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American Journal of Epidemiology Advance Access originally published online on June 22, 2006
American Journal of Epidemiology 2006 164(5):434-436; doi:10.1093/aje/kwj207
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Invited Commentary

Invited Commentary: Ripeness Is All

Joel Schwartz

From the Departments of Environmental Health and Epidemiology, Harvard School of Public Health, Boston, MA

Correspondence to Dr. Joel Schwartz, Departments of Environmental Health and Epidemiology, Harvard School of Public Health, Landmark Center, Room 415L West, 401 Park Drive, P.O. Box 15677, Boston, MA 02215 (e-mail: joel@hsph.harvard.edu).

Received for publication February 16, 2006. Accepted for publication February 28, 2006.

The first 10% of the full text of this article appears below.

Men must endure their going hence, even as their coming hither. Ripeness is all.

  —King Lear, Act 5, Sc IIa

An association between air pollution and hospital admission for heart failure was first noted in the literature in 1995 (1Go). The association was confirmed in subsequent studies (2Go, 3Go), along with many studies showing an association with a more general increase in cardiovascular admissions (4Go–6Go). The most consistent associations have been with carbon monoxide and particulate matter, and both Poisson time series (1Go, 2Go) and case-crossover analyses (3Go) have been used. Some of these studies have been quite large—for example, Wellenius et al. (3Go) examined seven cities and 293,000 emergency admissions.

More recently, studies of the health effects of air pollution have improved exposure assessment through better resolution in space within . . . [Full Text of this Article]


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A Case-Crossover Study of Fine Particulate Matter Air Pollution and Onset of Congestive Heart Failure Symptom Exacerbation Leading to Hospitalization
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Am. J. Epidemiol. 2006 164: 421-433. [Abstract] [FREE Full Text]