Air pollution and hospital admissions for respiratory conditions in Rome, Italy

Abstract

Most of the evidence regarding the association between particulate air pollution and emergency room visits or hospital admissions for respiratory conditions and asthma comes from the USA. European time-series analyses have suggested that gaseous air pollutants are important determinants of acute hospitalization for respiratory conditions, at least as important as particulate mass. The association between daily mean levels of suspended particles and gaseous pollutants (sulphur dioxide, nitrogen dioxide, carbon monoxide, ozone) was examined. The daily emergency hospital admissions for respiratory conditions in the metropolitan area of Rome during 1995 -1997 were also recorded.Daily counts of hospital admissions for total respiratory conditions (43 admissions?day -1 ), acute respiratory infections including pneumonia (18?day -1 ), chronic obstructive pulmonary disease (COPD) (13?day ) among residents of all ages and among children (0 -14 yrs) were analysed. The generalized additive models included spline smooth functions of the day of study, mean temperature, mean humidity, influenza epidemics, and indicator variables for day of the week and holidays.Total respiratory admissions were significantly associated with same-day level of NO 2 (2.5% increase per interquartile range (IQR) change, 22.3 mg?m -3 ) and CO (2.8% increase per IQR, 1.5 mg?m -3 ). No effect was found for particulate matter and SO 2 , whereas O 3 was associated with admissions only among children (lag 1, 5.5% increase per IQR, 23.9 mg?m 3 ). The effect of NO 2 was stronger on acute respiratory infections (lag 0, 4.0% increase) and on asthma among children (lag 1, 10.7% increase). The admissions for all ages for asthma and COPD were associated only with same-day level of CO (5.5% and 4.3% increase, respectively). Multipollutant models confirmed the role of CO on all respiratory admissions, including asthma and COPD, and that of NO 2 on acute respiratory infections. Among children, O 3 remained a strong indicator of acute respiratory infections.Carbon monoxide and photochemical pollutants (nitrogen dioxide, ozone) appear to be determinants of acute respiratory conditions in Rome. Since carbon monoxide and nitrogen dioxide are good indicators of combustion products from traffic related sources, the detected effect may be due to unmeasured fine and ultrafine particles.

Air pollution, avoidance behaviour and children's respiratory health: Evidence from England

“…Examining asthma hospitalisations between March and October, Neidell (2009) (1996), Atkinson et al (1999) and Anderson et al (2001) Leon et al (1996), Sunyer et al (1997), Petroeschevsky et al (2001), Burnett et al (1994) and Fusco et al (2001) find elasticities at the mean between 0.004 and 0.06, up to two-thirds of my estimates. These studies assign one air pollution measure to the whole study area, so their estimates suffer from measurement error.…”

“…Anderson et al (2001) conduct a study in the West Midlands conurbation in England for the period 1994 to 1996. Fusco et al (2001) report an association between air pollutants and respiratory hospital admissions in Rome, Italy, for the period 1995 to 1997.…”

Association between particulate matter and emergency room visits, hospital admissions and mortality in Spokane, Washington

“…The strongest associations were found for respiratory outcomes with CO, however, such low concentrations of CO could not directly cause the health effect. CO could be a surrogate measure for combustion particles (Burnett et al, 1999;Fusco et al, 2001) that induce a worsening of asthma by inciting an inflammatory response in the airways with progressive decrements in lung function and unresponsiveness to medications (Quay et al, 1998;Baeza-Squiban et al, 1999;Morio et al, 2001;Li et al, 2002).…”

Effects of weather types on hospital admissions for respiratory diseases in Castilla-La Mancha, Spain

“…Regarding pollutants, not analyzed in the present paper, hospital admissions due to asthma may rise in periods of poorer air quality and, in particular, admissions due to rises in ozone concentrations may increase (Fusco et al, 2001;Tortolero et al, 2002). An association between daily ozone levels and respiratory symptoms has been reported (Romieu et al, 1996;Rabinovitch et al, 2004).…”