Schwartz J, Morris R
Environmental Epidemiology Program, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Epidemiol. 1995 Jul 1;142(1):23-35. doi: 10.1093/oxfordjournals.aje.a117541.
In the December 1952 smog disaster in London, a substantial increase in mortality was closely associated with the increase in air pollution. Deaths from cardiovascular causes were elevated as well as respiratory deaths. The increase was greatest in the elderly. Hospital admissions were increased for both respiratory and cardiovascular diseases. Since then, many studies have reported associations between lower concentrations of air pollution and daily mortality. Little attention has been paid to the question of hospital admissions for cardiovascular illness, however. This study examined the association between air pollution and cardiovascular hospital admissions for persons aged 65 years and older in the Detroit, Michigan, metropolitan area during the years 1986-1989. After controlling for seasonal and other long-term temporal trends, temperature, and dew point temperature, the particulate matter with an aerodiameter of < or = 10 microns (PM10) was associated with daily admissions for ischemic heart disease (relative risk (RR) = 1.018, 95% confidence interval (CI) 1.005-1.032 for an interquartile range (32 micrograms/m3) increase in pollution). SO2, CO, and ozone made no independent contribution to ischemic heart disease admissions. Both PM10 (RR = 1.024, 95% CI 1.004-1.044) and CO (RR = 1.022, 95% CI 1.010-1.034 for an interquartile range (1.28 ppm) increase in pollution) showed independent associations with heart failure admissions. These results were robust to alternate methods of estimation and weather control.
在1952年12月伦敦的烟雾灾难中，死亡率的大幅上升与空气污染的增加密切相关。心血管疾病导致的死亡人数以及呼吸道疾病导致的死亡人数均有所上升。老年人的死亡人数增加幅度最大。呼吸道和心血管疾病的住院人数均有所增加。从那时起，许多研究报告了空气污染浓度降低与每日死亡率之间的关联。然而，对于心血管疾病住院问题却很少有人关注。本研究调查了1986 - 1989年期间密歇根州底特律市大都市区65岁及以上人群空气污染与心血管疾病住院之间的关联。在控制了季节和其他长期时间趋势、温度以及露点温度后，空气动力学直径≤10微米的颗粒物（PM10）与缺血性心脏病的每日住院人数相关（污染增加一个四分位间距（32微克/立方米）时，相对风险（RR）= 1.018，95%置信区间（CI）为1.005 - 1.032）。二氧化硫、一氧化碳和臭氧对缺血性心脏病住院人数没有独立影响。PM10（RR = 1.024，95% CI 1.004 - 1.044）和一氧化碳（污染增加一个四分位间距（1.28 ppm）时，RR = 1.022，95% CI 1.010 - 1.034）均与心力衰竭住院人数呈现独立关联。这些结果对于其他估计方法和天气控制方法而言是稳健的。
