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Air pollution and emergency admissions in Boston, MA

Department of Environmental Health, Harvard School of Public Health, Boston, USA

Correspondence to:
Correspondence to:
Dr A Zanobetti
Department of Environmental Health, Exposure Epidemiology and Risk Program, Harvard School of Public Health, 401 Park Drive, Landmark Center, Suite 415, PO Box 15698, Boston, MA 02215, USA; azanobet{at}hsph.harvard.edu

Study Objective: Many studies have shown that ambient particulate air pollution (PM) is associated with increased risk of hospital admissions and deaths for cardiovascular or respiratory causes around the world. In general these have been analysed in association with PM₁₀ and ozone, whereas PM_2.5 is now the particle measure of greatest health and regulatory concern. And little has been published on associations of hospital admissions and PM components.

Design: This study analysed hospital admissions for myocardial infarction (15 578 patients), and pneumonia (24 857 patients) in associations with fine particulate air pollution, black carbon (BC), ozone, nitrogen dioxide (NO₂), PM not from traffic, and carbon monoxide (CO) in the greater Boston area for the years 1995–1999 using a case-crossover analysis, with control days matched on temperature.

Main results: A significant association was found between NO₂ (12.7% change (95% CI: 5.8, 18)), PM_2.5 (8.6% increase (95% CI: 1.2, 15.4)), and BC (8.3% increase (95% CI: 0.2, 15.8)) and the risk of emergency myocardial infarction hospitalisation; and between BC (11.7% increase (95% CI: 4.8, 17.4)), PM_2.5 (6.5% increase (95% CI: 1.1, 11.4)), and CO (5.5% increase (95% CI: 1.1, 9.5)) and the risk of pneumonia hospitalisation.

Conclusions: The pattern of associations seen for myocardial infarction and pneumonia (strongest associations with NO₂, CO, and BC) suggests that traffic exposure is primarily responsible for the association with heart attacks.

Abbreviations: NO₂, nitrogen dioxide; BC, black carbon, PM, particulate matter; CO, carbon monoxide; MI, myocardial infarction

Keywords: air pollution; myocardial infarction; case-crossover; fine particulate air pollution; pneumonia

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