Increased temperatures were found to have same-day effects on ER admission for several outcomes. Age and race/ethnicity seemed to modify some of these impacts.
Several investigators have documented the effect of temperature on mortality, although fewer have studied its impact on morbidity. In addition, little is known about the effectiveness of mitigation strategies such as use of air conditioners (ACs). The authors investigated the association between temperature and hospital admissions in California from 1999 to 2005. They also determined whether AC ownership and usage, assessed at the zip-code level, mitigated this association. Because of the unique spatial pattern of income and climate in California, confounding of AC effects by other local factors is less likely. The authors included only persons who had a temperature monitor within 25 km of their residential zip code. Using a time-stratified case-crossover approach, the authors observed a significantly increased risk of hospitalization for multiple diseases, including cardiovascular disease, ischemic heart disease, ischemic stroke, respiratory disease, pneumonia, dehydration, heat stroke, diabetes, and acute renal failure, with a 10°F increase in same-day apparent temperature. They also found that ownership and usage of ACs significantly reduced the effects of temperature on these health outcomes, after controlling for potential confounding by family income and other socioeconomic factors. These results demonstrate important effects of temperature on public health and the potential for mitigation.
Recent studies have suggested an association between air pollution and stillbirth. In this California study, we examined the records of 13,999 stillbirths and 3,012,270 livebirths occurring between 1999 and 2009. Using a retrospective cohort design and logistic regression models, we calculated the odds of stillbirth associated with each pollutant exposure by trimester and throughout the entire pregnancy. Covariates considered in the model included infant sex, maternal demographic characteristics, season of last menstrual period, apparent temperature, air basin of mother's residence, and year of conception. In single-pollutant models, we found that a 10-µg/m(3) increase in particulate matter with an aerodynamic diameter less than or equal to 2.5 µm (odds ratio (OR) = 1.06, 95% confidence interval (CI): 0.99, 1.13) and a 10-ppb increase in nitrogen dioxide (OR = 1.08, 95% CI: 1.03, 1.13) during the entire pregnancy were associated with stillbirth. A 10-ppb increase in ozone exposure during the third trimester was also associated with a slightly elevated risk (OR = 1.03, 95% CI: 1.01, 1.05). These ozone and nitrogen dioxide findings were fairly stable after adjustment in 2-pollutant models. However, adjustment for nitrogen dioxide attenuated the full-pregnancy-particulate matter relationship. No significant associations were found for sulfur dioxide or carbon monoxide. These findings support growing evidence of an association between air pollution and adverse birth outcomes.
All female graduates of a major U.S. veterinary school were surveyed by mailed questionnaire to obtain details of work practice and hazard exposure during the most recent year worked and during all pregnancies. Exposure questions were based on previously implicated occupational hazards which included anesthetic gases, radiation, zoonoses, prostaglandins, vaccines, physical trauma, and pesticides. The response rate was 86% (462/537). We found that practice type and pregnancy status were major determinants of hazard exposure within the veterinary profession. Small-animal practitioners reported the highest rates of exposure to anesthetic gas (94%), X-ray (90%), and pesticides (57%). Large-animal practitioners reported greater rates of trauma (64%) and potential exposure to prostaglandins (92%), Brucella abortus vaccine (23%), and carbon monoxide (18%). Potentially hazardous workplace practices or equipment were common. Forty-one percent of respondents who reported taking X-rays did not wear film badges, and 76% reported physically restraining animals for X-ray procedures. Twenty-seven percent of the respondents exposed to anesthetic gases worked at facilities which did not have waste anesthetic gas scavenging systems. Women who worked as veterinarians during a pregnancy attempted to reduce exposures to X-rays, insecticides, and other potentially hazardous exposures. Some potentially hazardous workplace exposures are common in veterinary practice, and measures to educate workers and to reduce these exposures should not await demonstration of adverse health effects.
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