Ambient air pollution and respiratory emergency department visits.
BACKGROUND
A number of emergency department studies have corroborated findings from mortality and hospital admission studies regarding an association of ambient air pollution and respiratory outcomes. More refined assessment has been limited by study size and available air quality data.


METHODS
Measurements of 5 pollutants (particulate matter [PM10], ozone, nitrogen dioxide [NO2], carbon monoxide [CO], and sulfur dioxide [SO2]) were available for the entire study period (1 January 1993 to 31 August 2000); detailed measurements of particulate matter were available for 25 months. We obtained data on 4 million emergency department visits from 31 hospitals in Atlanta. Visits for asthma, chronic obstructive pulmonary disease, upper respiratory infection, and pneumonia were assessed in relation to air pollutants using Poisson generalized estimating equations.


RESULTS
In single-pollutant models examining 3-day moving averages of pollutants (lags 0, 1, and 2): standard deviation increases of ozone, NO2, CO, and PM10 were associated with 1-3% increases in URI visits; a 2 microg/m increase of PM2.5 organic carbon was associated with a 3% increase in pneumonia visits; and standard deviation increases of NO2 and CO were associated with 2-3% increases in chronic obstructive pulmonary disease visits. Positive associations persisted beyond 3 days for several of the outcomes, and over a week for asthma.


CONCLUSIONS
The results of this study contribute to the evidence of an association of several correlated gaseous and particulate pollutants, including ozone, NO2, CO, PM, and organic carbon, with specific respiratory conditions.
Peel
Jennifer L
JL
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. jennifer.peel@colostate.edu
Tolbert
Paige E
PE
Klein
Mitchel
M
Metzger
Kristi Busico
KB
Flanders
W Dana
WD
Todd
Knox
K
Mulholland
James A
JA
Ryan
P Barry
PB
Frumkin
Howard
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000506:poisoning*; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D016021:Epidemiologic Studies; D005260:Female; D005740:Gases; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010316:Particle Size; D010343:Patient Admission / Q000706:statistics & numerical data*
D000393:Air Pollutants; D005740:Gases