Effects of Urban Air Pollution on Emergency Room Admissions for Chronic Obstructive Pulmonary Disease

Sunyer, Jordi; Antó, Josep M.; Murillo, Carles; Sáez, Marc

doi:10.1093/oxfordjournals.aje.a116081

Cited by 143 publications

(82 citation statements)

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“…The studies conducted by Sunyer et al in Barcelona (32,33) and Diaz 81 pg/in, and NO2 concentrations were all below 95 pg/m3 as 24-hr averages. To take collinearity of some of the variables and autocorrelation properly into account, data were analyzed by a novel "neural network" approach.…”

Section: Particles Mortalitymentioning

confidence: 84%

“…in Barcelona (32,33). However, the authors themselves comment that the measure of particulate matter they used (black smoke) was poorly related to TSP, especially in summer; and it remains unclear to what extent adjustment for potential particle effects was sufficient in their data.…”

Section: Particles Mortalitymentioning

confidence: 98%

“…For hospital admissions, effects have been estimated at a 24% increase of COPD admissions per 100 pg/m3 in Barcelona (32,33), and a 40% increase of asthma admissions per 100 pg/m3 PM1O in Seattle (34). There are no data to make a reliable conversion of black smoke into PM10 for Barcelona, but if the 1:1 relationship mentioned earlier were valid there as well, the consistency of the effect estimates from these two separate studies is again high.…”

Section: Public Health Implicationsmentioning

confidence: 99%

“…Most convincing are the studies from Seattle (34), where measured PM10 levels never exceeded 103 pg/mi3 and Birmingham, England (35), where the weekly average black smoke concentration never exceeded 60 pg/m3. Studies from Barcelona have documented effects at black smoke levels censored to below 150 pg/m3 (32,33), and a study from Germany suggested effects on hospital and pediatrician croup visits at TSP levels below 100 pg/mi3 by graphic analysis (30).…”

Section: Particles Mortalitymentioning

confidence: 99%

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Epidemiologic Studies on Short-Term Effects of Low Levels of Major Ambient Air Pollution Components

Brunekreef¹,

Dockery²,

Krzyżanowski³

1995

Environmental Health Perspectives

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Since the development of the World Health Organization (WHO) Air Quality Guidelines for Europe, a large number of epidemiologic studies have been published documenting effects of major air pollutants on health at concentrations below existing guidelines and standards. In this review, recent studies are discussed that permit some evaluation of short-term health effects observed at exposure levels lower than the current WHO Guidelines or U.S. Environmental Protection Agency (U.S. EPA) standards. Some studies have been conducted at concentration levels that never exceeded existing guidelines or standards. Other studies have been conducted at exposure levels sometimes exceeding current guidelines or standards. The published analyses of several of these studies permit evaluation of low-level health effects either because analyses were restricted to levels not exceeding the guidelines or graphic analyses were reported suggesting effects at these low levels. For ambient ozone, effects on lung function of subjects exercising outdoors have now been documented at 1-hr maximum levels not exceeding 120 pg/m3, i.e., half the current U.S. EPA standard. One study even suggests that such effects occur at levels below 100 pg/m3. Several studies are now available documenting effects of particulate air pollution on health in the virtual absence of SOL. Effects on mortality and hospital admissions for asthma have been documented at levels not exceeding 100 pg/m3, expressed as 24-hr average inhalable particles PM10 concentration. Effects on lung function, acute respiratory symptoms, and medication use have been found at 24-hr average PM10 levels not exceeding 115 pg/m3. When the WHO Air Quality Guidelines and the U.S. EPA standard for PM10 were developed, there were no studies available on health effects of PM10. In this review, we include nine studies documenting health effects of measured PM1 0 at low levels of exposure, indicating that there is now an entirely new epidemiologic database that can be evaluated in the process of revising current guidelines and standards. The low levels of exposure at which effects on health were seen underscore the urgent need for such reevaluations. -Environ Health Perspect 1 03(Suppl 2): 3-13 (1995)

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Section: Particles Mortalitymentioning

confidence: 84%

Section: Particles Mortalitymentioning

confidence: 98%

Section: Public Health Implicationsmentioning

confidence: 99%

Section: Particles Mortalitymentioning

confidence: 99%

See 2 more Smart Citations

Epidemiologic Studies on Short-Term Effects of Low Levels of Major Ambient Air Pollution Components

Brunekreef¹,

Dockery²,

Krzyżanowski³

1995

Environmental Health Perspectives

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“…In a metaanalysis for COPD subjects, Dockery and Pope (1994) estimated that a 10 mg/m 3 increase in PM 10 was associated with a 3.4% increase in mortality. Daily emergency room admissions for COPD in Barcelona were found to be associated with particle and SO 2 concentrations (Sunyer et al, 1991) as was an increase in respiratory symptoms during the 1960s pollution episodes in Londoners with COPD (Lawther et al, 1997).…”

Section: Introductionmentioning

confidence: 97%

Exposure time and place: Do COPD patients differ from the general population?

Leech

Smith‐Doiron

2005

J Expo Sci Environ Epidemiol

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Time-activity patterns in a panel of 70 patients with COPD (35 males) are compared to an age-matched subgroup from the randomly sampled Canadian Human Activity Pattern Survey. Total time indoors and outdoors were similar in both groups but significantly more indoor time in COPD subjects was spent at home than the indoor time of controls, who were more often indoors elsewhere. As part of improving their indoor air at home, COPD subjects were significantly more likely to have air conditioning at home. These results suggest that while outdoor air exposure strategies need not differ in COPD subjects from normals, indoor mitigation strategies should emphasize source pollutant control in the patient's home.

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