Journal of The Korean Society of Emergency Medicine (대한응급의학회지)

The Korean Society of Emergency Medicine (대한응급의학회)
권호 표지

Effect of regional climatic conditions, air pollutants, and season on the occurrence and severity of injury in trauma patients

  • Kim, Young-Min (Department of Emergency Medicine, Chungbuk National University Hospital) ;
  • Yu, Gyeong-Gyu (Department of Emergency Medicine, Chungbuk National University School of Medicine) ;
  • Shin, Hyun-Jo (Department of Emergency Medicine, Chungbuk National University Hospital) ;
  • Lee, Suk-Woo (Department of Emergency Medicine, Chungbuk National University Hospital) ;
  • Park, Jung-Soo (Department of Emergency Medicine, Chungnam National University School of Medicine) ;
  • Kim, Hoon (Department of Emergency Medicine, Chungbuk National University Hospital)
  • ;
  • ;
  • ;
  • ;
  • ;
  • 김훈 (충북대학교 의과대학 응급의학교실)
  • Received : 2018.05.10
  • Accepted : 2018.09.28
  • Published : 2018.12.31

⟨ Previous Next ⟩

Abstract

Objective: We analyzed the association between regional weather and temporal changes on the daily occurrence of trauma emergencies and their severity. Methods: In this cross-sectional prospective study, we investigated daily atmospheric patterns in trauma episodes in 1,344 patients in Cheongju city, South Korea, from January 2016 to December 2016 and analyzed the association of trauma occurrence and Injury Severity Scores (ISS) with weather conditions on a daily scale. Results: The mean age of trauma patients was $53.0{\pm}23.8years$ and average ISS was $9.0{\pm}2.0$. Incidence of trauma was positively correlated with average temperature (r=0.512, P<0.001) and atmospheric pressure (r=0.332, P=0.010) and negatively correlated with air pollutants (particulate matter less than $2.5{\mu}m^3$ [PM2.5], r=-0.629, P<0.001; particulate matter less than $10{\mu}m^3$ [PM10], r=-0.679, P<0.001). ISS was not significantly correlated with climate parameters and air pollutants, and variability was observed in the frequency and severity of trauma by time of day (highest occurrence, 16-20 pm; highest ISS, 4-8 am), day of the week (highest occurrence and highest ISS, Saturday), month of the year (highest occurrence, July; highest ISS, November), and season (highest incidence, summer; highest ISS, autumn). Conclusion: The study shows a positive relationship between trauma occurrence and specific weather conditions, such as atmospheric temperature and pressure. There was a negative relationship between concentrations of PM2.5 or PM10, and trauma occurrence. However, no correlation was observed between weather conditions or the concentrations of air pollutants and ISS. In addition, seasonal, circaseptan, and circadian variations exist in trauma occurrence and severity. Thus, we suggest that evaluation of a larger, population-based data set is needed to further investigate and confirm these relationships.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea

