Air pollution and hospital admissions for the elderly in Detroit, Michigan.

Several studies in recent years have suggested that exposure to airborne particles and to ozone are associated with increases in respiratory hospital admissions. Few of those studies have used inhalable particles as their measure of exposure, and the studies did not always examine both particle and ozone exposure. This study examined the association between both PM10 and ozone and respiratory hospital admissions for persons 65 yr of age and older in the Detroit, Michigan, metropolitan area during the years 1986 to 1989. After controlling for seasonal and other long-term temporal trends, temperature, and dew point temperature, both PM10 (RR = 1.012, 95% CI = 1.019-1.004) and 24-h ozone concentrations (RR = 1.026, 95% CI = 1.040-1.013) were associated with daily admissions for pneumonia. The relative risks are for a 10-microgram/m3 increase in PM10 and a 5-ppb increase in 24-h ozone concentration and from models including both pollutants. Admissions for COPD other than asthma were associated with PM10 (RR = 1.020, 95% CI = 1.032-1.009) and ozone (RR = 1.028, 95% CI = 1.049-1.007) as well. Asthma admissions were not associated with either pollutant. Controlling for one pollutant did not effect the magnitude of the association with the other pollutant. The magnitude of these relative risks are very similar to those recently reported in Birmingham, Alabama, Ontario, and New York State. This suggests that the associations with both pollutants are likely to be causal.

[1]  D V Bates,et al.  Air pollution and hospital admissions in Southern Ontario: the acid summer haze effect. , 1987, Environmental research.

[2]  D. Fairley,et al.  The relationship of daily mortality to suspended particulates in Santa Clara County, 1980-1986. , 1990, Environmental health perspectives.

[3]  B. Brunekreef,et al.  Decline in children's pulmonary function during an air pollution episode. , 1986, Journal of the Air Pollution Control Association.

[4]  J. Schwartz,et al.  Particulate air pollution and daily mortality in Detroit. , 1991, Environmental research.

[5]  Winston Harrington,et al.  Ambient ozone and acute health effects: Evidence from daily data , 1990 .

[6]  R. Wyzga.  The effect of air pollution upon mortality: a consideration of distributed lag models. , 1978, Journal of the American Statistical Association.

[7]  J. Schwartz,et al.  Air pollution and the duration of acute respiratory symptoms. , 1992, Archives of environmental health.

[8]  R. Tibshirani,et al.  Generalized additive models for medical research , 1986, Statistical methods in medical research.

[9]  J. Schwartz,et al.  Mortality and air pollution in London: a time series analysis. , 1990, American journal of epidemiology.

[10]  D. Dockery,et al.  Particulate air pollution and daily mortality in Steubenville, Ohio. , 1992, American journal of epidemiology.

[11]  H. Wichmann,et al.  Air pollution and acute respiratory illness in five German communities. , 1991, Environmental research.

[12]  D Dockery,et al.  Effects of ambient ozone on respiratory function and symptoms in Mexico City schoolchildren. , 1992, The American review of respiratory disease.

[13]  J. Goldsmith,et al.  AIR POLLUTION AND DAILY MORTALITY , 1961, The American journal of the medical sciences.

[14]  C. Pope,et al.  Daily mortality and PM10 pollution in Utah Valley. , 1992, Archives of environmental health.

[15]  D V Bates,et al.  Asthma attack periodicity: a study of hospital emergency visits in Vancouver. , 1990, Environmental research.

[16]  G. Thurston,et al.  Effects of heavy industrial pollution on respiratory function in the children of Cubatao, Brazil: a preliminary report. , 1991, Environmental health perspectives.

[17]  J. Sunyer,et al.  Effects of urban air pollution on emergency room admissions for chronic obstructive pulmonary disease. , 1991, American journal of epidemiology.

[18]  D Krewski,et al.  Effects of low ambient levels of ozone and sulfates on the frequency of respiratory admissions to Ontario hospitals. , 1994, Environmental research.

[19]  J. Mackenbach,et al.  Air pollution, lagged effects of temperature, and mortality: The Netherlands 1979-87. , 1993, Journal of epidemiology and community health.

[20]  D. Abbey,et al.  Long-term ambient concentrations of total suspended particulates, ozone, and sulfur dioxide and respiratory symptoms in a nonsmoking population. , 1993, Archives of environmental health.

[21]  J Schwartz,et al.  Air pollution and daily mortality in Birmingham, Alabama. , 1993, American journal of epidemiology.

