Objective-To test for a significant association between air pollution and emergency hospital admissions for circulatory diseases (international classification of diseases-9 390-459) in London, England, that would be consistent with a causal effect of pollution on the previous day.
rate ratio at level z is estimated by x= jBIz+ I2S(z) Abstract Objective-To investigate whether outdoor air pollution levels in London influence daily mortality.
The Air Pollution and Health: a European Approach (APHEA) project is a coordinated study of the short-term effects of air pollution on mortality and hospital admissions using data from 15 European cities, with a wide range of geographic, sociodemographic, climatic, and air quality patterns. The objective of this paper is to summarize the results of the short-term effects of ambient oxidants on daily deaths from all causes (excluding accidents). Within the APHEA project, six cities spanning Central and Western Europe provided data on daily deaths and NO2 and/or O3 levels. The data were analyzed by each center separately following a standardized methodology to ensure comparability of results. Poisson autoregressive models allowing for overdispersion were fitted. Fixed effects models were used to pool the individual regression coefficients when there was no evidence of heterogeneity among the cities and random effects models otherwise. Factors possibly correlated with heterogeneity were also investigated. Significant positive associations were found between daily deaths and both NO2 and O3. Increases of 50 micrograms/m3 in NO2 (1-hour maximum) or O3 (1-hour maximum) were associated with a 1.3% (95% confidence interval 0.9-1.8) and 2.9% (95% confidence interval 1.0-4.9) increase in the daily number of deaths, respectively. Stratified analysis of NO2 effects by low and high levels of black smoke or O3 showed no significant evidence for an interaction within each city. However, there was a tendency for larger effects of NO2 in cities with higher levels of black smoke. The pooled estimate for the O3 effect was only slightly reduced, whereas the one for NO2 was almost halved (although it remained significant) when two pollutant models including black smoke were applied. The internal validity (consistency across cities) as well as the external validity (similarities with other published studies) of our results on the O3 effect support the hypothesis of a causal relation between O3 and all cause daily mortality. However, the short-term effects of NO2 on mortality may be confounded by other vehicle-derived pollutants. Thus, the issue of independent NO2 effects requires additional investigation.
There are concerns about the possible short-term effects of outdoor air pollution on health in the United Kingdom. In a study conducted during the time period between 1987 and 1992, investigators determined that ozone had small, but significant effects on emergency respiratory admissions. In the current study, the authors investigated associations between emergency admissions and outdoor air pollution for the time period from 1992 to 1994, inclusive, and compared the results with those obtained in the earlier study. The authors also examined particulate matter less than 10 microm in diameter (PM10) and carbon monoxide in the current study. Appropriate confounding factors, such as seasonal patterns, temperature, and humidity, were controlled for, and the authors used Poisson regression to estimate the association between daily emergency admissions for respiratory and cardiovascular diseases and ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, particles measured as Black Smoke, and PM10. Significant positive associations were found between emergency hospital admissions for respiratory disease and PM10 and sulfur dioxide, but such an association did not exist for ozone. The results were not significantly different from earlier results from London and were comparable with those determined in North America and Europe. Cardiovascular disease was associated with carbon monoxide and Black Smoke, but weaker associations existed with the other pollutants studied.
The results suggest that the levels of particulate matter from biomass burning in the Amazon are associated with adverse effects on the respiratory health of children.
Objective: To investigate the effect of five dimensions of social relationships on obesity and potential sex differences in these associations. Design and Methods: This study used longitudinal data from the Swedish Level of Living Surveys (LNU) in 1991 and 2000. The sample included 3,586 individuals. The dimensions of social relationships examined in this study include emotional support, frequency of visiting friends, marital status, marital status changes, and a Social Relationships Index (SRI). Obesity status was based on BMI (kg/m 2 ) and calculated with self-reported measurements. The association between social relationships and the incidence of obesity after 9 years of follow-up was evaluated through Poisson regressions. Results: After controlling for confounders, we found that the lack of emotional support (RR ¼ 1.98; 95% CI, 1.1-4.6) influenced the incidence of obesity among men. In addition, men with the lowest levels of SRI (RR ¼ 2.22; 95% CI, 1.1-4.4) had an increased risk of being obese. Among women, SRI was not significantly associated with obesity. Women who changed their marital status from married to unmarried had lower risk of obesity (RR ¼ 0.39; 95% CI, 0.2-0.9). Conclusions: This study provides evidence for the effect of social relationships on the incidence of obesity, with significant differences by sex.
These results suggest that interventions at the neighborhood level may offer an additional route for the prevention of the disorder and/or alleviation of its consequences.
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