Respiratory effects of sulphur dioxide: a hierarchical multicity analysis in the APHEA 2 study

Occupational and Environmental Medicine - Tập 60 Số 8 - Trang e2-e2 - 2003
Jordi Sunyer1, Richard Atkinson2, Ferrán Ballester3, Alain Le Tertre4, J G Ayres5, Francesco Forastiere6, Bertil Forsberg7, Judith M. Vonk8, L Bisanti9, Robert H. Anderson2, Joel Schwartz10, Klea Katsouyanni11
1Respiratory and Environmental Research Unit, IMIM, c./ Dr Aiguader 80, 08003-Barcelona, Spain
2Dept of Public Health Sciences, St George's Hospital Medical School, London SW17 ORE, UK
3Escola Valenciana d'Estudis per a la Salut (EVES), 46017-Valencia, Spain
4Environmental Health Unit, National Institute of Public Health Surveillance, France
5Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK
6Department of Epidemiology, Health Authority Rome, Italy
7Dept of Public Health and Clinical Medicine, Umea University, S-901 87, Umea, Sweden
8Faculty of Medical Sciences, Department of Epidemiology and Statistics, University of Groningen, Netherlands
9Department of Epidemiology, Local Health Authority, Milan, Italy
10Environmental Epidemiology Program, Dept of Environmental Health, Harvard School of Public Health, Boston, USA
11Dept Hygiene-Epidemiolgy, 75 Mikras Asias str., 115 27 Athens, Greece

Tóm tắt

Background:Sulphur dioxide (SO2) was associated with hospital admissions for asthma in children in the original APHEA study, but not with other respiratory admissions.Aims:To assess the association between daily levels of SO2and daily levels of respiratory admissions in a larger and more recent study.Methods:Time series of daily counts of hospital emergency admissions were constructed for asthma at ages 0–14 years and 15–64 years, COPD and asthma, and all respiratory admissions at ages 65+ years in the cities of Birmingham, London, Milan, Paris, Rome, Stockholm, and in the Netherlands for periods of varying duration between the years 1988 and 1997. A two stage hierarchical modelling approach was used. In the first stage generalised additive Poisson regression models were fitted in each city controlling for weather and season. These results were then combined across cities in a second stage ecological regression that looked at potential effect modifiers.Results:For an increase of 10 μg/m3of SO2the daily number of admissions for asthma in children increased 1.3% (95% CI 0.4% to 2.2%). Effect modification among cities by levels of other air pollutants or temperature was not found. The SO2effect disappeared after controlling for PM10or CO, but correlation among these pollutants was very high. Other respiratory admissions were not associated with SO2.Conclusion:SO2is associated with asthma admissions in children, indicating that reduction in current air pollution levels could lead to a decrease in the number of asthma admissions in children in Europe.

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Tài liệu tham khảo

1980, Am Rev Respir Dis, 122, 873

1983, Arch Environ Health, 38, 104, 10.1080/00039896.1983.10543989

1981, Am Rev Respir Dis, 123, 486

1987, Am Rev Respir Dis, 136, 1127, 10.1164/ajrccm/136.5.1127

10.1136/thx.52.9.760

10.1183/09031936.97.10051064

10.1164/ajrccm.164.10.2010138

Hastie T, Tibshirani R. Generalized additive models. London: Chapman and Hall, 1990.

2000, JASA, 95, 16, 10.1080/01621459.2000.10473895

10.1097/00001648-200109000-00011

10.1016/0021-8707(67)90047-0

1966, Br J Prev Soc Med, 20, 1

1999, Occup Environ Med, 56, 232, 10.1136/oem.56.4.232

1991, Am J Epidemiol, 134, 277, 10.1093/oxfordjournals.aje.a116081

2001, Int Arch Occup Environ Health, 74, 574, 10.1007/s004200100266

10.1097/00001648-200207000-00006

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Occupational and Environmental Medicine

Tập 60 Số 8

e2-e2

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