[22]  J. Schwartz,et al.  Lung function and chronic exposure to air pollution: a cross-sectional analysis of NHANES II. , 1989, Environmental research.

[23]  C. Pope,et al.  Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys. , 1991, Archives of environmental health.

[24]  D. Dockery,et al.  Short-term pulmonary function change in association with ozone levels. , 1989, The American review of respiratory disease.

[25]  F. Speizer,et al.  Effects of ambient ozone on respiratory function in active, normal children. , 1988, The American review of respiratory disease.

[26]  D. House,et al.  Ozone-induced inflammation in the lower airways of human subjects. , 1989, The American review of respiratory disease.

[27]  Tsoung-Chao Lee,et al.  The Theory and Practice of Econometrics , 1981 .

[28]  C. Pope,et al.  Elementary school absences and PM10 pollution in Utah Valley. , 1992, Environmental research.

[29]  D. Dockery,et al.  An association between air pollution and mortality in six U.S. cities. , 1993, The New England journal of medicine.

[30]  B. Ostro,et al.  Air pollution and acute respiratory morbidity: an observational study of multiple pollutants. , 1989, Environmental research.

[31]  L. Zangwill,et al.  Monitoring of hospital emergency room visits as a method for detecting health effects of environmental exposures. , 1984, The Science of the total environment.

[32]  James J. Quackenboss,et al.  Indoor-outdoor relationships for particulate matter: Exposure classifications and health effects , 1989 .

[33]  S Zeger,et al.  Passive smoking, air pollution, and acute respiratory symptoms in a diary study of student nurses. , 1990, The American review of respiratory disease.

[34]  D A Savitz,et al.  Pulmonary function and ambient particulate matter: epidemiological evidence from NHANES I. , 1991, Archives of environmental health.

[35]  J D Spengler,et al.  Acute effects of summer air pollution on respiratory symptom reporting in children. , 1994, American journal of respiratory and critical care medicine.

[36]  L. Greenburg,et al.  Air Pollution, Mortality, and Weather , 1971 .

[37]  Sensitive subgroups and normal variation in pulmonary function response to air pollution episodes. , 1991, Environmental health perspectives.

[38]  D V Bates,et al.  Health indices of the adverse effects of air pollution: the question of coherence. , 1992, Environmental research.

[39]  S. Zeger,et al.  Longitudinal data analysis using generalized linear models , 1986 .

[40]  J D Spengler,et al.  Respiratory health and PM10 pollution. A daily time series analysis. , 1991, The American review of respiratory disease.

[41]  A S Whittemore,et al.  Methods for analyzing panel studies of acute health effects of air pollution. , 1979, Biometrics.

[42]  J Schwartz,et al.  Increased mortality in Philadelphia associated with daily air pollution concentrations. , 1992, The American review of respiratory disease.

[43]  D. House,et al.  Exposure of humans to ambient levels of ozone for 6.6 hours causes cellular and biochemical changes in the lung. , 1991, American journal of respiratory cell and molecular biology.

[44]  R. Devlin,et al.  Time-dependent Changes of Markers Associated with Inflammation in the Lungs of Humans Exposed to Ambient Levels of Ozone 1 2 , 1991 .

[45]  P. Kinney,et al.  Associations of daily mortality and air pollution in Los Angeles County. , 1991, Environmental research.

[46]  J. Hodgkin,et al.  Chronic obstructive pulmonary disease symptom effects of long-term cumulative exposure to ambient levels of total suspended particulates and sulfur dioxide in California Seventh-Day Adventist residents. , 1987, Archives of environmental health.

[47]  U Ackermann-Liebrich,et al.  Air pollution and respiratory symptoms in preschool children. , 1992, The American review of respiratory disease.

[48]  C. Pope,et al.  Respiratory disease associated with community air pollution and a steel mill, Utah Valley. , 1989, American journal of public health.

[49]  J. Schwartz.  Particulate air pollution and daily mortality: a synthesis. , 1991, Public health reviews.

[50]  D. Dockery,et al.  Change in pulmonary function in children associated with air pollution episodes. , 1982, Journal of the Air Pollution Control Association.

[51]  B. Brunekreef,et al.  Effect of ambient ozone on peak expiratory flow of exercising children in The Netherlands. , 1993, Archives of environmental health.

[52]  W. McCartney,et al.  Ozone exposure increases respiratory epithelial permeability in humans. , 1987, The American review of respiratory disease.

[53]  J Schwartz,et al.  Air pollution and daily mortality: associations with particulates and acid aerosols. , 1992, Environmental research.