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Air pollution and daily ED visits for migraine and headache in Edmonton, Canada.

https://arctichealth.org/en/permalink/ahliterature150066
Source
Am J Emerg Med. 2009 May;27(4):391-6
Publication Type
Article
Date
May-2009
Author
Mieczyslaw Szyszkowicz
David M Stieb
Brian H Rowe
Author Affiliation
Air Health Effects Research Section, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada K1A OK9. mietek_szyszkowicz@hc-sc.gc.ca
Source
Am J Emerg Med. 2009 May;27(4):391-6
Date
May-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Air Pollutants - adverse effects - analysis
Air Pollution - adverse effects
Alberta - epidemiology
Emergency Service, Hospital - utilization
Female
Headache - epidemiology - etiology
Humans
Linear Models
Male
Middle Aged
Migraine Disorders - epidemiology - etiology
Retrospective Studies
Risk factors
Seasons
Weather
Abstract
A variety of environmental factors have been identified as possible triggers for migraine and other headache syndromes.
We analyzed associations between air pollution and emergency department (ED) visits for migraine and headache.
Analysis was based on 56,241 ED visits for migraine and 48,022 ED visits for headache to Edmonton hospitals between 1992 and 2002. A Poisson model of counts hierarchically clustered by day of week, month, and year was applied using generalized linear mixed models. Temperature and relative humidity were included as covariates.
Females accounted for 78.5% of migraine visits and 56.3% of headache visits. An interquartile range (IQR) increase (6.2 microg/m3) in daily average particulate matter of median aerodynamic diameter less than 2.5 microm (PM2.5) was associated with increases in visits of 3.3% for migraine (95% confidence interval [CI]: 0.6-6.0), lagged 2 days, and 3.4% for headache (95% CI: 0.3-6.6), lagged 0 days, among females in the cold season (October-March). PM2.5 was also associated with cold season migraine visits among females at lag 0 and 1 day (P
PubMed ID
19555607 View in PubMed
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Air pollution and daily emergency department visits for depression.

https://arctichealth.org/en/permalink/ahliterature153438
Source
Int J Occup Med Environ Health. 2009;22(4):355-62
Publication Type
Article
Date
2009
Author
Mieczyslaw Szyszkowicz
Brian H Rowe
Ian Colman
Author Affiliation
Population Studies Division, Health Canada, Ottawa, ON, Canada. mietek_szyszkowicz@hc-sc.gc.ca
Source
Int J Occup Med Environ Health. 2009;22(4):355-62
Date
2009
Language
English
Publication Type
Article
Keywords
Air Pollutants - analysis
Canada - epidemiology
Cluster analysis
Depressive Disorder - epidemiology
Emergency Service, Hospital
Female
Humans
Linear Models
Male
Meteorological Concepts
Risk factors
Urban Population
Abstract
To investigate the potential correlation between ambient air pollution exposure and emergency department (ED) visits for depression.
A hierarchical clusters design was used to study 27 047 ED visits for depression in six cities in Canada. The data used in the analysis contain the dates of visits, daily numbers of diagnosed visits, and daily mean concentrations of air pollutants as well as the meteorological factors. The generalized linear mixed models technique was applied to data analysis. Poisson models were fitted to the clustered counts of ED visits with a single air pollutant, temperature and relative humidity.
Statistically significant positive correlations were observed between the number of ED visits for depression and the air concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), sulphur dioxide (SO2) and particulate matter (PM10). The percentage increase in daily ED visits was 15.5% (95% CI: 8.0-23.5) for CO per 0.8 ppm and 20.0% (95% CI: 13.3-27.2) for NO2 per 20.1 ppb, for same day exposure in the warm weather period (April-September). For PM10, the largest increase, 7.2% (95% CI: 3.0-11.6) per 19.4 ug/m3, was observed for the cold weather period (October-March).
The results support the hypothesis that ED visits for depressive disorder correlate with ambient air pollution, and that a large majority of this pollution results from combustion of fossil fuels (e.g. in motor vehicles).
PubMed ID
20197262 View in PubMed
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Air pollution and emergency department visits for otitis media: a case-crossover study in Edmonton, Canada.

https://arctichealth.org/en/permalink/ahliterature141881
Source
Environ Health Perspect. 2010 Nov;118(11):1631-6
Publication Type
Article
Date
Nov-2010
Author
Roger Zemek
Mieczyslaw Szyszkowicz
Brian H Rowe
Author Affiliation
Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada.
Source
Environ Health Perspect. 2010 Nov;118(11):1631-6
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Air Pollutants - analysis
Air Pollution - statistics & numerical data
Alberta
Carbon Monoxide - analysis
Child, Preschool
Cross-Over Studies
Emergency Service, Hospital - statistics & numerical data
Environmental monitoring
Epidemiological Monitoring
Female
Humans
Infant
Inhalation Exposure - analysis - statistics & numerical data
Logistic Models
Male
Nitrogen Dioxide - analysis
Odds Ratio
Otitis Media - epidemiology
Ozone - analysis
Particle Size
Particulate Matter - analysis
Risk factors
Sulfur Dioxide - analysis
Weather
Abstract
Otitis media (OM) is one of the most common early childhood infections, resulting in an enormous economic burden to the health care system through unscheduled doctor visits and antibiotic prescriptions.
The objective of this study was to investigate the potential association between ambient air pollution exposure and emergency department (ED) visits for OM.
Ten years of ED data were obtained from Edmonton, Alberta, Canada, and linked to levels of air pollution: carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide, and particulate matter (PM) of median aerometric diameter
Notes
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PubMed ID
20663739 View in PubMed
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Ambient ozone and emergency department visits for cellulitis.

https://arctichealth.org/en/permalink/ahliterature138755
Source
Int J Environ Res Public Health. 2010 Nov;7(11):4078-88
Publication Type
Article
Date
Nov-2010
Author
Mieczyslaw Szyszkowicz
Eugeniusz Porada
Gilaad G Kaplan
Brian H Rowe
Author Affiliation
Population Studies Division, Health Canada, 269 Laurier Avenue, Ottawa, ON K1A 0K9, Canada. mietek.szyszkowicz@hc-sc.gc.ca
Source
Int J Environ Res Public Health. 2010 Nov;7(11):4078-88
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Alberta
Cellulitis - etiology - therapy
Cross-Over Studies
Emergency Service, Hospital - utilization
Environmental Exposure
Female
Humans
Male
Odds Ratio
Ozone - analysis
Seasons
Abstract
Objectives were to assess and estimate an association between exposure to ground-level ozone and emergency department (ED) visits for cellulitis. All ED visits for cellulitis in Edmonton, Canada, in the period April 1992-March 2002 (N = 69,547) were examined. Case-crossover design was applied to estimate odds ratio (OR, and 95% confidence interval) per one interquartile range (IQR) increase in ozone concentration (IQR = 14.0 ppb). Delay of ED visit relating to exposure was probed using 0- to 5-day exposure lags. For all patients in the all months (January-December) and lags 0 to 2 days, OR = 1.05 (1.02, 1.07). For male patients during the cold months (October-March): OR = 1.05 (1.02, 1.09) for lags 0 and 2 and OR = 1.06 (1.02, 1.10) for lag 3. For female patients in the warm months (April-September): OR = 1.12 (1.06, 1.18) for lags 1 and 2. Cellulitis developing on uncovered (more exposed) skin was analyzed separately, observed effects being stronger. Cellulitis may be associated with exposure to ambient ground level ozone; the exposure may facilitate cellulitis infection and aggravate acute symptoms.
Notes
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PubMed ID
21139878 View in PubMed
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Ambient sulphur dioxide exposure and emergency department visits for migraine in Vancouver, Canada.

