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.
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.
Medina
S
S
Regional Observatory of Health (ORS), Paris, France.
Le Tertre
A
A
Quénel
P
P
Le Moullec
Y
Y
Lameloise
P
P
Guzzo
J C
JC
Festy
B
B
Ferry
R
R
Dab
W
W
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
D000393:Air Pollutants