GIS analysis of the relationship between PM2.5 and acute CVD and respiratory hospitalizations

Abstract Background and aims The PM air pollution is a serious concern in northern Moravia in the Czech Republic. The aim is to evaluate the risk of acute hospital admissions for cardiovascular and respiratory causes with the use of the Geographic information system (GIS). Methods The data on acute hospital admissions for cardiovascular (I00-99 according to ICD-10) and respiratory (J00-99) causes was assigned based on the information on residence to 77 geographical units (601,299 inhabitants). The annual concentrations of PM2.5 in the period 2013-2019 were assigned to this units according to the respective concentration iso-shapes (step 2 μg.m-3, concentrations ≤29 to ≥ 38 μg.m-3). The Incidence Rate Ratio (IRR) and 95% confidence interval (CI) was calculated for each concentration category. The incidence in the first category with the lowest PM2.5 concentrations (≤29 μg.m-3) was chosen the reference category. The statistical analyses were performed using the SW STATA v.15. Results About a half of population (56%) in the year 2013 belonged into the PM2.5 category 34-35 μg.m-3, 26 thousand of inhabitants (4%) live in the PM2.5 concentrations ≥38 μg.m-3. During the analysed period the average concentration values decreased from 30.8 to 21.4 μg.m-3. A statistically significant risk of the acute hospitalization for cardiovascular causes was identified in the categories ≤36 μg.m-3, in the highest interval of PM2.5 the IRR values were 2-3-fold higher comparing with the reference category. As for respiratory causes, the trend is similar, but the statistically significant risk was found already from the interval 34-35 μg.m-3. Conclusions With increasing concentrations, the risk of both acute cardiovascular, and respiratory hospitalizations increased. This presentation was supported by the project TH03030195 of the Technology Agency of the Czech Republic and the project Healthy Aging in the Industrial Environment CZ.02.1.01/0.0/0.0/16_019/0000798 (HAIE). Key messages • A statistically significant increase of the IRR for acute cardiovascular and respiratory hospitalizations was found at PM2.5 concentrations ≤34 μg.m-3 compared to the reference category ≤29 μg.m-3. • Average annual PM2.5 concentration decreased from 30.8 to 21.4 μg.m-3 during the followed period and also the risk of acute hospitalization from cardiovascular and respiratory causes decreased.


Background and aims:
The PM air pollution is a serious concern in northern Moravia in the Czech Republic. The aim is to evaluate the risk of acute hospital admissions for cardiovascular and respiratory causes with the use of the Geographic information system (GIS).

Methods:
The data on acute hospital admissions for cardiovascular (I00-99 according to ICD-10) and respiratory (J00-99) causes was assigned based on the information on residence to 77 geographical units (601,299 inhabitants). The annual concentrations of PM2.5 in the period 2013-2019 were assigned to this units according to the respective concentration iso-shapes (step 2 mg.m-3, concentrations 29 to 38 mg.m-3). The Incidence Rate Ratio (IRR) and 95% confidence interval (CI) was calculated for each concentration category. The incidence in the first category with the lowest PM2.5 concentrations (29 mg.m-3) was chosen the reference category. The statistical analyses were performed using the SW STATA v.15. Results: About a half of population (56%) in the year 2013 belonged into the PM2.5 category 34-35 mg.m-3, 26 thousand of inhabitants (4%) live in the PM2.5 concentrations 38 mg.m-3. During the analysed period the average concentration values decreased from 30.8 to 21.4 mg.m-3. A statistically significant risk of the acute hospitalization for cardiovascular causes was identified in the categories 36 mg.m-3, in the highest interval of PM2.5 the IRR values were 2-3-fold higher comparing with the reference category. As for respiratory causes, the trend is similar, but the statistically significant risk was found already from the interval 34-35 mg.m-3.

Conclusions:
With increasing concentrations, the risk of both acute cardiovascular, and respiratory hospitalizations increased. This presentation was supported by the project TH03030195 of the Technology Agency of the Czech Republic and the project Healthy Aging in the Industrial Environment CZ.02.1.01/0.0/ 0.0/16_019/0000798 (HAIE).

Key messages:
A statistically significant increase of the IRR for acute cardiovascular and respiratory hospitalizations was found at PM2.5 concentrations 34 mg.m-3 compared to the reference category 29 mg.m-3. Average annual PM2.5 concentration decreased from 30.8 to 21.4 mg.m-3 during the followed period and also the risk of acute hospitalization from cardiovascular and respiratory causes decreased.

Background:
Child mental health problems are considered the second highest cause of burden of disease in Europe and the Americas. Children's own opinions and experiences are pivotal in addressing these problems. However, including young children as active informants in health research and practice not only requires a well-trained and highly qualified workforce, but also valid methods that enhance and support children's selfexpression. The aim was to investigate preschool aged children's experiences in two health and welfare contexts using the interactive computer-assisted interview In My Shoes (IMS).

Methods:
Interviews were conducted using IMS in three studies encompassing 43 children aged 3-6 years old. The setting for the first and second study was Child Health Centres and the third setting was families entering the Triple P group parenting programme. Qualitative content analysis was performed.

Results:
The IMS interview aided preschool aged children to report on the factual, emotional and physical aspects of their experiences within a health care context. In addition, IMS helped young children verbalise unique information on negative interplay within their families, especially experiences of negative parenting including verbal and physical child abuse. The successes with IMS are likely related to the structured and systematic approach, that it is pictorial-based and emotion-focused, as well as the interactive, collaborative and triadic conversation between the child, the interviewer and the computer.

Conclusions:
The interactive computer-assisted interview IMS, is a suitable and valid method for aiding young children to provide unique and extensive information about different aspects of their experiences and lives. We urge professionals and researchers to systematically include the young children's own perspectives to better tailor and evaluate interventions on all levels to improve children's health and wellbeing. Key messages: Young children's own perspectives on their health and wellbeing are pivotal to better tailor and evaluate interventions.
The interactive computer-assisted interview In My Shoes is a suitable and valid method to capture children's voices.
Abstract citation ID: ckac131.247 Evaluation of a universal early intervention for parents and children from birth to age five