Air pollution and hospital admissions for pneumonia: are there potentially sensitive groups?
Recent studies have shown that air pollution is a risk factor for hospitalization for pneumonia. However, there is limited evidence to suggest what subpopulations are at greater risk from air pollution. This study was undertaken to examine the modifying effect of specific secondary diagnosis (including hypertension, diabetes, asthma, and upper respiratory infections) on the relationship between hospital admissions for pneumonia and ambient air pollutants. Hospital admissions for pneumonia and ambient air pollution data for Kaohsiung were obtained for the period 1996-2006. The relative risk of hospital admission was estimated using a case-crossover approach. We found that an interquartile range (IQR) increase in PM(10), NO(2), and CO on warm days was associated with a 28% (95% confidence interval [CI], 11-48%), 40% (95% CI, 20-63%), and 31% (95% CI, 19-45%), respectively, increase in admissions for pneumonia with upper respiratory infections (URI), but only 23% (95% CI, 18-28%), 30% (95% CI, 25-36%), and 24% (95% CI, 21-28%), respectively, increase for persons without URI. An IQR increase in PM(10), SO(2), and CO on cool days was associated with a 70% (95% CI, 50-92%), 30% (95% CI, 15-47%), and 64% (95% CI, 47-83%), respectively, increase in admissions in persons with URI, and an increase of 64% (95% CI, 57-70%), 18% (95% CI, 14-22%), and 55% (95% CI, 50-60%), respectively, in admissions in persons without URI. Our findings provide evidence that patients with comorbid URI may increase the risk of hospital admissions for pneumonia, in relation to air pollutant levels.
Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ming-Fen
MF
Cheng
Shang-Shyue
SS
Tsai
Hui-Fen
HF
Chiu
Fung-Chang
FC
Sung
Trong-Neng
TN
Wu
Chun-Yuh
CY
Yang
D000368:Aged; D000397:Air Pollution / Q000009:adverse effects*; D018592:Cross-Over Studies; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000506:poisoning; D010343:Patient Admission / Q000639:trends*; D011014:Pneumonia / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
D052638:Particulate Matter