| Summary: | 碩士 === 中國醫藥大學 === 環境醫學研究所 === 93 === Chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) are important public health problems in the world. The mortality from COPD and IHD have been related to meteorologic factors in studies, but whether a cold environment is associated with acute exacerbation of COPD or acute coronary syndrome (ACS) is not well known. This study examined the relationship between environmental temperature and acute exacerbation of COPD and ACS attack.
The purpose of this study was to assess the association between ambient temperature and emergency room (ER) visits for COPD and ACS in an ER in Taichung. The design was a longitudinal study in which examined the relationship between highest daily temperature (HDT), lowest daily temperature (LDT), mean of daily temperature (MDT), variation of daily temperature (VDT) and the visits of COPD and ACS to the ER of the city’s largest hospital. Daily ER visits for COPD, ACS and ambient temperature were collected from January 1, 2000 to March 31, 2003. The multivariate Poisson regression model was used in the analysis.
After adjusting for the effects of holiday, season, and air pollutants the results showed that there was a negative significant association between HDT, LDT, MDT and COPD visits. The risk of COPD visits increased 30% when HDT below 30.0℃, compared with 32.2℃ or greater. There were 70% excess risk of COPD visits when LDT below 18.9℃, compared with LDT higher than 25.5℃. When MDT below 22.3℃ the risk of COPD visits raised 35%, compared with MDT above 28.4℃. The ambient temperature played an important role in COPD morbidity but not in ACS. A positive association between VDT and ACS visits was noted but no significant association between VDT and COPD visits. The risk of ACS visits increased 19.4% when VDT was 9.0℃ or greater, compared with VDT below 5.5℃.
The data indicate that patients with COPD or IHD must be made aware of the increased risk posed by lower ambient temperature and larger temperature change. Hospitals and ERs should take into account the increased demand of specific facilities during colder weather and larger temperature variation.
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