Air pollutants and atmospheric pressure increased risk of ED visit for spontaneous pneumothorax

Joo Hyung Park, Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Objective: To investigate the impact of short-term exposure to air pollutants and meteorological variation on ED visits for primary spontaneous pneumothorax (PSP). Material and methods: We retrospectively identified PSP cases that presented at the ED of our tertiary center between January 2015 and September 2016. We classified the days into three types: no PSP day (0 case/day), sporadic days (1–2 cases/day), and cluster days (PSP, ≥3 cases/day). Association between the daily incidence of PSP with air pollutants and meteorological data were determined using Poisson generalized-linear-model to calculate incidence rate ratio (IRRs) and the use of time-series (lag-1 [the cumulative air pollution level on the previous day of PSP], lag-2 [two days ago], and lag-3 [three days ago]). Results: Using multivariate logistic regression analysis, O3 (p = 0.010), NO2 (p = 0.047), particulate matters (PM)10 (p = 0.021), and PM2.5 (p = 0.008) were significant factors of PSP occurrence. When the concentration of O3, NO2, PM10, and PM2.5 were increased, PSP IRRs increased approximately 15, 16, 3, and 5-fold, respectively. With the time-series analyses, atmospheric pressure in lag-3 was significantly lower and in lag-2, was significantly higher in PSP days compared with no PSP days. Among air pollutant concentrations, O3 in lag-1 (p = 0.017) and lag-2 (p = 0.038), NO2 in lag-1 (p = 0.015) and lag-2 (p = 0.009), PM10 in lag-1 (p = 0.012), and PM2.5 in lag-1 (p = 0.021) and lag-2 (p = 0.032) were significantly different between no PSP and PSP days. Conclusion: Increased concentrations of air pollutants and abrupt change in atmospheric pressure were significantly associated with increased IRR of PSP.

Original languageEnglish
Pages (from-to)2249-2253
Number of pages5
JournalAmerican Journal of Emergency Medicine
Issue number12
StatePublished - Dec 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier Inc.


  • Air pollution
  • Atmospheric pressure
  • Epidemiology
  • Meteorology
  • Primary spontaneous pneumothorax


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