Airborne particles are a risk factor for hospital admissions for heart and lung disease.

We examined the association between particulate matter [less than/equal to] 10 microm; (PM(10)) and hospital admission for heart and lung disease in ten U.S. cities. Our three goals were to determine whether there was an association, to estimate how the association was distributed across various lags between exposure and response, and to examine socioeconomic factors and copollutants as effect modifiers and confounders. We fit a Poisson regression model in each city to allow for city-specific differences and then combined the city-specific results. We examined potential confounding by a meta-regression of the city-specific results. Using a model that considered simultaneously the effects of PM(10) up to lags of 5 days, we found a 2.5% [95% confidence interval (CI), 1.8-3. 3] increase in chronic obstructive pulmonary disease, a 1.95% (CI, 1. 5-2.4) increase in pneumonia, and a 1.27% increase (CI, 1-1.5) in CVD for a 10 microg/m(3) increase in PM(10). We found similar effect estimates using the mean of PM(10) on the same and previous day, but lower estimates using only PM(10) for a single day. When using only days with PM(10) < 50 mg/m(3), the effect size increased by [greater/equal to] 20% for all three outcomes. These effects are not modified by poverty rates or minority status. The results were stable when controlling for confounding by sulfur dioxide, ozone, and carbon monoxide. These results are consistent with previous epidemiology and recent mechanistic studies in animals and humans.

[1]  J Schwartz,et al.  What are people dying of on high air pollution days? , 1994, Environmental research.

[2]  Gerald J. Nehls,et al.  Procedures for Handling Aerometric Data , 1973 .

[3]  J. Vandenberg,et al.  Research priorities: airborne particulate matter , 2001 .

[4]  R. Corker Econometric Models and Economic Forecasting , 1982 .

[5]  J Schwartz,et al.  Air pollution and hospital admissions for heart disease in eight U.S. counties. , 1998, Epidemiology.

[6]  J Schwartz,et al.  Air pollution and incidence of cardiac arrhythmia. , 2000, Epidemiology.

[7]  P. S. Gilmour,et al.  Free radical activity and pro-inflammatory effects of particulate air pollution (PM10) in vivo and in vitro. , 1996, Thorax.

[8]  J Schwartz,et al.  Short term fluctuations in air pollution and hospital admissions of the elderly for respiratory disease. , 1995, Thorax.

[9]  A. Peters,et al.  Increased plasma viscosity during an air pollution episode: a link to mortality? , 1997, The Lancet.

[10]  J. Schwartz,et al.  Particulate air pollution and mortality: more than the Philadelphia story. , 1995, Epidemiology.

[11]  J Schwartz,et al.  Ambient pollution and heart rate variability. , 2000, Circulation.

[12]  Joel Schwartz,et al.  Transitional Regression Models, with Application to Environmental Time Series , 2000 .

[13]  J. Schwartz,et al.  Is Daily Mortality Associated Specifically with Fine Particles? , 1996, Journal of the Air & Waste Management Association.

[14]  J. Howland,et al.  Predicting radon testing among university employees. , 1996, Journal of the Air & Waste Management Association.

[15]  S Perz,et al.  Increases in heart rate during an air pollution episode. , 1999, American journal of epidemiology.

[16]  Suresh H. Moolgavkar,et al.  Air Pollution and Daily Mortality in Philadelphia , 1995, Epidemiology.

[17]  H. Akaike,et al.  Information Theory and an Extension of the Maximum Likelihood Principle , 1973 .

[18]  J Schwartz,et al.  The distributed lag between air pollution and daily deaths. , 2000, Epidemiology.

[19]  J. Schwartz,et al.  Air pollution and daily admissions for chronic obstructive pulmonary disease in 6 European cities: results from the APHEA project. , 1997, The European respiratory journal.

[20]  J. Schwartz,et al.  Heart rate variability associated with particulate air pollution. , 1999, American heart journal.

[21]  R. D. Morris,et al.  Air pollution and hospital admissions for cardiovascular disease in Detroit, Michigan. , 1995, American journal of epidemiology.

[22]  D. Costa,et al.  Oxidant Generation and Lung Injury after Particulate Air Pollutant Exposure Increase with the Concentrations of Associated Metals , 1996 .

[23]  C. Pope,et al.  Time series for the analysis of pulmonary health data. , 1996, American journal of respiratory and critical care medicine.

[24]  D. Costa,et al.  Bioavailable transition metals in particulate matter mediate cardiopulmonary injury in healthy and compromised animal models. , 1997, Environmental health perspectives.

[25]  R. Elton,et al.  Particulate air pollution and the blood , 1999, Thorax.

[26]  Peter Schmidt,et al.  The Theory and Practice of Econometrics , 1985 .

[27]  J M Wolfson,et al.  Mechanisms of morbidity and mortality from exposure to ambient air particles. , 2000, Research report.

[28]  W. Cleveland Robust Locally Weighted Regression and Smoothing Scatterplots , 1979 .

[29]  W. Pierson,et al.  Particulate air pollution and hospital emergency room visits for asthma in Seattle. , 1993, The American review of respiratory disease.

[30]  D. Rubinfeld,et al.  Econometric models and economic forecasts , 2002 .

[31]  Shirley Almon The Distributed Lag Between Capital Appropriations and Expenditures , 1965 .

[32]  Joel Schwartz,et al.  Simultaneous immunisation with influenza vaccine and pneumococcal polysaccharide vaccine in patients with chronic respiratory disease , 1997, BMJ.

[33]  J. Schwartz,et al.  Air pollution and daily mortality: a review and meta analysis. , 1994, Environmental research.

[34]  F. Dominici,et al.  Combining evidence on air pollution and daily mortality from the 20 largest US cities: a hierarchical modelling strategy , 2000 .

[35]  Joel Schwartz,et al.  REVIEW OF EPIDEMIOLOGICAL EVIDENCE OF HEALTH EFFECTS OF PARTICULATE AIR POLLUTION , 1995 .

[36]  J Schwartz,et al.  Oxygen saturation, pulse rate, and particulate air pollution: A daily time-series panel study. , 1999, American journal of respiratory and critical care medicine.

[37]  W. MacNee,et al.  Adverse health effects of PM10 particles: involvement of iron in generation of hydroxyl radical. , 1996, Occupational and environmental medicine.

[38]  Ronald W. Williams,et al.  Daily variation of particulate air pollution and poor cardiac autonomic control in the elderly. , 1999, Environmental health perspectives.

[39]  D. Costa,et al.  Cardiac arrhythmia induction after exposure to residual oil fly ash particles in a rodent model of pulmonary hypertension. , 1998, Toxicological sciences : an official journal of the Society of Toxicology.

[40]  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.

[41]  J. Schwartz,et al.  Assessing confounding, effect modification, and thresholds in the association between ambient particles and daily deaths. , 2000, Environmental health perspectives.

[42]  S Greenland,et al.  Hierarchical Regression Analysis Applied to a Study of Multiple Dietary Exposures and Breast Cancer , 1994, Epidemiology.

[43]  G. Judge,et al.  The Theory and Practice of Econometrics , 1981 .