https://arctichealth.org/en/permalink/ahliterature151800
Source
Int J Occup Med Environ Health. 2009;22(1):7-12
Publication Type
Article
Date
2009
Author
Mieczyslaw Szyszkowicz
Brian H Rowe
Gilaad G Kaplan
Author Affiliation
Population Studies Division, Health Canada, Ottawa, ON, Canada. mietek_szyszkowicz@hc-sc.gc.ca
Source
Int J Occup Med Environ Health. 2009;22(1):7-12
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Air Pollutants - toxicity
Air Pollution - adverse effects
Canada - epidemiology
Child
Child, Preschool
Emergency Service, Hospital - statistics & numerical data
Environmental Exposure - adverse effects
Environmental monitoring
Epidemiological Monitoring
Female
Humans
Infant
Male
Middle Aged
Migraine Disorders - chemically induced
Seasons
Sex Factors
Sulfur Dioxide - toxicity
Young Adult
Abstract
Ambient exposure to sulphur dioxide (SO2) has been previously associated with emergency department (ED) visits for migraine headaches. In the present study, the objective was to examine the relationship between ED visits for migraine and ambient sulphur dioxide concentrations.
This was a time-series study of 1059 ED visits for migraine (ICD-9: 346) recorded at a Vancouver hospital between 1999 and 2003 (1 520 days). Air pollution levels of SO2 were measured by fixed-site monitoring stations. The generalized linear mixed models technique was applied to regress daily counts of ED visits for migraine on the levels of the pollutant after adjusting for meteorological conditions: temperature and relative humidity. The analysis was stratified by season and gender.
Positive and statistically significant correlations were observed for SO2 exposure and ED visits for migraine for females during colder months (October-March). The percentage increase in daily visits was 16.8% (95% CI: 1.2-34.8) for a 4-day average (of daily mean concentrations) SO2 level, for an interquartile range (IQR) increase of 1.9 ppb.
Our findings provide additional support for a consistent correlation between migraine headache and air pollution (SO2).
PubMed ID
19329386 View in PubMed
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Analysis of prehospital transport of head-injured patients after consolidation of neurosurgery resources.

https://arctichealth.org/en/permalink/ahliterature189076
Source
J Trauma. 2002 Aug;53(2):345-50; discussion 350
Publication Type
Article
Date
Aug-2002
Author
Carol D Holmen
Terry Sosnowski
Karen L Latoszek
Darryl Dow
Brian H Rowe
Author Affiliation
Division of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada. cholmen@ualberta.ca
Source
J Trauma. 2002 Aug;53(2):345-50; discussion 350
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alberta - epidemiology
Brain Injuries - diagnosis - mortality - therapy
Emergency Medical Services - organization & administration
Female
Hospital Restructuring
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Transfer - statistics & numerical data
Retrospective Studies
Triage - methods
Abstract
Consolidation of neurosurgical (NS) services resulted in emergency medical services guidelines mandating transport of head-injured patients to the NS center if the Glasgow Coma Scale score is 3. This study determined what paramedic, system, or patient factors were associated with secondary head-injury transfer.
This study was a retrospective chart review from January 1996 to November 1998.
Ninety-one patient charts were reviewed. The median transport delay to the NS site was 4 hours 22 minutes. After transfer, 79 (96%) patients were admitted, 25 (30%) underwent craniotomy, and 18 (22%) died. The final diagnosis in 35 (43%) cases was subdural hematoma. Triage guidelines were violated in five patients (6%) and the NS center was on diversion in three (4%) cases. Most delays were related to patient presentations; 17 (21%) patients had no history of head trauma.
Unpredictable patient factors were the most frequent reasons patients required secondary transfer; few protocol violations or system factors were identified. No modifications to the current NS triage criteria are recommended.
PubMed ID
12169945 View in PubMed
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Assessing inter-rater agreement of environmental audit data in a matched case-control study on bicycling injuries.

https://arctichealth.org/en/permalink/ahliterature116749
Source
Inj Prev. 2013 Oct;19(5):336-41
Publication Type
Article
Date
Oct-2013
Author
Nicole T R Romanow
Amy B Couperthwaite
Gavin R McCormack
Alberto Nettel-Aguirre
Brian H Rowe
Brent E Hagel
Author Affiliation
Departments of Paediatrics and Community Health Sciences, University of Calgary, , Calgary, Alberta, Canada.
Source
Inj Prev. 2013 Oct;19(5):336-41
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - statistics & numerical data
Adolescent
Adult
Bicycling - injuries
Canada
Case-Control Studies
Child
Environment Design - statistics & numerical data
Female
Humans
Male
Observer Variation
Public Health - methods
Young Adult
Abstract
Environmental audit tools must be reliable in order to accurately estimate the association between built environmental characteristics and bicycling injury risk.
To examine the inter-rater agreement of a built environment audit tool within a case-control study on the environmental determinants of bicycling injuries.
Auditor pairs visited locations where bicycling injuries occurred and independently recorded location characteristics using the Systematic Pedestrian and Cyclist Environmental Scan (SPACES). Two case groups were defined: (1) where a bicyclist was struck by a motor-vehicle (MV) and (2) where the bicyclist's injuries required hospitalisation. The two corresponding control groups were (1) where non-MV bicycle-related injuries occurred and (2) where minor bicycle-related injuries occurred. Inter-rater reliability of each item on the tool was assessed using observed agreement and ? with 95% CI.
Ninety-seven locations were audited. Inter-observer agreement was generally high (=95%); most items had a 1-2% difference in responses. Items with =5% differences between raters included path condition, slope and obstructions. For land use, path and roadway characteristics, ? ranged from 0.3 for presence of offices and cleanliness to 0.9 for schools and number of lanes; overall, 78% of items had at least substantial agreement (?=0.61). For bicyclists struck by a MV the proportion of items with substantial agreement was 60%, compared with 73% for non-MV related injuries. For hospitalisations and minor bicycle-related injuries, 76% of items had substantial agreement.
Agreement was substantial for most, but not all SPACES items. The SPACES provides reliable quantitative descriptions of built environmental characteristics at bicycling injury locations.
PubMed ID
23364159 View in PubMed
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Assessing the sensibility of two clinical decision support systems.

