title: Air pollution and multiple acute respiratory outcomes.
abstract: Short-term effects of air pollutants on respiratory mortality and morbidity have been consistently reported but usually studied separately. To more completely assess air pollution effects, we studied hospitalisations for respiratory diseases together with out-of-hospital respiratory deaths. A time-stratified case-crossover study was carried out in six Italian cities from 2001 to 2005. Daily particulate matter (particles with a 50% cut-off aerodynamic diameter of 10 μm (PM10)) and nitrogen dioxide (NO2) associations with hospitalisations for respiratory diseases (n = 100 690), chronic obstructive pulmonary disease (COPD) (n = 38 577), lower respiratory tract infections (LRTI) among COPD patients (n = 9886) and out-of-hospital respiratory deaths (n = 5490) were estimated for residents aged ≥35 years. For an increase of 10 μg·m(-3) in PM10, we found an immediate 0.59% (lag 0-1 days) increase in hospitalisations for respiratory diseases and a 0.67% increase for COPD; the 1.91% increase in LRTI hospitalisations lasted longer (lag 0-3 days) and the 3.95% increase in respiratory mortality lasted 6 days. Effects of NO2 were stronger and lasted longer (lag 0-5 days). Age, sex and previous ischaemic heart disease acted as effect modifiers for different outcomes. Analysing multiple rather than single respiratory events shows stronger air pollution effects. The temporal relationship between the pollutant increases and hospitalisations or mortality for respiratory diseases differs.
authors: Regional Health Service, Rome, Italy. a.faustini@deplazio.it
authors: Annunziata
authors: A
authors: Faustini
authors: Massimo
authors: M
authors: Stafoggia
authors: Paola
authors: P
authors: Colais
authors: Giovanna
authors: G
authors: Berti
authors: Luigi
authors: L
authors: Bisanti
authors: Ennio
authors: E
authors: Cadum
authors: Achille
authors: A
authors: Cernigliaro
authors: Sandra
authors: S
authors: Mallone
authors: Corrado
authors: C
authors: Scarnato
authors: Francesco
authors: F
authors: Forastiere
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000009:adverse effects*; D002947:Cities; D018592:Cross-Over Studies; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000032:analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D012120:Respiration Disorders / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter