The Effect of Ozone and PM10 on Hospital Admissions for Pneumonia and Chronic Obstructive Pulmonary Disease: A National Multicity Study

• Published in: American journal of epidemiology 2006-03, Vol.163 (6), p.579-588
• Main Authors: Medina-Ramón, Mercedes, Zanobetti, Antonella, Schwartz, Joel
• Format: Article
• Language: English
• Subjects: Aged; Air Conditioning - statistics & numerical data; Air Pollutants - adverse effects; Air pollution; Air Pollution - adverse effects; Air Pollution - statistics & numerical data; Analysis. Health state; Biological and medical sciences; chronic obstructive; chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease, asthma; confidence interval; COPD; Cross-Over Studies; Effect Modifier, Epidemiologic; effect modifiers (epidemiology); Environment. Living conditions; Epidemiology; General aspects; Hospitals, Urban - utilization; Humans; Medical sciences; Ozone; Ozone - adverse effects; Particle Size; particulate matter with an aerodynamic diameter of ≤10 μm; particulate matter with an aerodynamic diameter of ≤2.5 μm; Patient Admission - statistics & numerical data; Patient admissions; PM10; PM2.5; Pneumology; pneumonia; Pneumonia - epidemiology; Pneumonia - etiology; Poverty; Public health. Hygiene; Public health. Hygiene-occupational medicine; pulmonary disease; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - etiology; Respiratory diseases; Risk Assessment; Risk Factors; Seasons; United States - epidemiology; Urban Health - statistics & numerical data
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwj078

A case-crossover study was conducted in 36 US cities to evaluate the effect of ozone and particulate matter with an aerodynamic diameter of ≤10 μm (PM10) on respiratory hospital admissions and to identify which city characteristics may explain the heterogeneity in risk estimates. Respiratory hospital admissions and air pollution data were obtained for 1986–1999. In a meta-analysis based on the city-specific regression models, several city characteristics were evaluated as effect modifiers. During the warm season, the 2-day cumulative effect of a 5-ppb increase in ozone was a 0.27% (95% confidence interval (CI): 0.08, 0.47) increase in chronic obstructive pulmonary disease admissions and a 0.41% (95% CI: 0.26, 0.57) increase in pneumonia admissions. Similarly, a 10-μg/m3 increase in PM10 during the warm season resulted in a 1.47% (95% CI: 0.93, 2.01) increase in chronic obstructive pulmonary disease at lag 1 and a 0.84% (95% CI: 0.50, 1.19) increase in pneumonia at lag 0. Percentage of households with central air conditioning reduced the effect of air pollution, and variability of summer apparent temperature reduced the effect of ozone on chronic obstructive pulmonary disease. The study confirmed, in a large sample of cities, that exposure to ozone and PM10 is associated with respiratory hospital admissions and provided evidence that the effect of air pollution is modified by certain city characteristics.