title: Association between Atmospheric Fine Particulate Matter and Hospital Admissions for Chronic Obstructive Pulmonary Disease in Southwestern Taiwan: A Population-Based Study.
abstract: OBJECTIVE
  This paper reports on the findings of a population-based study to evaluate the relationship between atmospheric fine particulate matter (PM2.5) levels and hospital admissions for chronic obstructive pulmonary disease (COPD) in southwestern Taiwan over a three-year period, 2008-2010.
  
  
  METHODS
  Data on hospital admissions for COPD and PM2.5 levels were obtained from the National Health Insurance Research database (NHIRD) and the Environmental Protection Administration from 2008 to 2010, respectively. The lag structure of relative risks (RRs) of hospital admissions for COPD was estimated using a Poisson regression model.
  
  
  RESULTS
  During the study period, the overall average hospitalization rate of COPD and mean 24-h average level of PM2.5 was 0.18% and 39.37 μg/m³, respectively. There were seasonal variations in PM2.5 concentrations in southwestern Taiwan, with higher PM2.5 concentrations in both spring (average: 48.54 μg/m³) and winter (49.96 μg/m³) than in summer (25.89 μg/m³) and autumn (33.37 μg/m³). Increased COPD admissions were significantly associated with PM2.5 in both spring (February-April) and winter (October-January), with the relative risks (RRs) for every 10 μg/m³ increase in PM2.5 being 1.25 (95% CI = 1.22-1.27) and 1.24 (95% CI = 1.23-1.26), respectively, at a lag zero days (i.e., no lag days). Lag effects on COPD admissions were observed for PM2.5, with the elevated RRs beginning at lag zero days and larger RRs estimates tending to occur at longer lags (up to six days, i.e., lag 0-5 days).
  
  
  CONCLUSIONS
  In general, findings reveal an association between atmospheric fine particulate matter (PM2.5) and hospital admissions for COPD in southwestern Taiwan, especially during both spring and winter seasons.
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi County 613, Taiwan. slhuang@mail.cgust.edu.tw.|Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi County 613, Taiwan. slhuang@mail.cgust.edu.tw.
authors.forename: Su-Lun
authors.initials: SL
authors.lastname: Hwang
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi County 613, Taiwan. seguo@mail.cgust.edu.tw.|Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi County 613, Taiwan. seguo@mail.cgust.edu.tw.
authors.forename: Su-Er
authors.initials: SE
authors.lastname: Guo
authors.affiliation: Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi County 613, Taiwan. mcchi@mail.cgust.edu.tw.|Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi County 613, Taiwan. mcchi@mail.cgust.edu.tw.
authors.forename: Miao-Ching
authors.initials: MC
authors.lastname: Chi
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi County 613, Taiwan. ctchou@mail.cgust.edu.tw.|Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi County 613, Taiwan. ctchou@mail.cgust.edu.tw.
authors.forename: Chiang-Ting
authors.initials: CT
authors.lastname: Chou
authors.affiliation: Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi County 613, Taiwan. lin0927@cgmh.org.tw.|Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi County 613, Taiwan. lin0927@cgmh.org.tw.|Department of Respiratory Care, Chang Gung University, Taoyuan 333, Taiwan. lin0927@cgmh.org.tw.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi County 613, Taiwan. f124510714@cgmh.org.tw.|Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi County 613, Taiwan. f124510714@cgmh.org.tw.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan. f124510714@cgmh.org.tw.
authors.forename: Chieh-Mo
authors.initials: CM
authors.lastname: Lin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi County 613, Taiwan. mr2554@cgmh.org.tw.
authors.forename: Yen-Li
authors.initials: YL
authors.lastname: Chou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis*; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced / Q000453:epidemiology*; D012621:Seasons; D013624:Taiwan / Q000453:epidemiology
chemical_list: D052638:Particulate Matter
keywords: chronic obstructive pulmonary disease; fine particulate matter; hospital admissions