Aylin P, Bottle A, Wakefield J, Jarup L, Elliott P
The Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Imperial College School of Medicine, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
Thorax. 2001 Mar;56(3):228-33. doi: 10.1136/thorax.56.3.228.
The incidence of hospital admissions for respiratory and cardiovascular diseases in areas close to operating coke works in England and Wales was investigated.
A small area study using distance from source as a proxy for exposure was undertaken in subjects aged 65 or over and children under 5 years within 7.5 km of four coke works (1991 estimated populations 87 760 and 43 932, respectively). The main outcome measures were emergency hospital admissions in 1992/3-1994/5 with a primary diagnosis of coronary heart disease (ICD 410-414), stroke (ICD 431-438), all respiratory diseases (ICD 460-519), chronic obstructive pulmonary disease (ICD 491-492), and asthma (ICD 493) in those aged 65 or over, and all respiratory and asthma admissions in children under 5 years of age.
At age 65 or over the combined estimate of relative risk with proximity to coke works (per km) ranged from 0.99 (95% CI 0.90 to 1.09) for chronic obstructive pulmonary disease to 1.03 (95% CI 0.94 to 1.13) for asthma. For children under 5 years the combined estimate of risk was 1.08 (95% CI 0.98 to 1.20) for all respiratory disease and 1.07 (95% CI 0.98 to 1.18) for asthma. There was evidence of significant heterogeneity in risk estimates between coke work groups, especially in children under 5 years (p<0.001 and p=0.004 for respiratory disease and asthma, respectively). For the Teesside coke works in North East England the relative risk with proximity (per km) was 1.09 (95% CI 1.06 to 1.12) for respiratory disease and 1.09 (95% CI 1.04 to 1.15) for asthma.
No evidence overall was found for an association between hospital admissions and living near operational coke works in England and Wales. Trends of a higher risk of hospital admission for respiratory disease and asthma among children with proximity to the Teesside plant require further investigation.
对英格兰和威尔士靠近运营中的炼焦厂地区因呼吸系统和心血管疾病住院的发生率进行了调查。
在四家炼焦厂7.5公里范围内，对65岁及以上的老年人和5岁以下儿童进行了一项小范围研究，以离污染源的距离作为接触程度的替代指标（1991年估计人口分别为87760人和43932人）。主要观察指标为1992/3 - 1994/5年因以下疾病而急诊住院的情况：65岁及以上人群中，以冠心病（国际疾病分类410 - 414）、中风（国际疾病分类431 - 438）、所有呼吸系统疾病（国际疾病分类460 - 519）、慢性阻塞性肺疾病（国际疾病分类491 - 492）和哮喘（国际疾病分类493）为主要诊断；5岁以下儿童中，以所有呼吸系统疾病和哮喘为主要诊断。
在65岁及以上人群中，与炼焦厂距离（每公里）相关的相对风险合并估计值范围为：慢性阻塞性肺疾病为0.99（95%可信区间0.90至1.09），哮喘为1.03（95%可信区间0.94至1.13）。在5岁以下儿童中，所有呼吸系统疾病的风险合并估计值为1.08（95%可信区间0.98至1.20），哮喘为1.07（95%可信区间0.98至1.18）。有证据表明炼焦厂组之间的风险估计存在显著异质性，尤其是在5岁以下儿童中（呼吸系统疾病和哮喘的p值分别<0.001和p = 0.004）。对于英格兰东北部的蒂斯河畔炼焦厂，距离相关的相对风险（每公里）为：呼吸系统疾病为1.09（95%可信区间1.06至1.12），哮喘为1.09（95%可信区间1.04至1.15）。
总体上未发现英格兰和威尔士住院情况与居住在运营中的炼焦厂附近之间存在关联。靠近蒂斯河畔工厂的儿童呼吸系统疾病和哮喘住院风险较高的趋势需要进一步调查。
