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HERO ID
1790950
Reference Type
Journal Article
Title
Ambient ozone concentrations and the risk of perforated and nonperforated appendicitis: A multicity case-crossover study
Author(s)
Kaplan, GG; Tanyingoh, D; Dixon, E; Johnson, M; Wheeler, AJ; Myers, RP; Bertazzon, S; Saini, V; Madsen, K; Ghosh, S; Villeneuve, PJ
Year
2013
Is Peer Reviewed?
Yes
Journal
Environmental Health Perspectives
ISSN:
0091-6765
EISSN:
1552-9924
Volume
121
Issue
8
Page Numbers
939-943
Language
English
PMID
23842601
DOI
10.1289/ehp.1206085
Web of Science Id
WOS:000323711700022
Relationship(s)
is supplemented by
4543557
: Supplemental materials
Abstract
BACKGROUND:
Environmental determinants of appendicitis are poorly understood. Past work suggests that air pollution may increase the risk of appendicitis.
OBJECTIVES:
We investigated whether ambient ground-level ozone concentrations were associated with appendicitis and whether these associations varied between perforated and nonperforated appendicitis.
METHODS:
This time-stratified case-crossover study was based on 35,811 individuals hospitalized with appendicitis from 2004-2008 in 12 Canadian cities. Data from a national network of fixed-site monitors were used to calculate daily maximum ozone concentrations for each city. Conditional logistic regression was used to estimate city-specific odds ratios (OR) relative to an interquartile range (IQR) increase in ozone adjusted for temperature and relative humidity. A random effects meta-analysis was used to derive a pooled risk estimate. Stratified analyses were used to estimate associations separately for perforated and nonperforated appendicitis.
RESULTS:
Overall, a 16 ppb increase in the 7-day cumulative average daily maximum ozone concentration was associated with all appendicitis cases across the 12 cities (pooled OR=1.07; 95% CI: 1.02, 1.13). The association was stronger among patients presenting with perforated appendicitis for the 7-day average (pooled OR=1.22; 95% CI: 1.09, 1.36), when compared to the corresponding estimate for nonperforated appendicitis (7-day average: pooled OR=1.02, 95% CI: 0.95, 1.09). Heterogeneity was not statistically significant across cities for either perforated or nonperforated appendicitis (p>0.20).
CONCLUSIONS:
Our findings suggest that higher levels of ambient ozone exposure may increase the risk of perforated appendicitis.
Keywords
air pollution; appendicitis; environmental health; risk factors
Tags
NAAQS
•
ISA-NOx (2016)
Considered
Health Effects
•
ISA-Ozone (2013 Final Project Page)
Health Effects
•
ISA-Ozone (2020 Final Project Page)
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Topic Classified Epidemiology
Title-Abstract Screening (SWIFT-AS) - Included
Title-Abstract Screening (SWIFT-AS) - Included
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