title: Air pollution and doctors' house calls: results from the ERPURS system for monitoring the effects of air pollution on public health in Greater Paris, France, 1991-1995. Evaluation des Risques de la Pollution Urbaine pour la Santé.
abstract: This study examines short-term relationships between doctors' house calls and urban air pollution in Greater Paris for the period 1991-1995. Poisson regressions using nonparametric smoothing functions controlled for time trend, seasonal patterns, pollen counts, influenza epidemics, and weather. The relationship between asthma visits and air pollution was stronger for children. A relative risk (RRP95/P5) of 1.32 [95% confidence interval (CI) = 1.17-1.47)] was observed for an increase from the 5th to the 95th percentile (7-51 micrograms/m3) in daily concentrations of black smoke (BS). The risks for 24-hr sulfur dioxide and nitrogen dioxide levels were in the same range. Cardiovascular conditions, considered globally, showed weaker associations than angina pectoris/myocardial infarction, for which RRP95/P5 was 1.63 (95% CI = 1.10-2.41) in relation to ozone ambient levels. Eye conditions were exclusively related to ozone (RRP95/P5 = 1.17, 95% CI 1.02-1.33). Asthma visits and ozone showed an interaction with minimum temperature: an effect was observed only at 10 degrees C or higher. In two-pollutant models including BS with, successively, SO2, NO2, and O3, only BS and O3 effects remained stable. Along with mortality and hospital admissions, house call activity data, available on a regular basis, may be a sensitive indicator for monitoring health effects related to air pollution.
authors.affiliation: Regional Observatory of Health (ORS), Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Medina
authors.forename: A
authors.initials: A
authors.lastname: Le Tertre
authors.forename: P
authors.initials: P
authors.lastname: Quénel
authors.forename: Y
authors.initials: Y
authors.lastname: Le Moullec
authors.forename: P
authors.initials: P
authors.lastname: Lameloise
authors.forename: J C
authors.initials: JC
authors.lastname: Guzzo
authors.forename: B
authors.initials: B
authors.lastname: Festy
authors.forename: R
authors.initials: R
authors.lastname: Ferry
authors.forename: W
authors.initials: W
authors.lastname: Dab
mesh_terms: D000393:Air Pollutants / Q000506:poisoning*; D001249:Asthma / Q000139:chemically induced; D002318:Cardiovascular Diseases / Q000139:chemically induced; D004781:Environmental Exposure; D005128:Eye Diseases / Q000139:chemically induced; D006261:Headache / Q000139:chemically induced; D006792:House Calls; D006801:Humans; D010297:Paris; D016012:Poisson Distribution; D014504:Urban Health
chemical_list: D000393:Air Pollutants