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Int. J. Environ. Res. Public Health 2010, 7(11), 4078-4088; doi:10.3390/ijerph7114078
Article

Ambient Ozone and Emergency Department Visits for Cellulitis

1,* , 1
,
2
 and
3,4
1 Population Studies Division, Health Canada, 269 Laurier Avenue, Ottawa, ON K1A 0K9, Canada 2 Departments of Medicine and Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 1N4, Canada 3 Department of Emergency Medicine, University of Alberta, 8440-112 Street, Edmonton, AB T6G 2B7, Canada 4 School of Public Health, University of Alberta, 8440-112 Street, Edmonton, AB T6G 2B7, Canada
* Author to whom correspondence should be addressed.
Received: 10 October 2010 / Revised: 12 November 2010 / Accepted: 16 November 2010 / Published: 19 November 2010
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Abstract

Objectives were to assess and estimate an association between exposure to ground-level ozone and emergency department (ED) visits for cellulitis. All ED visits for cellulitis in Edmonton, Canada, in the period April 1992–March 2002 (N = 69,547) were examined. Case-crossover design was applied to estimate odds ratio (OR, and 95% confidence interval) per one interquartile range (IQR) increase in ozone concentration (IQR = 14.0 ppb). Delay of ED visit relating to exposure was probed using 0- to 5-day exposure lags. For all patients in the all months (January–December) and lags 0 to 2 days, OR = 1.05 (1.02, 1.07). For male patients during the cold months (October-March): OR = 1.05 (1.02, 1.09) for lags 0 and 2 and OR = 1.06 (1.02, 1.10) for lag 3. For female patients in the warm months (April-September): OR = 1.12 (1.06, 1.18) for lags 1 and 2. Cellulitis developing on uncovered (more exposed) skin was analyzed separately, observed effects being stronger. Cellulitis may be associated with exposure to ambient ground level ozone; the exposure may facilitate cellulitis infection and aggravate acute symptoms.
Keywords: cellulitis; skin infection; emergency department visit; ozone; bacteria; urban cellulitis; skin infection; emergency department visit; ozone; bacteria; urban
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Szyszkowicz, M.; Porada, E.; Kaplan, G.G.; Rowe, B.H. Ambient Ozone and Emergency Department Visits for Cellulitis. Int. J. Environ. Res. Public Health 2010, 7, 4078-4088.

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