Environmental risk factors for community-acquired pneumonia hospitalization in older adults.
OBJECTIVE
To investigate the risk of hospitalization for pneumonia in older adults in relation to biophysical environmental factors.


METHODS
Population-based case control study with collection of personal interview data.


METHODS
Hamilton, Ontario, and Edmonton, Alberta, Canada.


METHODS
Seven hundred seventeen people aged 65 and older hospitalized for community-acquired pneumonia (CAP) from September 2002 to April 2005 and 867 controls aged 65 and older randomly selected from the same communities as the cases.


METHODS
Odds ratios (ORs) for risk of pneumonia in relation to environmental and other variables.


RESULTS
Exposure to secondhand smoke in the previous month (OR=1.73, 95% confidence interval (CI)=1.04-2.90); poor nutritional score (OR=1.83, 95% CI=1.19-2.80); alcohol use per month (per gram; OR=1.69, 95% CI=1.08-2.61); history of regular exposure to gases, fumes, or chemicals at work (OR=3.69, 95% CI=2.37-5.75); history of regular exposure to fumes from solvents, paints, or gasoline at home (OR=3.31, 95% CI=1.59-6.87); and non-English language spoken at home (OR=5.31, 95% CI=2.60-10.87) were associated with a greater risk of pneumonia hospitalization in multivariable analysis. Age, congestive heart failure, chronic obstructive lung disease, dysphagia, renal disease, functional status, use of immunosuppressive disease medications, and lifetime history of smoking of more than 100 cigarettes were other variables associated with hospitalization for pneumonia.


CONCLUSIONS
In elderly people, present and past exposures in the physical environmental are associated with hospitalization for CAP.
Loeb
Mark
M
Departments of Pathology and Molecular Medicine, McMaster University, MDCL 3200, 1200 Main St. W., Hamilton, ON L8N 3Z5, Canada. loebm@mcmaster.ca
Neupane
Binod
B
Walter
Stephen D
SD
Hanning
Rhona
R
Carusone
Soo Chan
SC
Lewis
David
D
Krueger
Paul
P
Simor
Andrew E
AE
Nicolle
Lindsay
L
Marrie
Thomas J
TJ
D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D017714:Community-Acquired Infections / Q000628:therapy*; D003680:Deglutition Disorders / Q000150:complications; D005260:Female; D006333:Heart Failure / Q000150:complications; D006760:Hospitalization; D006801:Humans; D007166:Immunosuppressive Agents; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D009752:Nutritional Status; D016273:Occupational Exposure; D011014:Pneumonia / Q000628:therapy*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012307:Risk Factors; D014028:Tobacco Smoke Pollution
D007166:Immunosuppressive Agents; D014028:Tobacco Smoke Pollution