Short-term impact of air pollution, noise and temperature on emergency hospital admissions in Madrid (Spain) due to liver and gallbladder diseases

• Published in: Environmental research 2024-05, Vol.249, p.118439-118439, Article 118439
• Main Authors: López-Bueno, J.A., Padrón- Monedero, A., Díaz, J., Navas-Martín, M.A., Linares, C.
• Format: Article
• Language: English
• Subjects: Air pollution; cold; ecological studies; gall bladder; Gallbladder diseases; heat; Hospital admissions; hospitals; Liver; liver failure; Noise; noise pollution; ozone; relative humidity; risk; Spain; temperature; traffic; viral hepatitis
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2024.118439

Very few epidemiological studies have explored the environmental and meteorological risk factors that influence liver diseases and gallbladder disorders, and no studies have addressed the specific case of Spain. This is a retrospective ecological study conducted during 2013–2018. We analysed emergency admissions in the central area of the Region of Madrid for the following causes: Liver and gallbladder diseases (L&GB) (ICD-10: K70–K81); disorders of gallbladder (DGB) (ICD 10: K80–K81); liver disease (LD) (ICD 10: K70–K77); alcoholic liver disease (ALD) (ICD-10: K70); viral hepatitis (VH) (ICD10:B15–B19); and hepatic failure, not elsewhere classified (HFNS) (ICD-10: K72). Independent variables used: meteorological (maximum daily temperature (Tmax in ⁰C), minimum daily temperature (Tmin in ⁰C), and relative humidity (RH in %)); chemical air pollution (8-hO3, NO2, PM10, PM2.5 in μg/m3); and noise pollution (equivalent level of daily noise (Ld in dB(A)). Transformed variables: extreme heat in degrees (Theat); wet cold (WC); and high ozone. We fitted Poisson models, negative binomials and zero-inflated Poisson controlled for seasonality, day of the week, holidays, trend, and autoregressive trend. Based on these models, the percentage of cases attributable to statistically significant risk factors was then estimated. In L&GB emergency admissions daily noise is related to 4.4% (CI95%: 0.8 7.9) of admissions; NO2 to 2.9% (CI95%: 0.1 5.7) and wet cold to 0.2% (CI95%: 0.8 7.9). Heat wave temperature was only related to ALD. In addition, the wet cold association with L&GB is also related to HFNS attributing 1.0% (CI95%: 0.3 1.8) of admissions for this cause. Daily noise and NO2 are associated with more than 7% of urgent L&GB admissions. Both pollutants, are mainly emitted by road traffic. A reduction of traffic in cities would result in a reduction of emergency admissions due to this cause. •The leading environmental risk factors for liver and gallbladder disease are noise and NO2.•4.4% (0.8, 7.9) of hospitalisations due to L&GB were attributable to daily noise.•2.9% (0.1, 5.7) of hospitalisations due to L&GB were attributable to NO2.•Heat wave temperature is associated with alcoholic liver disease.•Wet cold is associated with liver and gallbladder disease.