https://arctichealth.org/en/permalink/ahliterature155030
Source
J Med Syst. 2008 Oct;32(5):361-8
Publication Type
Article
Date
Oct-2008
Author
Timothy A D Graham
Michael J Bullard
Andre W Kushniruk
Brian R Holroyd
Brian H Rowe
Author Affiliation
Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada. graham71@gmail.com
Source
J Med Syst. 2008 Oct;32(5):361-8
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Alberta
Community-Acquired Infections
Decision Support Systems, Clinical - standards
Emergency medical services
Female
Health Care Surveys
Humans
Male
Middle Aged
Neutropenia
Questionnaires
Young Adult
Abstract
Clinicians in Emergency Medicine (EM) are increasingly exposed to guidelines and treatment recommendations. To help access and recall these recommendations, electronic Clinical Decision Support Systems (CDSS) have been developed. This study examined the use and sensibility of two CDSS designed for emergency physicians. CDDS for community acquired pneumonia (CAP) and neutropenic fever (NF) were developed by multidisciplinary teams and have been accessed via an intranet-based homepage (eCPG) for several years. Sensibility is a term coined by Feinstein that describes common sense aspects of a survey instrument. It was modified by emergency researchers to include four main headings: (1) Appropriateness; (2) Objectivity; (3) Content; and (4) Discriminative Power. Sensibility surveys were developed using an iterative approach for both the CAP and NF CDSS and distributed to all 25 emergency physicians at one Canadian site. The overall response rate was 88%. Respondents were 88% male and 83% were less than 40; all were attending EM physicians with specialty designations. A number reported never having used the CAP (21%) or NF (33%) CDSS; 54% (CAP) and 21% (NF) of respondents had used the respective CDSS less than 10 times. Overall, both CDSS were rated highly by users with a mean response of 4.95 (SD 0.56) for CAP and 5.62 (SD 0.62) for NF on a seven-point Likert scale. The majority or respondents (CAP 59%, NF 80%) felt that the NF CDSS was more likely than the CAP CDSS to decrease the chances of making a medical error in medication dose, antibiotic choice or patient disposition (4.61 vs. 5.81, p=0.008). Despite being in place for several years, CDSS for CAP and NF are not used by all EM clinicians. Users were generally satisfied with the CDSS and felt that the NF was more likely than the CAP CDSS to decrease medical errors. Additional research is required to determine the barriers to CDSS use.
PubMed ID
18814492 View in PubMed
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Associations between outdoor air pollution and emergency department visits for stroke in Edmonton, Canada.

