title: Associations between ambient air pollution and daily mortality among persons with congestive heart failure.
abstract: We conducted a mortality time series study to investigate the association between daily mortality for congestive heart failure (CHF), and daily concentrations of particles and gaseous pollutants in the ambient air of Montreal, Quebec, during the period 1984-1993. In addition, using data from the universal Quebec Health Insurance Plan, we identified individuals >/=65 years of age who, one year before death, had a diagnosis of CHF. Fixed-site air pollution monitors in Montreal provided daily mean levels of pollutants. We regressed the logarithm of daily counts of mortality on the daily mean levels of each pollutant, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and other gaseous and particle pollutants. Using cause of death information, we did not find any associations between daily mortality for CHF and any air pollutants. The analyses of CHF defined from the medical record showed positive associations with coefficient of haze, the extinction coefficient, SO(2), and NO(2). For example, the mean percent increase in daily mortality for an increase in the coefficient of haze across the interquartile range was 4.32% (95% CI: 0.95-7.80%) and for NO(2) it was 4.08% (95% CI: 0.59-7.68%). These effects were generally higher in the warm season.
authors.affiliation: Department of Medicine, McGill University, Montreal, Que, Canada. mark.goldberg@mcgill.ca
authors.forename: Mark S
authors.initials: MS
authors.lastname: Goldberg
authors.forename: Richard T
authors.initials: RT
authors.lastname: Burnett
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Valois
authors.forename: Kenneth
authors.initials: K
authors.lastname: Flegel
authors.forename: John C
authors.initials: JC
authors.lastname: Bailar
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Brook
authors.forename: Renaud
authors.initials: R
authors.lastname: Vincent
authors.forename: Katja
authors.initials: K
authors.lastname: Radon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects*; D016021:Epidemiologic Studies; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D010316:Particle Size; D011792:Quebec / Q000453:epidemiology; D012044:Regression Analysis; D018570:Risk Assessment; D014505:Urban Population
chemical_list: D000393:Air Pollutants