

Plus & list_uids=18036253 & itool=iconabstr & itool=pubmed_DocSum_

(http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed & cmd=Retrieve & dopt=AbstractPl\

us & list_uids=18

036253 & itool=iconabstr & itool=pubmed_DocSum)

 

 

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