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Sectione (Applieation)
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Answers
Answer:
Many studies have shown that ambient particulate air pollution (PM) is associated with increased risk of hospital admissions and deaths for cardiovascular or respiratory causes around the world. In general these have been analysed in association with PM10 and ozone, whereas PM2.5 is now the particle measure of greatest health and regulatory concern. And little has been published on associations of hospital admissions and PM components.
Design
This study analysed hospital admissions for myocardial infarction (15 578 patients), and pneumonia (24 857 patients) in associations with fine particulate air pollution, black carbon (BC), ozone, nitrogen dioxide (NO2), PM not from traffic, and carbon monoxide (CO) in the greater Boston area for the years 1995–1999 using a case‐crossover analysis, with control days matched on temperature.
Main results
A significant association was found between NO2 (12.7% change (95% CI: 5.8, 18)), PM2.5 (8.6% increase (95% CI: 1.2, 15.4)), and BC (8.3% increase (95% CI: 0.2, 15.8)) and the risk of emergency myocardial infarction hospitalisation; and between BC (11.7% increase (95% CI: 4.8, 17.4)), PM2.5 (6.5% increase (95% CI: 1.1, 11.4)), and CO (5.5% increase (95% CI: 1.1, 9.5)) and the risk of pneumonia hospitalisation.
Conclusions
The pattern of associations seen for myocardial infarction and pneumonia (strongest associations with NO2, CO, and BC) suggests that traffic exposure is primarily responsible for the association with heart attacks.
Keywords: air pollution, myocardial infarction, case‐crossover, fine particulate air pollution, pneumonia
Many studies have shown that ambient particulate air pollution (PM), generally measured as particles with aerodynamic diameter less then 10 μm (PM10), is associated with increased risk of hospital admissions and deaths for broadly defined cardiovascular or respiratory causes.1,2,3,4,5,6
Similar relations have been reported in locations reflecting a wide range of particulate matter (PM), and of gaseous copollutant concentrations 7,8,9,10,11,12; multicity and recent studies have shown that the mortality associations13,14 and the hospital admissions studies15,16 are independent of gaseous pollutants.
Less work has investigated more specific outcomes, which may be relevant to understanding mechanisms. And comparatively little has been published on characteristics of PM pollution, or on associations with fine particles (PM2.5), because the Environmental Protection Agency (EPA) did not begin PM2.5 monitoring until 1999, and speciation monitors (which examine particle components) did not begin until 2000.
Several studies have recently examined whether PM is a specific trigger of myocardial infarction (MI) both in Europe3,17 and in America.18,19,20,21 In general these are associations with PM10, whereas PM2.5 is now the particle measure of greatest health and regulatory concern.
Recent interest has also focused on whether traffic particles are a particularly toxic component,22,23 although again, there are few studies of hospital admissions24 directly addressing this question.
An exception was a study by Peters and colleagues20 who conducted a case‐crossover study of 772 patients presenting to Boston area hospitals with strictly defined MI, and reported that increased concentrations of ambient particulates (PM2.5 and PM10) were strongly associated with higher risks of MI.
Hospital admissions for specific types of respiratory disease such as pneumonia have been analysed in several US cities4,16 and around the world1,24,25 and have been found to be associated with particulate pollution; again without examining PM2.5.
Boston, MA, is a medium size city near the ocean in the north eastern USA; the greater Boston area comprises three counties: Middlesex, Norfolk, and Suffolk, with an area of 2063 km2 and a population of 2.8 million inhabitants. Between 1995 and 1999 we operated a PM2.5 monitor at the Harvard School of Public Health. We also measured black carbon (BC), a good surrogate for traffic particles, at the same site.
We analysed hospital admissions for MI, and pneumonia in associations with PM2.5, BC, ozone, nitrogen dioxide (NO2), PM not from traffic, and carbon monoxide (CO) in the greater Boston area for the years 1995–1999 using a case‐crossover analysis.
Step-by-step explanation:
Answer:
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