Assessing the impact of specific PM2.5-Bound metallic elements on asthma emergency department visits: A case-crossover study in Taiwan

Miku Kono; Ting-Yao Su; Yu-Yin Chang; Charles Chung-Kuang Chou; Chung-Te Lee; Pau-Chung Chen; Wei-Te Wu

doi:10.1016/j.envres.2024.119130

Assessing the impact of specific PM_2.5-Bound metallic elements on asthma emergency department visits: A case-crossover study in Taiwan

Environ Res. 2024 May 11:255:119130. doi: 10.1016/j.envres.2024.119130. Online ahead of print.

Authors

Miku Kono¹, Ting-Yao Su², Yu-Yin Chang¹, Charles Chung-Kuang Chou³, Chung-Te Lee⁴, Pau-Chung Chen⁵, Wei-Te Wu⁶

Affiliations

¹ National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.
² National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; School of Public Health, National Defense Medical Center, Taipei City, Taiwan.
³ Research Center for Environmental Changes, Academia Sinica, Taipei City, Taiwan.
⁴ Graduate Institute of Environmental Engineering, National Central University, Taoyuan City, Taiwan.
⁵ National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
⁶ National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, National Yang-Ming Chiao Tung University, Taipei, Taiwan. Electronic address: ader.una@gmail.com.

PMID: 38735375
DOI: 10.1016/j.envres.2024.119130

Abstract

Objectives: This study aims to assess the specific PM_2.5-bound metallic elements that contribute to asthma emergency department visits by using a case-crossover study design.

Methods: This study analyzed data from 11,410 asthma emergency department visits as case group and 22,820 non-asthma onset dates occurring one week and two weeks preceding the case day as controls from 2017 to 2020. PM_2.5 monitoring data and 35 PM._2.5-bound metallic elements from six different regions in Taiwan were collected. Conditional logistic regression models were used to assess the relationship between asthma and PM_2.5-bound metallic elements.

Results: Our investigation revealed a statistically significant risk of asthma emergency department visits associated with PM_2.5 exposure at lag 0, 1, 2, and 3 during autumn. Additionally, PM_2.5-bound hafnium (Hf), thallium (Tl), rubidium (Rb), and aluminum (Al) exhibited a consistently significant positive correlation with asthma emergency department visits at lags 1, 2, and 3. In stratified analyses by area, age, and sex, PM_2.5-bound Hf showed a significant and consistent correlation.

Conclusions: This study provides evidence of PM_2.5-bound metallic elements effects in asthma exacerbations, particularly for Hf. It emphasizes the importance of understanding the origins of these metallic elements and pursuing emission reductions to mitigate regional health risks.

Keywords: Asthma; Case-crossover study; PM(2.5)-bound metallic elements; Precision environmental health.