| Are There Sensitive Subgroups for the Effects of Airborne Particles? Antonella Zanobetti,1 Joel Schwartz,1,2 and Diane Gold1,2 1Environmental Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
2Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA Abstract
Recent studies have shown that particulate air pollution is a risk factor for hospitalization for heart and lung disease ; however, little is known about what subpopulations are most sensitive to this pollutant. We analyzed Medicare hospital admissions for heart disease, chronic obstructive pulmonary disorders (COPD) and pneumonia in Chicago, Cook County, Illinois, between 1985 and 1994. We examined whether previous admissions or secondary diagnoses for selected conditions predisposed persons to having a greater risk from air pollution. We also considered effect modification by age, sex, and race. We found that the air-pollution-associated increase in hospital admissions for cardiovascular diseases was almost doubled in subjects with concurrent respiratory infections. The risk was also increased by a previous admission for conduction disorders. For COPD and pneumonia admissions, diagnosis of conduction disorders or dysrhythmias increased the risk of particulate matter < 10 µm in aerodynamic diameter (PM10) -associated admissions. Persons with asthma had twice the risk of a PM10-associated pneumonia admission and persons with heart failure had twice the risk of PM10-induced COPD admissions. The PM10 effect did not vary by sex, age, and race. These results suggest that patients with acute respiratory infections or defects in the electrical control of the heart are a risk group for particulate matter effects. Key words: effect modification, hospital admissions, particulate air pollution. Environ Health Perspect 108:841-845 (2000) . [Online 28 July 2000] http://ehpnet1.niehs.nih.gov/docs/2000/108p841-845zanobetti/ abstract.html Address correspondence to A. Zanobetti, Department of Environmental Health, Environmental Epidemiology Program, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 USA. Telephone: (617) 432-4642. Fax: (617) 277-2382. E-mail: azanob@sparc6a.harvard.edu Supported by NIEHS grant ES07937. Received 18 January 2000 ; accepted 18 April 2000.
The full version of this article is available for free in HTML or PDF formats. |
