Smargiassi Audrey, Berrada Khalid, Fortier Isabel, Kosatsky Tom
Institut National de Santé Publique, 1301 Sherbrooke East, Montreal, Quebec, Canada H2L 1M3.
J Epidemiol Community Health. 2006 Jun;60(6):507-12. doi: 10.1136/jech.2005.037044.
Persons exposed to residential traffic have increased rates of respiratory morbidity and mortality. As poverty is an important determinant of ill health, some have argued that these associations may relate to the lower socioeconomic status of those living along major roads.
The objective was to evaluate the association between traffic intensity at home and hospital admissions for respiratory disease among Montreal residents of 60 years and older.
Case hospitalisations were those with respiratory diagnoses and control hospitalisations were those where the primary discharge diagnosis was non-respiratory. Morning peak traffic estimates from the EMME/2 Montreal traffic model (MOTREM98) were used as an indicator of exposure to road traffic outside the homes of those hospitalised. The crude association between traffic intensity and hospitalisation for respiratory disease was adjusted by an area based estimate of the appraised value of patients' residences, expressed as a dollar average over a small segment of road (lodging value). This indicator of socioeconomic status, as calculated from the Montreal property assessment database, is available at a finer geographical scale than the neighbourhood socioeconomic indicators accessible from the Canadian census.
Increased odds of being hospitalised for a respiratory compared with a control diagnosis were associated with higher levels of estimated road traffic nearby patients' homes, even after adjustment for lodging value (crude OR 1.35, CI95% 1.22 to 1.49; adjusted OR 1.18, CI95% 1.06 to 1.31 for >3160 vehicles passing during the three hour morning traffic peak compared with secondary roads off network).
The results suggest that road traffic intensity itself, may affect the respiratory health of elderly residents of a large Canadian city, an association that is not solely a reflection of socioeconomic status.
接触住宅交通的人群呼吸道发病率和死亡率有所上升。由于贫困是健康不良的一个重要决定因素，一些人认为这些关联可能与居住在主要道路沿线人群较低的社会经济地位有关。
评估60岁及以上蒙特利尔居民家中交通强度与呼吸道疾病住院之间的关联。
病例住院患者为呼吸道诊断患者，对照住院患者为主要出院诊断为非呼吸道疾病的患者。使用EMME/2蒙特利尔交通模型（MOTREM98）的早高峰交通估计值作为住院患者家外道路交通暴露的指标。交通强度与呼吸道疾病住院之间的粗略关联通过基于患者住所评估价值的区域估计值进行调整，该估计值表示为一小段道路上的平均美元价值（住宿价值）。根据蒙特利尔房产评估数据库计算得出的这一社会经济地位指标，在地理尺度上比从加拿大人口普查中获取的邻里社会经济指标更精细。
与对照诊断相比，因呼吸道疾病住院的几率增加与患者家附近估计道路交通水平较高有关，即使在调整住宿价值后也是如此（与非网络二级道路相比，在三小时早高峰期间有超过3160辆车通过时，粗略比值比为1.35，95%置信区间为1.22至l.49；调整后比值比为1.18，95%置信区间为1.06至1.31）。
结果表明，道路交通强度本身可能会影响加拿大一个大城市老年居民的呼吸道健康，这种关联并不完全是社会经济地位的反映。
