Department of Environmental Health Science, School of Public Health, 1 University Place, University at Albany, Rensselaer, NY 12144, USA.
Institute for Health and the Environment, 5 University Place, University at Albany, Rensselaer, NY 12144, USA.
Int J Environ Res Public Health. 2023 Feb 13;20(4):3267. doi: 10.3390/ijerph20043267.
We have explored differences in rates of emergency room (ER) visits for respiratory diseases in the counties of New York State (NYS) in relation to levels of air pollution, poverty, and smoking. Air pollution information was derived from the National Emissions Inventory, which provides information on road, non-road, point, and non-point sources of 12 different air pollutants. This information is only available at the county level. Four types of respiratory diseases were considered: asthma, chronic obstructive pulmonary disease (COPD), acute lower respiratory diseases, and acute upper respiratory diseases. Asthma ER visits were elevated in counties with greater total air pollution. All forms of respiratory diseases were elevated in counties with a greater rate of poverty, although this may reflect the fact that poor people often use ERs for routine care. There was a very strong association between rates of smoking for COPD and acute lower respiratory diseases. There was an apparent negative association between smoking and asthma ER visits, but this must reflect the fact that smoking was much more common in upstate counties while asthma was more common in the New York City area, where air pollution is high. Air pollution was much greater in urban than in rural areas. Our evidence indicates that air pollution is the greatest risk factor for asthma attacks, whereas smoking is the greatest risk factor for chronic obstructive pulmonary disease (COPD) and lower respiratory disease. Poor people are more vulnerable to all forms of respiratory diseases.
我们探讨了纽约州（NYS）各县与空气污染程度、贫困和吸烟水平相关的呼吸系统疾病急诊率的差异。空气污染信息来源于国家排放清单，其中提供了 12 种不同空气污染物的道路、非道路、点源和非点源信息。这些信息仅在县级可用。考虑了四种类型的呼吸系统疾病：哮喘、慢性阻塞性肺疾病（COPD）、急性下呼吸道疾病和急性上呼吸道疾病。哮喘急诊率在总空气污染程度较高的县中升高。在贫困率较高的县中，所有形式的呼吸系统疾病都升高，尽管这可能反映了穷人经常将急诊室用于常规护理的事实。COPD 和急性下呼吸道疾病的吸烟率之间存在很强的关联。吸烟与哮喘急诊率之间存在明显的负相关，但这必须反映出这样一个事实，即吸烟在纽约州北部各县更为普遍，而哮喘在空气污染程度较高的纽约市地区更为普遍。城市地区的空气污染程度远高于农村地区。我们的证据表明，空气污染是哮喘发作的最大风险因素，而吸烟是 COPD 和下呼吸道疾病的最大风险因素。穷人更容易受到各种呼吸系统疾病的影响。
