Proximity to coke works and hospital admissions for respiratory and cardiovascular disease in England and Wales

Aylin, Paul; Bottle, Alex; Wakefield, Julie; Järup, Lars; Elliott, Paul

doi:10.1136/thorax.56.3.228

Cited by 30 publications

(17 citation statements)

References 30 publications

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“…Several studies were carried out to evaluate the health outcomes of coke oven emissions on exposed populations, but most of them failed to find conclusive evidences (Aylin et al, 2001;Bhopal et al, 1994;Bottle and Wakefield, 2004;Dolk et al, 2000;Parodi et al, 2003). Our institute monitored PAH concentrations around Genoa (Italy) coke oven plant for 13 years and used these data to evaluate possible health effects on population living near this plant (Parodi et al, 2005).…”

Section: Introductionmentioning

confidence: 98%

Temporal and spatial variations of polycyclic aromatic hydrocarbon concentrations around a coke oven plant

Stella

Piccardo

Pala

et al. 2012

Journal of the Air & Waste Management Association

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Around a coking plant, polycyclic aromatic hydrocarbons (PAHs), concentrations depend mainly on downwind hours and distance. Equations that best fit these variables were experimentally calculated. Fugitive emissions of an old coke oven did not comply with the threshold BAP air concentration proposed by the World Health Organization (WHO), up to 1,900 m distance. The study identified the PAH profile of fugitive emissions of a coke oven, statistically different from the profile of traffic emissions. During its activity, in the Genoa residential area, 575 m away from the plant, 92.8% of found PAHs was due to coke oven emission only.

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Section: Introductionmentioning

confidence: 98%

Temporal and spatial variations of polycyclic aromatic hydrocarbon concentrations around a coke oven plant

Stella

Piccardo

Pala

et al. 2012

Journal of the Air & Waste Management Association

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“…For the current study, Aylin et al [6] considered a number of cardiorespiratory endpoints: respiratory disease as a whole (ICD-9, 460-519), asthma (493), ischaemic heart disease (IHD, 410-414), cerebrovascular disease (CVD, 413-418) and chronic obstructive airways disease (COAD, 491-492). Two Welsh cokeworks groups were excluded from the study due to highly incomplete diagnostic coding (¿25 per cent of recorded admissions had missing codes) in the local hospitals taking most of the admissions from residents living near the plants.…”

Section: Datamentioning

confidence: 99%

“…In Section 5, we provide a substantive analysis of the cokeworks example in order to illustrate the statistical issues and the control for provider. The full results of the study are given elsewhere [6]. In Section 6, we provide a concluding discussion.…”

Section: Introductionmentioning

confidence: 99%

Controlling for provider of treatment in the modelling of respiratory disease risk near cokeworks

Bottle

Wakefield

2004

Statistics in Medicine

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The improved quality of hospital admissions data makes them a valuable resource for researchers. However, we show that, when multiple providers of health care are considered, the provider (in this case hospital) may act like other confounders such as socio-economic status, and hence must be controlled for. Such control is not as straightforward as for conventional confounders, however, but we describe a method that is appropriate under certain assumptions. We also describe a number of other statistical issues, such as the modelling of spatial and non-spatial overdispersion, that arose during the use of hospital data in a study to investigate the possible adverse health effects of living in proximity to six cokeworks groups in England and Wales. The outcome data that we consider consist of hospital admissions for all respiratory disease in the under-5s. The ecological level of the analysis is the census-defined enumeration district, and the main (proxy) exposure measure utilised is the spatial location of the enumeration district population-weighted centroid in relation to the cokeworks. We focus on the Teesside cokeworks group, for which we also had sulphur dioxide measurements from dispersion modelling as an alternative exposure measure. The major local providers varied appreciably in their standardized admission ratios for respiratory disease, and when provider was controlled for, the size of the observed excess risk found close to the cokeworks was decreased, making control for the provider of health care vital. However, the presence of multiple pollution sources, in addition to the usual shortcomings of ecological studies, makes interpretation difficult.

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“…Several studies have been performed around point sources of pollution, such as industrial plants, using circular areas at different distances from the source to define exposure zones (e.g., Aylin et al 2001; Wilkinson et al 1997). This approach has proven useful although it provides a rather crude estimate of exposure that does not consider, for example, meteorologic conditions or topography…”

Section: Exposure Mappingmentioning

confidence: 99%

Health and Environment Information Systems for Exposure and Disease Mapping, and Risk Assessment

Järup

2004

Environ Health Perspect

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A large number of chemicals are used on a regular basis in modern society. Thousands of new chemicals are added each year, many of which may have toxic properties constituting potential health hazards. Rapid assessment of the risk associated with the use of these chemicals is therefore essential to protect people from exposure to potentially harmful substances. Exposures to chemicals (and physical agents) are typically unevenly distributed geographically as well as temporally. Disease occurrence also shows geographically varying patterns. Geographic information systems (GIS) may be used to produce maps of exposure and/or disease to reveal spatial patterns. Exposure mapping using advanced GIS modeling may enhance exposure assessment in environmental epidemiology studies. Disease maps can be valuable tools in risk assessment to explore changes in disease patterns potentially associated with changes in environmental exposures. Spatial variations in risk and trends related to distance from pollution sources may be studied using software tools such as the Rapid Inquiry Facility, developed by the U.K. Small Area Health Statistics Unit and enhanced in the European Health and Environment Information System project, for an initial quick evaluation of any potential health hazards associated with an environmental pollutant.

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Proximity to coke works and hospital admissions for respiratory and cardiovascular disease in England and Wales

Cited by 30 publications

References 30 publications

Temporal and spatial variations of polycyclic aromatic hydrocarbon concentrations around a coke oven plant

Temporal and spatial variations of polycyclic aromatic hydrocarbon concentrations around a coke oven plant

Controlling for provider of treatment in the modelling of respiratory disease risk near cokeworks

Health and Environment Information Systems for Exposure and Disease Mapping, and Risk Assessment

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