Air pollution and emergency admissions in Boston, MA.
OBJECTIVE
Many studies have shown that ambient particulate air pollution (PM) is associated with increased risk of hospital admissions and deaths for cardiovascular or respiratory causes around the world. In general these have been analysed in association with PM(10) and ozone, whereas PM(2.5) is now the particle measure of greatest health and regulatory concern. And little has been published on associations of hospital admissions and PM components.


METHODS
This study analysed hospital admissions for myocardial infarction (15 578 patients), and pneumonia (24 857 patients) in associations with fine particulate air pollution, black carbon (BC), ozone, nitrogen dioxide (NO(2)), PM not from traffic, and carbon monoxide (CO) in the greater Boston area for the years 1995-1999 using a case-crossover analysis, with control days matched on temperature.


RESULTS
A significant association was found between NO(2) (12.7% change (95% CI: 5.8, 18)), PM(2.5) (8.6% increase (95% CI: 1.2, 15.4)), and BC (8.3% increase (95% CI: 0.2, 15.8)) and the risk of emergency myocardial infarction hospitalisation; and between BC (11.7% increase (95% CI: 4.8, 17.4)), PM(2.5) (6.5% increase (95% CI: 1.1, 11.4)), and CO (5.5% increase (95% CI: 1.1, 9.5)) and the risk of pneumonia hospitalisation.


CONCLUSIONS
The pattern of associations seen for myocardial infarction and pneumonia (strongest associations with NO(2), CO, and BC) suggests that traffic exposure is primarily responsible for the association with heart attacks.
Zanobetti
Antonella
A
Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA. azanobet@hsph.harvard.edu
Schwartz
Joel
J
D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects; D000397:Air Pollution / Q000009:adverse effects*; D001900:Boston / Q000453:epidemiology; D002244:Carbon / Q000009:adverse effects; D016022:Case-Control Studies; D018592:Cross-Over Studies; D004630:Emergencies / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced / Q000453:epidemiology*; D009585:Nitrogen Dioxide / Q000009:adverse effects*; D010126:Ozone / Q000009:adverse effects; D011014:Pneumonia / Q000139:chemically induced / Q000453:epidemiology*
D000393:Air Pollutants; D010126:Ozone; D002244:Carbon; D009585:Nitrogen Dioxide