Chen Yue, Yang Qiuying, Krewski Daniel, Burnett Richard T, Shi Yuanli, McGrail Kimberlyn M
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Inhal Toxicol. 2005 Nov;17(12):649-55. doi: 10.1080/08958370500189420.
The objective of this article is to examine differences in the effect of ambient particulate matter on first, second, and overall hospital admissions for respiratory disease among the elderly. We studied 8989 adults 65 yr of age or older living in the greater Vancouver area who were admitted to hospital for any acute respiratory disease (ICD-9 codes 460-519) between June 1, 1995, and March 31, 1999. Time-series analysis was used to evaluate the association between respiratory admissions and daily measures of particulate matter (PM10, PM2.5, and PM10 - 2.5) in urban air, after adjustment for gaseous copollutants (CO, O3, NO2, and SO2) and meteorological variables. Repeated admissions for respiratory disease were common among the elderly. Approximately 30% of the subjects were readmitted to hospital after the first admission; 9% had more than 2 admissions for respiratory disease during the 4-yr study period. PM10 - 2.5 was significantly associated with the second and overall admissions for respiratory disease, but not with the first admission. The adjusted relative risks for an increment of 4.2 microg/m(3) in -day average PM10 - 2.5 concentrations were 1.03 (95% confidence interval: 0.98-1.09) for the first admission, 1.22 (1.10-1.36) for the second admission, and 1.06 (1.02, 1.11) for overall admissions. There was no significant association between PM2.5 and hospital admissions for respiratory disease among the elderly. Our data suggest that (1) people with a history of respiratory admissions are at a higher risk of respiratory disease in relation to particulate air pollution in urban areas, (2) analyses based on overall rather than repeated hospital admissions lead to lower estimates of the risk of respiratory disease associated with particulate air pollution, and (3) PM10 - 2.5 has a larger effect on respiratory admissions than PM2.5.
本文的目的是研究环境颗粒物对老年人因呼吸系统疾病首次、再次及总体住院情况影响的差异。我们对居住在大温哥华地区的8989名65岁及以上的成年人进行了研究，这些人在1995年6月1日至1999年3月31日期间因任何急性呼吸系统疾病（国际疾病分类第九版编码460 - 519）而住院。在对气态共污染物（一氧化碳、臭氧、二氧化氮和二氧化硫）及气象变量进行调整后，采用时间序列分析来评估呼吸系统住院情况与城市空气中颗粒物（PM10、PM2.5和PM10 - 2.5）的每日测量值之间的关联。老年人因呼吸系统疾病反复住院的情况很常见。约30%的受试者在首次住院后再次入院；在4年的研究期间，9%的人因呼吸系统疾病住院超过2次。PM10 - 2.5与呼吸系统疾病的再次及总体住院情况显著相关，但与首次住院无关。当日均PM10 - 2.5浓度增加4.2微克/立方米时，首次住院的调整后相对风险为1.03（95%置信区间：0.98 - 1.09），再次住院为1.22（1.10 - 1.36），总体住院为1.06（1.02，1.11）。PM2.5与老年人呼吸系统疾病住院情况之间无显著关联。我们的数据表明：（1）有呼吸系统住院史的人在城市地区因颗粒物空气污染患呼吸系统疾病的风险更高；（2）基于总体而非反复住院情况进行分析会导致对与颗粒物空气污染相关的呼吸系统疾病风险的估计值偏低；（3）PM10 - 2.5对呼吸系统住院情况的影响比PM2.5更大。
