Sunyer J, Antó J M, Murillo C, Saez M
Department d'Epidemiologia i Salut Pública, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
Am J Epidemiol. 1991 Aug 1;134(3):277-86; discussion 287-9. doi: 10.1093/oxfordjournals.aje.a116081.
The authors assessed the relation between sulfur dioxide and other air pollutants (black smoke, carbon monoxide, nitrogen dioxide, and ozone) and daily emergency room admissions for chronic obstructive pulmonary disease in Barcelona, Spain, during 1985-1986. Barcelona is a Mediterranean city of 1.7 million inhabitants that has air pollution levels lower than standard values. A weak but statistically significant association between emergency room admissions and levels of sulfur dioxide, black smoke, and carbon monoxide was observed. Daily emergency room admissions for chronic obstructive pulmonary disease increased by 0.02 and 0.01 for each microgram of sulfur dioxide and black smoke per cubic meter, respectively, and 0.11 for each milligram of carbon monoxide per cubic meter, after adjusting for meteorologic and temporal variables. Similar estimations were obtained after controlling for the autocorrelation effect by means of time series analysis. In addition, when the data were stratified by season, the effects remained in summer. This strengthened the conclusion that the relation observed in winter, spring, and throughout the study period was indeed real. After truncating the data according to sulfur dioxide or black smoke levels, the authors still found effects for these pollutants at levels below the air quality guideline of 100 micrograms/m3 established by the World Health Organization. The consistency of these results with other recent toxicologic and epidemiologic observations suggest that current air pollution standards do not totally protect public health with a margin of safety in specific places.
作者评估了1985 - 1986年期间西班牙巴塞罗那二氧化硫及其他空气污染物（黑烟、一氧化碳、二氧化氮和臭氧）与慢性阻塞性肺疾病每日急诊入院人数之间的关系。巴塞罗那是一座拥有170万居民的地中海城市，其空气污染水平低于标准值。研究观察到急诊入院人数与二氧化硫、黑烟和一氧化碳水平之间存在微弱但具有统计学意义的关联。在对气象和时间变量进行调整后，每立方米空气中每微克二氧化硫和黑烟导致慢性阻塞性肺疾病的每日急诊入院人数分别增加0.02和0.01，每立方米空气中每毫克一氧化碳导致该人数增加0.11。通过时间序列分析控制自相关效应后，得到了类似的估计结果。此外，当数据按季节分层时，夏季仍存在这种效应。这强化了在冬季、春季以及整个研究期间观察到的这种关系确实存在的结论。根据二氧化硫或黑烟水平对数据进行截断后，作者仍发现这些污染物在低于世界卫生组织制定的空气质量准则100微克/立方米的水平时也存在影响。这些结果与其他近期毒理学和流行病学观察结果的一致性表明，当前的空气污染标准并不能在特定地点完全保障公众健康并留有安全边际。