References

  1. World Health Organization. Injuries and violence: the facts [Internet]. Geneva: World Health Organization; 2010 [cited 2018 May 10]. Available from: http://whqlibdoc.who.int/publications/2010/9789241599375_eng.pdf.
  2. Web-based Injury Statistics Query and Reporting System. Annual report of Centers for Disease Control and Prevention: trauma statistics 2014. Atlanta, GA: Centers for Disease Control and Prevention; 2014.
  3. Theofilatos A, Yannis G. A review of the effect of traffic and weather characteristics on road safety. Accid Anal Prev 2014;72:244-56. https://doi.org/10.1016/j.aap.2014.06.017
  4. Organization for Economic Co-operation and Development/International Transport Forum. Road safety annual report, 2015 [Internet]. Paris: OECD Publishing; 2015 [cited 2018 orumMay 10]. Available from: https://www.itf-oecd.org/sites/default/files/docs/15irtadannualreport_0.pdf.
  5. Newnam S, Goode N. Do not blame the driver: a systems analysis of the causes of road freight crashes. Accid Anal Prev 2015;76:141-51. https://doi.org/10.1016/j.aap.2015.01.016
  6. Dastoorpoor M, Idani E, Khanjani N, Goudarzi G, Bahrampour A. Relationship between air pollution, weather, traffic, and traffic-related mortality. Trauma Mon 2016;21:e37585.
  7. Laursen B, Nielsen JW. Influence of sociodemographic factors on the risk of unintentional childhood home injuries. Eur J Public Health 2008;18:366-70. https://doi.org/10.1093/eurpub/ckn034
  8. Usman T, Fu L, Miranda-Moreno LF. A disaggregate model for quantifying the safety effects of winter road maintenance activities at an operational level. Accid Anal Prev 2012;48:368-78. https://doi.org/10.1016/j.aap.2012.02.005
  9. Ho VP, Towe CW, Chan J, Barie PS. How's the weather? Relationship between weather and trauma admissions at a Level I Trauma Center. World J Surg 2015;39:934-9. https://doi.org/10.1007/s00268-014-2881-8
  10. Friede KA, Osborne MC, Erickson DJ, et al. Predicting trauma admissions: the effect of weather, weekday, and other variables. Minn Med 2009;92:47-9.
  11. Andrey J, Yagar S. A temporal analysis of rain-related crash risk. Accid Anal Prev 1993;25:465-72. https://doi.org/10.1016/0001-4575(93)90076-9
  12. Bourcier T, Viboud C, Cohen JC, et al. Effects of air pollution and climatic conditions on the frequency of ophthalmological emergency examinations. Br J Ophthalmol 2003;87:809-11. https://doi.org/10.1136/bjo.87.7.809
  13. Ruckerl R, Schneider A, Breitner S, Cyrys J, Peters A. Health effects of particulate air pollution: a review of epidemiological evidence. Inhal Toxicol 2011;23:555-92. https://doi.org/10.3109/08958378.2011.593587
  14. Pope CA 3rd, Burnett RT, Thurston GD, et al. Cardiovascular mortality and long-term exposure to particulate air pollution: epidemiological evidence of general pathophysiological pathways of disease. Circulation 2004;109:71-7. https://doi.org/10.1161/01.CIR.0000108927.80044.7F
  15. Cho EJ, Shin SD, Jeong S, Kwak YH, Suh GJ. The effect of atmosphere temperature on out-of-hospital cardiac arrest outcomes. Resuscitation 2016;109:64-70. https://doi.org/10.1016/j.resuscitation.2016.10.004
  16. Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974;14:187-96. https://doi.org/10.1097/00005373-197403000-00001
  17. Stomp W, Fidler V, ten Duis HJ, Nijsten MW. Relation of the weather and the lunar cycle with the incidence of trauma in the Groningen region over a 36-year period. J Trauma 2009;67:1103-8. https://doi.org/10.1097/TA.0b013e3181986941
  18. Bhattacharyya T, Millham FH. Relationship between weather and seasonal factors and trauma admission volume at a Level I trauma center. J Trauma 2001;51:118-22. https://doi.org/10.1097/00005373-200107000-00019
  19. Atherton WG, Harper WM, Abrams KR. A year's trauma admissions and the effect of the weather. Injury 2005;36:40-6. https://doi.org/10.1016/j.injury.2003.10.027
  20. Lin LW, Lin HY, Hsu CY, Rau HH, Chen PL. Effect of weather and time on trauma events determined using emergency medical service registry data. Injury 2015;46:1814-20. https://doi.org/10.1016/j.injury.2015.02.026
  21. Mogaka EO, Ng'ang'a Z, Oundo J, Omolo J, Luman E. Factors associated with severity of road traffic injuries, Thika, Kenya. Pan Afr Med J 2011;8:20.
  22. Bundi M, Meier L, Amsler F, Gross T. Impact of weather, time of day and season on the admission and outcome of major trauma patients. Unfallchirurg 2018;121:10-9. https://doi.org/10.1007/s00113-016-0267-0
  23. Lim JS, Kwon HM, Kim SE, Lee J, Lee YS, Yoon BW. Effects of temperature and pressure on acute stroke incidence assessed using a Korean nationwide insurance database. J Stroke 2017;19:295-303. https://doi.org/10.5853/jos.2017.00045
  24. Son JY, Lee JT, Bell ML. Is ambient temperature associated with risk of infant mortality? A multi-city study in Korea. Environ Res 2017;158:748-52. https://doi.org/10.1016/j.envres.2017.07.034
  25. Kang SH, Oh IY, Heo J, et al. Heat, heat waves, and outof-hospital cardiac arrest. Int J Cardiol 2016;221:232-7. https://doi.org/10.1016/j.ijcard.2016.07.071
  26. Kim Y, Kim H, Kim DS. Association between daily environmental temperature and suicide mortality in Korea (2001-2005). Psychiatry Res 2011;186:390-6. https://doi.org/10.1016/j.psychres.2010.08.006
  27. Rising WR, O'Daniel JA, Roberts CS. Correlating weather and trauma admissions at a level I trauma center. J Trauma 2006;60:1096-100. https://doi.org/10.1097/01.ta.0000197435.82141.27
  28. Kim HC, Kim S, Kim BU, et al. Recent increase of surface particulate matter concentrations in the Seoul Metropolitan Area, Korea. Sci Rep 2017;7:4710. https://doi.org/10.1038/s41598-017-05092-8
  29. Burnett RT, Pope CA 3rd, Ezzati M, et al. An integrated risk function for estimating the global burden of disease attributable to ambient fine particulate matter exposure. Environ Health Perspect 2014;122:397-403. https://doi.org/10.1289/ehp.1307049
  30. Park M, Luo S, Kwon J, et al. Effects of air pollution on asthma hospitalization rates in different age groups in metropolitan cities of Korea. Air Qual Atmos Health 2013;6:543-51. https://doi.org/10.1007/s11869-013-0195-x
  31. Kang D, Kim JE. Fine, ultrafine, and yellow dust: emerging health problems in Korea. J Korean Med Sci 2014;29:621-2. https://doi.org/10.3346/jkms.2014.29.5.621
  32. Usman T, Fu L, Miranda-Moreno LF. Quantifying safety benefit of winter road maintenance: accident frequency modeling. Accid Anal Prev 2010;42:1878-87. https://doi.org/10.1016/j.aap.2010.05.008