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Air Pollution and Daily Emergency Department Visits for Headache in Montreal, Canada

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(Headache 2008;48:417-423) Background.—

Many studies have indicated that weather can trigger headache. Here we propose a new methodological approach to assess the relationship between weather, ambient air pollution, and emergency department (ED) visits for this condition. Objective.—

To examine the associations between ED visits for headache and selected meteorological and air pollution factors. Design and Methods.—

A hierarchical clusters design was used to study 10,497 ED visits for headache (ICD-9: 784) that occurred at a Montreal hospital between 1997 and 2002. The generalized linear mixed models technique was applied to create Poisson models for the clustered counts of visits for headache. Results.—

Statistically significant positive associations were observed between the number of ED visits for headache and the atmospheric pressure for all and for female visits for 1-day and 2-day lagged exposures. The percentage increase in daily ED female visits was 4.1% (95% CI: 2.0, 6.2), 3.4% (95% CI: 1.4, 5.6), and 2.2% (95% CI: 1.4, 5.6) for current day, 1-day and 2-day lagged exposure to SO2, respectively, for an increase of an interquartile range (IQR) of 2.4 ppb. The percentage increase was also statistically significant for current day and 1-day lagged exposure to NO2 and CO for all and for female visits. Conclusions.—

Presented findings provide support for the hypothesis that ED visits for headache are correlated to weather conditions and ambient air pollution – to atmospheric pressure and exposure to SO2, NO2, CO, and PM2.5. An increase in levels of these factors is associated with an increase in the number of ED visits for headache.
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Keywords: air pollution; atmospheric pressure; cluster; emergency department visit; headache; mixed model

Document Type: Research Article

Publication date: March 1, 2008

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