Air pollution and multiple acute respiratory outcomes

European Respiratory Journal - Tập 42 Số 2 - Trang 304-313 - 2013
Annunziata Faustini1, Massimo Stafoggia1, Paola Colais1, Giovanna Berti2, Luigi Bisanti3, Ennio Cadum2, Achille Cernigliaro4, Sandra Mallone5, Corrado Scarnato6, Francesco Forastiere1
1Dept of Epidemiology
2Epidemiology Services, Regional Environmental Protection Agency
3Epidemiology Unit
4Epidemiological Observatory
5Centre for Cancer Prevention
6Local Health Authority

Tóm tắt

Short-term effects of air pollutants on respiratory mortality and morbidity have been consistently reported but usually studied separately. To more completely assess air pollution effects, we studied hospitalisations for respiratory diseases together with out-of-hospital respiratory deaths.A time-stratified case-crossover study was carried out in six Italian cities from 2001 to 2005. Daily particulate matter (particles with a 50% cut-off aerodynamic diameter of 10 μm (PM10)) and nitrogen dioxide (NO2) associations with hospitalisations for respiratory diseases (n = 100 690), chronic obstructive pulmonary disease (COPD) (n = 38 577), lower respiratory tract infections (LRTI) among COPD patients (n = 9886) and out-of-hospital respiratory deaths (n = 5490) were estimated for residents aged ≥35 years.For an increase of 10 μg·m−3in PM10, we found an immediate 0.59% (lag 0–1 days) increase in hospitalisations for respiratory diseases and a 0.67% increase for COPD; the 1.91% increase in LRTI hospitalisations lasted longer (lag 0–3 days) and the 3.95% increase in respiratory mortality lasted 6 days. Effects of NO2were stronger and lasted longer (lag 0–5 days). Age, sex and previous ischaemic heart disease acted as effect modifiers for different outcomes.Analysing multiple rather than single respiratory events shows stronger air pollution effects. The temporal relationship between the pollutant increases and hospitalisations or mortality for respiratory diseases differs.

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