Burnett R T, Dales R E, Brook J R, Raizenne M E, Krewski D
Environmental Health Directorate, Health Canada, Ottawa, Canada.
Epidemiology. 1997 Mar;8(2):162-7. doi: 10.1097/00001648-199703000-00007.
We examined the role that ambient air pollution plays in exacerbating cardiac disease by relating daily fluctuations in admissions to 134 hospitals for congestive heart failure in the elderly to daily variations in ambient concentrations of carbon monoxide, nitrogen dioxide, sulfur dioxide, ozone, and the coefficient of haze in Canada's 10 largest cities for the 11-year period 1981-1991 inclusive. We adjusted the hospitalization time series for seasonal, subseasonal, and weekly cycles and for hospital usage patterns. The logarithm of the daily high-hour ambient carbon monoxide concentration recorded on the day of admission displayed the strongest and most consistent association with hospitalization rates among the pollutants, after stratifying the time series by month of year and adjusting simultaneously for temperature, dew point, and the other ambient air pollutants. The relative risk for a change from 1 ppm to 3 ppm, the 25th and 75th percentiles of the exposure distribution, was 1.065 (95% confidence interval = 1.028-1.104). The regression coefficients of the other air pollutants were much more sensitive to simultaneous adjustment for either multiple pollutant or weather model specifications.
我们通过将1981年至1991年（含）这11年间加拿大10个最大城市中134家医院收治老年充血性心力衰竭患者的每日波动情况与一氧化碳、二氧化氮、二氧化硫、臭氧的环境浓度日变化以及霾系数联系起来，研究了环境空气污染在加重心脏病方面所起的作用。我们对住院时间序列进行了季节性、亚季节性和每周周期以及医院使用模式的调整。在按年份月份对时间序列进行分层并同时对温度、露点和其他环境空气污染物进行调整后，入院当天记录的每日最高小时环境一氧化碳浓度的对数与住院率之间呈现出最强且最一致的关联。暴露分布的第25和第75百分位数从1 ppm变化到3 ppm时的相对风险为1.065（95%置信区间 = 1.028 - 1.104）。对于其他空气污染物，其回归系数对多种污染物或天气模型规格的同时调整更为敏感。