https://arctichealth.org/en/permalink/ahliterature166990
Source
Eur J Epidemiol. 2006;21(9):689-700
Publication Type
Article
Date
2006
Author
Paul J Villeneuve
Li Chen
Dave Stieb
Brian H Rowe
Author Affiliation
Air Health Effects Division, Environmental Contaminants Bureau, Health Canada, 269 Laurier Ave. W. 3rd Floor, 3-022 PL4903C, Ottawa, Ontario, Canada, K1A 0K9. Paul_Villeneuve@hc-sc.gc.ca
Source
Eur J Epidemiol. 2006;21(9):689-700
Date
2006
Language
English
Publication Type
Article
Keywords
Aged
Air Pollutants - toxicity
Air Pollution - adverse effects
Canada
Carbon Monoxide - toxicity
Cerebral Hemorrhage - chemically induced
Emergency Medical Services - statistics & numerical data
Hospital Departments
Humans
Nitrogen Dioxide - toxicity
Odds Ratio
Risk factors
Seasons
Stroke - chemically induced - epidemiology - etiology
Vehicle Emissions - toxicity
Abstract
Inconsistent results have been obtained from studies that have examined the relationship between air pollution and hospital visits for stroke. We undertook a time-stratified case-crossover study to evaluate associations between outdoor air pollution and emergency department visits for stroke among the elderly according to stroke type, season, and sex. Analyses are based on a total of 12,422 stroke visits among those 65 years of age and older in Edmonton, Canada between April 1, 1992 and March 31, 2002. Daily air pollution levels for SO(2), NO(2), PM(2.5), PM(10), CO and O(3) were estimated using data from fixed-site monitoring stations. Particulate matter data were only available from 1998 onwards. Conditional logistic regression was used to estimate the odds ratios (ORs) and their 95% confidence intervals in relation to an increase in the interquartile range (IQR) of each pollutant. ORs were adjusted for the effects of temperature and relative humidity. We found no association between outdoor measures of air pollution and all stroke visits. In contrast, elevated risks were observed between levels of air pollution and acute ischemic stroke between April and September. During this season, the ORs associated with an increase in the IQR of the 3-day average for CO and NO(2) were 1.32 (95% CI = 1.09-1.60) and 1.26 (95% CI = 1.09-1.46), respectively. CO exposures in the same season, lagged 1 day, were associated with an increased risk of hemorrhagic stroke with ORs was 1.20 (95% CI = 1.00-1.43). Our results suggest it is possible that vehicular traffic, which produces increased levels of NO(2) and CO, contributes to an increased incidence of emergency department visits for stroke.
PubMed ID
17048082 View in PubMed
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Asthma presentations by adults to emergency departments in Alberta, Canada: a large population-based study.

https://arctichealth.org/en/permalink/ahliterature155763
Source
Chest. 2009 Jan;135(1):57-65
Publication Type
Article
Date
Jan-2009
Author
Brian H Rowe
Donald C Voaklander
Dongsu Wang
Ambikaipakan Senthilselvan
Terry P Klassen
Thomas J Marrie
Rhonda J Rosychuk
Author Affiliation
Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada.
Source
Chest. 2009 Jan;135(1):57-65
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Alberta - epidemiology
Asthma - epidemiology - therapy
Databases, Factual
Emergency Service, Hospital - utilization
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Retrospective Studies
Sex Distribution
Socioeconomic Factors
Young Adult
Abstract
Asthma is a widespread disease with a prevalence of approximately 7 to 10% in adults. Exacerbations are common in the emergency department (ED) setting. The objective of this study was to describe the epidemiology of asthma presentations to EDs made by adults in the province of Alberta, Canada.
The Ambulatory Care Classification System of Alberta and provincial administrative databases were used to obtain all ED encounters for asthma during 6 fiscal years (April 1999 to March 2005). Information extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Data analysis included descriptive summaries and directly standardized visit rates.
There were 105,813 ED visits for asthma made by 48,942 distinct adults, with an average of 2.2 visits per individual. Most patients (66%) had only one asthma-related ED visit. Female patients (61.2%) presented more commonly than male patients. The gender- and age-standardized visit rates declined from 9.7/1,000 in 1999/2000 to 6.8/1,000 in 2004/2005. The welfare and Aboriginal subsidy groups had larger age-specific ED visits rates than other populations. Important daily, weekly, and monthly trends were observed. Hospital admission occurred in 9.8% of the cases; 6.4% had a repeat ED visit within 7 days. Overall, 67.4% of individuals had yet to have a non-ED follow-up visit by 1 week. The estimated median time to the first follow-up visit was 19 days (95% confidence interval, 18 to 21).
Asthma is a common presenting problem in Alberta EDs, and further study of these trends is required to understand the factors associated with the variation in presentations. The important findings include an overall decrease in the rates of presentation over the study period, disparities based on age, gender, and socioeconomic/cultural status, and the low rate of early follow-up. Targeted interventions could be implemented to address specific groups and reduce asthma-related visits to Alberta EDs.
PubMed ID
18689586 View in PubMed
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103 records – page 1 of 11.