Hosseinali Shahidi, MD¹, Yu-Feng Chan, MD², Leonard Bielory, MD³, Richard J. Massone, BA¹, Susan Meehan⁴, Van Dunn, MD MPH⁵, Katherine Benevenia, MD⁶, Robert Barricella, DO⁶, Maureen Rickerhauser-Krall, MD⁶, Maria Alvarez⁶, and Ronald Low, MD². (1) Division of Emergency Medicine/ Department of Surgery, University of Medicine & Dentistry of New Jersey - New Jersey Medical School, 150 Bergen Street, Room M219, Newark, NJ 07103, 973-972-7882, shahidho@umdnj.edu, (2) Division of Emergency Medicine/ Department of Surgery, UMDNJ New Jersey Medical School, 150 Bergen Street, Room M219, Newark, NJ 07103, (3) Dept of Medicine /Asthma & Allergy Research Center, UMDNJ - New Jersey Medical School, 90 Bergen Street, Doctors Office Complex, DOC 4700, Newark, NJ 07103, (4) Division of Emergency Medicine/ Department of Surgery, NYC Health & Hospitals Corporation, 125 Worth Street, Room 507, New York, NY 10013, (5) New York City Health and Hospitals Corporation, 125 Worth Street, Room 507, New York, NY 10013, (6) Department of Pediatrics, UMDNJ-New Jersey Medical School, 150 Bergen Street, Newark, NJ 07103

Purpose: To examine the relationships between the incidence of otitis media and: air pollutants, weather, airborne allergens, and URI incidence.

Methods: We studied outpatient visits to 11 public hospitals and 6 freestanding clinics operated by the New York City Health and Hospitals Corporation. Weather data were obtained from the National Weather Service, Pollution from the EPA, and allergen data from one of the author’s laboratories. Data were analyzed with an ARIMA model using SAS 9.1.

Results: From 1/1/1991 until 12/31/2002 there were 817,940 (mean 187+-84) visits for otitis media and 4,457,526 (mean 817 +-365) visits for URI. The mean and standard deviations for of NOx (ppm) and temperature (degrees Celsius) were 0.068+-0.035 and 9.07+-8.86 respectively. ARIMA modeling showed the incidence of otitis to be related to prior otitis visits (p=.0001), with effects delayed up to a week. Otitis incidence was also statistically related to URI visits, also with effects delayed up to a week (p=.0001). We found both immediate (p=.0012) and two day delayed (p=.0047) effects of NOx. The model also has immediate (p=.0398) and 1 day delayed (p=.0642) relationships with temperature. We found no statistically significant exacerbating effects of precipitation, pollens, airborne allergens, or other pollutants.

Conclusion: ARIMA modeling is conservative. With this modeling, we found the incidence of otitis media to be increased by prior otitis cases, URI incidence, increasing NOx, and increasing temperatures.

Learning Objectives:

• To determine whether variables such as, weather airborne allergens, or previous upper respiratory infection have an effect on the incidence otitis media.
• To use the information to possibly identify preventable causes of otitis media.
• To better understand how to deliver treatment to patients who may be susceptible to otitis media. (i.e. treat URI more promptly before otitis media develops.)

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.