title: Traffic intensity, dwelling value, and hospital admissions for respiratory disease among the elderly in Montreal (Canada): a case-control analysis.
abstract: BACKGROUND
  Persons exposed to residential traffic have increased rates of respiratory morbidity and mortality. As poverty is an important determinant of ill health, some have argued that these associations may relate to the lower socioeconomic status of those living along major roads.
  
  
  OBJECTIVE
  The objective was to evaluate the association between traffic intensity at home and hospital admissions for respiratory disease among Montreal residents of 60 years and older.
  
  
  METHODS
  Case hospitalisations were those with respiratory diagnoses and control hospitalisations were those where the primary discharge diagnosis was non-respiratory. Morning peak traffic estimates from the EMME/2 Montreal traffic model (MOTREM98) were used as an indicator of exposure to road traffic outside the homes of those hospitalised. The crude association between traffic intensity and hospitalisation for respiratory disease was adjusted by an area based estimate of the appraised value of patients' residences, expressed as a dollar average over a small segment of road (lodging value). This indicator of socioeconomic status, as calculated from the Montreal property assessment database, is available at a finer geographical scale than the neighbourhood socioeconomic indicators accessible from the Canadian census.
  
  
  RESULTS
  Increased odds of being hospitalised for a respiratory compared with a control diagnosis were associated with higher levels of estimated road traffic nearby patients' homes, even after adjustment for lodging value (crude OR 1.35, CI95% 1.22 to 1.49; adjusted OR 1.18, CI95% 1.06 to 1.31 for >3160 vehicles passing during the three hour morning traffic peak compared with secondary roads off network).
  
  
  CONCLUSIONS
  The results suggest that road traffic intensity itself, may affect the respiratory health of elderly residents of a large Canadian city, an association that is not solely a reflection of socioeconomic status.
authors.affiliation: Institut National de Santé Publique, 1301 Sherbrooke East, Montreal, Quebec, Canada H2L 1M3. asmargia@santepub-mtl.qc.ca
authors.forename: Audrey
authors.initials: A
authors.lastname: Smargiassi
authors.forename: Khalid
authors.initials: K
authors.lastname: Berrada
authors.forename: Isabel
authors.initials: I
authors.lastname: Fortier
authors.forename: Tom
authors.initials: T
authors.lastname: Kosatsky
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects*; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D001335:Vehicle Emissions
chemical_list: D000393:Air Pollutants; D001335:Vehicle Emissions