Khuder Sadik A, Milz Sheryl, Jordan Timothy, Price James, Silvestri Kathi, Butler Pam
Department of Medicine, College of Medicine, University of Toledo, OH 43614, USA.
Prev Med. 2007 Jul;45(1):3-8. doi: 10.1016/j.ypmed.2007.03.011. Epub 2007 Apr 4.
In March 2002, the city of Bowling Green, Ohio, implemented a clean indoor air ordinance banning smoking in workplaces and public places. This study evaluates the effect of this ordinance on hospital admissions for smoking-related diseases.
A quasi-experimental design with interrupted time-series was used including a matched control city (Kent, Ohio) with no clean indoor air ordinance. Data on hospital admissions during the period of January 1999 to June 2005 were analyzed using Autoregressive Integrated Moving Average (ARIMA) models.
A reduction in admission rates for smoking-related diseases was achieved in Bowling Green compared to the control city. The largest reduction was for coronary heart disease, where rates were decreased significantly by 39% after 1 year and by 47% after 3 years following the implementation of the ordinance. ARIMA models revealed a statistically significant downward trend in monthly admission rates for coronary heart disease (Bowling Green, omega=-1.69, p=0.036 vs. Kent, omega=-1.14, p=0.183) and support the hypothesis that the ordinance had a significant impact on admission rates for coronary heart disease.
The findings of this study suggest that clean indoor air ordinances lead to a reduction in hospital admissions for coronary heart disease, thus reducing health care costs.
2002年3月，俄亥俄州鲍灵格林市实施了一项室内空气清洁条例，禁止在工作场所和公共场所吸烟。本研究评估该条例对与吸烟相关疾病住院率的影响。
采用中断时间序列的准实验设计，包括一个无室内空气清洁条例的匹配对照城市（俄亥俄州肯特市）。使用自回归积分移动平均（ARIMA）模型分析1999年1月至2005年6月期间的住院数据。
与对照城市相比，鲍灵格林市与吸烟相关疾病的住院率有所下降。下降幅度最大的是冠心病，条例实施1年后发病率显著下降39%，3年后下降47%。ARIMA模型显示，冠心病每月住院率存在统计学上显著的下降趋势（鲍灵格林市，ω=-1.69，p=0.036；肯特市，ω=-1.14，p=0.183），支持该条例对冠心病住院率有显著影响的假设。
本研究结果表明，室内空气清洁条例可降低冠心病住院率，从而降低医疗成本。
