title: Association between particulate matter and emergency room visits, hospital admissions and mortality in Spokane, Washington.
abstract: There is conflicting evidence regarding the association between different size fractions of particulate matter (PM) and cardiac and respiratory morbidity and mortality. We investigated the short-term associations of four size fractions of particulate matter (PM(1), PM(2.5), PM(10), and PM(10-2.5)) and carbon monoxide with hospital admissions and emergency room (ER) visits for respiratory and cardiac conditions and mortality in Spokane, Washington. We used a log-linear generalized linear model to compare daily averages of PM and carbon monoxide with daily counts of the morbidity and mortality outcomes from January 1995 to June 2001. We examined pollution lags ranging from 0 to 3 days and compared our results to a similar log-linear generalized additive model. Effect estimates tended to be smaller and have larger standard errors for the generalized linear model. Overall, we saw no association with respiratory ER visits and any size fraction of PM. However, there was a suggestion of greater respiratory effect from fine PM when compared to coarse fraction. Carbon monoxide was associated with both all respiratory ER visits and visits for asthma at the 3-day lag. We feel that carbon monoxide may be serving as a marker for combustion-derived pollutants, which is one large component of the diverse air pollutant mixture. We also found no association with any size fraction of PM or CO with cardiac hospital admissions or mortality at the 0- to 3-day lag. We found no consistent associations between any size fraction of PM and cardiac or respiratory ER visits or hospital admissions.
authors.affiliation: Department of Environmental Health, University of Washington, Seattle, Washington 98195, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Slaughter
authors.forename: Eugene
authors.initials: E
authors.lastname: Kim
authors.forename: Lianne
authors.initials: L
authors.lastname: Sheppard
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Sullivan
authors.forename: Timothy V
authors.initials: TV
authors.lastname: Larson
authors.forename: Candis
authors.initials: C
authors.lastname: Claiborn
mesh_terms: D000393:Air Pollutants / Q000506:poisoning*; D002248:Carbon Monoxide / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D008962:Models, Theoretical; D010316:Particle Size; D010343:Patient Admission / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000401:mortality*; D014861:Washington
chemical_list: D000393:Air Pollutants; D002248:Carbon Monoxide