American Journal of Epidemiology Advance Access originally published online on January 27, 2006
American Journal of Epidemiology 2006 163(6):579-588; doi:10.1093/aje/kwj078
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Original Contribution |
The Effect of Ozone and PM10 on Hospital Admissions for Pneumonia and Chronic Obstructive Pulmonary Disease: A National Multicity Study
1 Department of Environmental Health, Harvard School of Public Health, Boston, MA
2 Channing Laboratory, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA
Correspondence to Dr. Mercedes Medina-Ramón, Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Landmark Center, Suite 415 West, Boston, MA 02215 (e-mail: mmedinar{at}hsph.harvard.edu).
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.
air pollution; effect modifiers (epidemiology); ozone; pneumonia; pulmonary disease, chronic obstructive
Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; PM10, particulate matter with an aerodynamic diameter of
10 µm; PM2.5, particulate matter with an aerodynamic diameter of 2.5 µm
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