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Environ Health Perspect. 1997 June; 105(6): 614–620.
PMCID: PMC1470088
Research Article

The role of particulate size and chemistry in the association between summertime ambient air pollution and hospitalization for cardiorespiratory diseases.


In order to address the role that the ambient air pollution mix, comprised of gaseous pollutants and various physical and chemical measures of particulate matter, plays in exacerbating cardiorespiratory disease, daily measures of fine and coarse particulate mass, aerosol chemistry (sulfates and acidity), and gaseous pollution (ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide) were collected in Toronto, Ontario, Canada, in the summers of 1992, 1993, and 1994. These time series were then compared with concurrent data on the number of daily admissions to hospitals for either cardiac diseases (ischemic heart disease, heart failure, and dysthymias) or respiratory diseases (tracheobronchitis, chronic obstructive long disease, asthma, and pneumonia). After adjusting the admission time series for long-term temporal trends, seasonal variations, the effects of short-term epidemics, day of the week effects, and ambient temperature and dew point temperature, positive associations were observed for all ambient air pollutants for both respiratory and cardiac diseases. Ozone was least sensitive to adjustment for the gaseous and particulate pollution measures. However, the association between the health outcomes and carbon monoxide, fine and coarse mass, sulfate levels and aerosol acidity could be explained by adjustment for exposure to gaseous pollutants. Increases in ozone, nitrogen dioxide, and sulfur dioxide equivalent to their interquartile ranges corresponded to an 11% and 13% increase in daily hospitalizations for respiratory and cardiac diseases, respectively. The inclusion of any one of the particulate air pollutants in multiple regression models did not increase these percentages. Particle mass and chemistry could not be identified as an independent risk factor for the exacerbation of cardiorespiratory diseases in this study beyond that attributable to climate and gaseous air pollution. We recommend that effects of particulate matter on health be assessed in conjunction with temporally covarying gaseous air pollutants.

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Selected References

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  • Schwartz J, Dockery DW, Neas LM. Is daily mortality associated specifically with fine particles? J Air Waste Manag Assoc. 1996 Oct;46(10):927–939. [PubMed]
  • Thurston GD, Ito K, Hayes CG, Bates DV, Lippmann M. Respiratory hospital admissions and summertime haze air pollution in Toronto, Ontario: consideration of the role of acid aerosols. Environ Res. 1994 May;65(2):271–290. [PubMed]
  • Burnett RT, Dales RE, Raizenne ME, Krewski D, Summers PW, Roberts GR, Raad-Young M, Dann T, Brook J. Effects of low ambient levels of ozone and sulfates on the frequency of respiratory admissions to Ontario hospitals. Environ Res. 1994 May;65(2):172–194. [PubMed]
  • Wallace L. Indoor particles: a review. J Air Waste Manag Assoc. 1996 Feb;46(2):98–126. [PubMed]
  • Suh HH, Koutrakis P, Spengler JD. Validation of personal exposure models for sulfate and aerosol strong acidity. Air Waste. 1993 Jun;43(6):845–850. [PubMed]
  • Thurston GD, Gorczynski JE, Jr, Currie JH, He D, Ito K, Hipfner J, Waldman J, Lioy PJ, Lippmann M. The nature and origins of acid summer haze air pollution in metropolitan Toronto, Ontario. Environ Res. 1994 May;65(2):254–270. [PubMed]
  • Delfino RJ, Murphy-Moulton AM, Burnett RT, Brook JR, Becklake MR. Effects of air pollution on emergency room visits for respiratory illnesses in Montreal, Quebec. Am J Respir Crit Care Med. 1997 Feb;155(2):568–576. [PubMed]
  • Stieb DM, Burnett RT, Beveridge RC, Brook JR. Association between ozone and asthma emergency department visits in Saint John, New Brunswick, Canada. Environ Health Perspect. 1996 Dec;104(12):1354–1360. [PMC free article] [PubMed]
  • Romieu I, Meneses F, Sienra-Monge JJ, Huerta J, Ruiz Velasco S, White MC, Etzel RA, Hernandez-Avila M. Effects of urban air pollutants on emergency visits for childhood asthma in Mexico City. Am J Epidemiol. 1995 Mar 15;141(6):546–553. [PubMed]
  • Schwartz J. Air pollution and hospital admissions for the elderly in Detroit, Michigan. Am J Respir Crit Care Med. 1994 Sep;150(3):648–655. [PubMed]
  • Ponce de Leon A, Anderson HR, Bland JM, Strachan DP, Bower J. Effects of air pollution on daily hospital admissions for respiratory disease in London between 1987-88 and 1991-92. J Epidemiol Community Health. 1996 Apr;50 (Suppl 1):s63–s70. [PMC free article] [PubMed]
  • Burnett RT, Brook JR, Yung WT, Dales RE, Krewski D. Association between ozone and hospitalization for respiratory diseases in 16 Canadian cities. Environ Res. 1997 Jan;72(1):24–31. [PubMed]
  • Moolgavkar SH, Luebeck EG. A critical review of the evidence on particulate air pollution and mortality. Epidemiology. 1996 Jul;7(4):420–428. [PubMed]
  • Anderson HR, Ponce de Leon A, Bland JM, Bower JS, Strachan DP. Air pollution and daily mortality in London: 1987-92. BMJ. 1996 Mar 16;312(7032):665–669. [PMC free article] [PubMed]
  • Kinney PL, Ozkaynak H. Associations of daily mortality and air pollution in Los Angeles County. Environ Res. 1991 Apr;54(2):99–120. [PubMed]
  • Sunyer J, Sáez M, Murillo C, Castellsague J, Martínez F, Antó JM. Air pollution and emergency room admissions for chronic obstructive pulmonary disease: a 5-year study. Am J Epidemiol. 1993 Apr 1;137(7):701–705. [PubMed]
  • Castellsague J, Sunyer J, Sáez M, Antó JM. Short-term association between air pollution and emergency room visits for asthma in Barcelona. Thorax. 1995 Oct;50(10):1051–1056. [PMC free article] [PubMed]
  • Pantazopoulou A, Katsouyanni K, Kourea-Kremastinou J, Trichopoulos D. Short-term effects of air pollution on hospital emergency outpatient visits and admissions in the greater Athens, Greece area. Environ Res. 1995 Apr;69(1):31–36. [PubMed]
  • Verhoeff AP, Hoek G, Schwartz J, van Wijnen JH. Air pollution and daily mortality in Amsterdam. Epidemiology. 1996 May;7(3):225–230. [PubMed]
  • Pönkä A, Virtanen M. Chronic bronchitis, emphysema, and low-level air pollution in Helsinki, 1987-1989. Environ Res. 1994 May;65(2):207–217. [PubMed]
  • Burnett RT, Dales RE, Brook JR, Raizenne ME, Krewski D. Association between ambient carbon monoxide levels and hospitalizations for congestive heart failure in the elderly in 10 Canadian cities. Epidemiology. 1997 Mar;8(2):162–167. [PubMed]

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