Background Climate change adversely affects human health, resulting in higher demand for health care services. However, the impact of climate-related environmental exposures on medical imaging utilization is currently unknown. Purpose To determine associations of short-term exposures to ambient heat and particulate air pollution with utilization of emergency department medical imaging. Materials and Methods In this retrospective time-stratified case-crossover study, daily imaging utilization counts from four emergency departments were linked to local daily environmental data-including fine particulate matter with 2.5-µm or smaller aerodynamic diameter (PM2.5) and ambient temperature-over 10 years (January 2013 to December 2022). Conditional Poisson regression models were used to evaluate the associations between daily imaging utilization and environmental exposures on the same day and each of the 7 days preceding imaging, lag days 0-7, controlling for day of the week, month, and year. Moving averages of mean daily PM2.5 and temperature were calculated to account for lagged exposure effects. Imaging counts were also stratified by modality (CT, radiography, US, and MRI). Results In an analysis of 1 666 420 emergency department imaging studies, a rise of 10 °C in the 2-day moving average of mean daily temperature and a rise of 10 μg/m3 in the 3-day moving average of mean daily PM2.5 were associated with overall imaging utilization increases of 5.1% (incidence rate ratio [IRR], 1.051; 95% CI: 1.045, 1.056) and 4.0% (IRR, 1.040; 95% CI: 1.035, 1.046), respectively. Heat exposure days (mean temperature >20 °C) and air pollution exposure days (mean PM2.5 >12 μg/m3) were associated with same-day excess absolute risk of 5.5 and 6.4 imaging studies per 1 million people at risk per day, respectively. Heat exposure days and air pollution exposure days were associated with increased utilization of radiography (excess relative risk, 2.7% [P < .001] and 2.1% [P < .001], respectively) and CT (excess relative risk, 2.0% [P = .001] and 2.7% [P < .001]) but not US (P = .14 and P = .14) or MRI (P = .70 and P = .65). Conclusion Short-term exposures to ambient heat and particulate air pollution were associated with increased utilization of radiography and CT but not US or MRI. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Vosshenrich in this issue.

中文翻译：

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急诊科医学成像增加：与短期暴露于环境热量和颗粒物空气污染的关联。


背景 气候变化对人类健康产生不利影响，导致对医疗保健服务的需求增加。然而，与气候相关的环境暴露对医学成像利用的影响目前尚不清楚。目的 确定短期暴露于环境热量和颗粒物空气污染与急诊科医学成像利用的关联。材料和方法 在这项回顾性时间分层病例交叉研究中，四个急诊科的每日成像利用计数与当地每日环境数据相关联，包括空气动力学直径 （PM2.5） 为或更小的细颗粒物和环境温度 - 超过 10 年（2013 年 1 月至 2022 年 12 月）。使用条件泊松回归模型评估每日成像利用率与同一天以及成像前 7 天中的每一天、滞后第 0-7 天的环境暴露之间的关联，控制星期几、月份和年份。计算平均每日 PM2.5 和温度的移动平均值以考虑滞后暴露效应。影像学计数也按模式（CT、X 线、超声和 MRI）分层。结果 在对 1 666 420 项急诊科影像学研究的分析中，日平均气温的 2 天移动平均气温上升 10 °C，平均日均 PM2.5 的 3 天移动平均线上升 10 μg/m3 与总体成像利用率增加 5.1% 相关（发病率比 [IRR]， 1.051;95% CI：1.045、1.056）和 4.0%（IRR，1.040;95% CI：1.035,1.046）。热暴露天数 （平均温度 >20 °C） 和空气污染暴露天数 （平均 PM2.5 >12 μg/m3） 与当天超额绝对风险 5.5 和 6 相关。每天每 100 万高危人群中分别进行 4 次影像学检查。高温暴露天数和空气污染暴露天数与射线照相（超额相对风险，分别为 2.7% [P < .001] 和 2.1% [P < .001]）和 CT （超额相对风险，2.0% [P = .001] 和 2.7% [P < .001]）的利用率增加相关，但与 US （P = .14 和 P = .14） 或 MRI （P = .70 和 P = .65） 无关。结论 短期暴露于环境热和颗粒物空气污染与 X 线照片和 CT 的使用增加相关，但与 US 或 MRI 的使用增加无关。© RSNA，2024 年本文提供补充材料。另请参见本期 Vosshenrich 的社论。