Effects of air pollution and meteorological factors on long-term institutional care of elderly people in Tainan City, Taiwan

摘要

Background: Knowledge to understand the adverse health effects of air pollution have a rich history and been proven in substantial health studies and large-scale surveys. Objectives: This study is an attempt to use the epidemiological approach to investigate the health impacts of air pollution and meteorological factors on cardiovascular and respiratory disease among demented people in the long-term institutions in Tainan City, Taiwan. Methods: The daily air pollutant measurements retrieved from Taiwan EPA monitoring stations contain levels of SO2, NO2, CO, PM10 and 03. Daily meteorological data, including temperature, humidity, precipitation amounts, barometric pressure, wind direction, and wind speed, were provided by the Central Weather Bureau (CWB) of Taiwan. The medical records demented elderly people, including gender, age, diagnosis, and disposition, were claimed by several major long-term institutions in Tainan City during the period January 1, 2010, to December 31, 2012. Time-series analysis and generalized linear mixed model (GLIMMIX) were used to evaluate the short-term impacts of five primary pollutants and lag effects on daily morbidity and mortality for cardiovascular and respiratory disease, adjusting for calendar month and meteorological covariates. Results: The levels of PM10 appeared to be associated with morbidity risks of cardiovascular disease for both genders, especially for the elderly in cold weather. However, respiratory disease were more likely to happen in the population aged 65 and older who were found to be more susceptible to the extremely high 03 concentration (99th percentile). Conclusions: Daily air pollutant levels were associated with increases of incidence for cardiovascular and respiratory disease for those aged 65 and over in long-term institutions, highlighting the need for precautionary measures.