Air pollution and hospital admissions for ischemic heart disease in persons with congestive heart failure or arrhythmia

被引:152
作者
Mann, JK
Tager, IB
Lurmann, F
Segal, M
Quesenberry, CP
Lugg, MM
Shan, J
Van Den Eeden, SK
机构
[1] Univ Calif Berkeley, Sch Publ Hlth, Dept Epidemiol, Berkeley, CA 94720 USA
[2] Sonoma Technol Inc, Petaluma, CA USA
[3] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
[4] No Calif Kaiser Permanente, Div Res, Oakland, CA USA
[5] So Calif Kaiser Permanente, Panorama City Med Ctr, Panorama City, CA USA
关键词
air pollution; arrhythmia; carbon monoxide; congestive heart failure; hospital admissions; ischemic heart disease; nitrogen dioxide;
D O I
10.1289/ehp.021101247
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
We examined whether ischemic heart disease (IHD) hospital admissions were associated with air pollutants in those with and without secondary diagnoses of arrhythmia (ARR) or congestive heart failure (CHF). We assessed the occurrence of increased vulnerability among persons with these conditions to daily variations in ozone, carbon monoxide, nitrogen dioxide, or particulate matter less than or equal to 10 mum in aerodynamic diameter (PM10). The study population consisted of members of a large health maintenance organization residing in the South Coast Air Basin of California from 1988 to 1995. After adjustment for day of week, study year, and smoothing splines for day of study, temperature, and relative humidity, CO and NO2 were both associated with admissions with the greatest effects for CO. A 1-ppm increase in 8-hr average CO was associated with a 3.60% [95% confidence interval (CI), 1.62-5.63%] increase in same-day IHD admissions in persons with a secondary diagnosis of CHF, a 2.99% (95% CI, 1.80-4.19%) increase in persons with a secondary diagnosis of ARR, and a 1.62% (95% CI, 0.65-2.59%) increase in IHD admissions in persons without either secondary diagnosis. Air pollution was most strongly associated with myocardial infarction hospital admissions. The vulnerability of the secondary CHF subgroup may be due to a greater prevalence of myocardial infarction primary diagnoses and not the modifying effect of CHF. This study suggests that people with IHD and accompanying CHF and/or ARR constitute a sensitive subgroup in relation to the effects of criteria ambient air pollutants associated with motor vehicle combustion.
引用
收藏
页码:1247 / 1252
页数:6
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