Respiratory effects of sulphur dioxide: a hierarchical multicity analysis in the APHEA 2 study
Respiratory effects of sulphur dioxide: a hierarchical multicity analysis in the APHEA 2 study
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DOI：
10.1136/oem.60.8.e2
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发表时间：
2003-08-01
影响因子：
4.9
通讯作者：
Katsouyanni, K
中科院分区：
文献类型：
--
作者：
Sunyer, J;Atkinson, R;Katsouyanni, K
背景：在最初的 APHEA 研究中，二氧化硫 (SO2) 与儿童因哮喘入院有关，但与其他呼吸道入院无关。目的：在一项更大规模、更新的研究中评估每日 SO2 水平与每日呼吸道入院水平之间的关联。方法：针对 0-14 岁和 15-64 岁的哮喘、慢性阻塞性肺病和哮喘以及 65 岁以上的所有呼吸道入院患者构建每日住院急诊计数的时间序列在伯明翰、伦敦、米兰、巴黎、罗马、斯德哥尔摩和荷兰等城市，以及 1988 年至 1997 年之间不同持续时间的时期内，采用了两阶段分层建模方法。在第一阶段，在控制天气和季节的每个城市中拟合了广义加性泊松回归模型。然后将这些结果在第二阶段的生态回归中将各城市的结果结合起来，研究潜在的效应调节剂。结果：SO2 浓度每增加 10 微克/米(3)，每天因哮喘入院的儿童人数就会增加 1.3%（95% Cl 0.4% 至 2.2%）。没有发现其他空气污染物水平或温度对城市之间的影响有影响。在控制 PM 或 CO 后，SO2 效应消失，但这些污染物之间的相关性非常高。其他呼吸系统入院病例与 SO2 无关。结论：SO2 与儿童哮喘入院病例相关，表明当前空气污染水平的降低可能会导致欧洲儿童哮喘入院人数减少。
Background: Sulphur dioxide (SO2) was associated with hospital admissions for asthma in children in the original APHEA study, but not with other respiratory admissions.Aims: To assess the association between daily levels of SO2 and daily levels of respiratory admissions in a larger and more recent study.Methods: Time series of daily counts of hospital emergency admissions were constructed for asthma at ages 0-14 years and 15-64 years, COPD and asthma, and all respiratory admissions at ages 65+ years in the cities of Birmingham, London, Milan, Paris, Rome, Stockholm, and in the Netherlands for periods of varying duration between the years 1988 and 1997. A two stage hierarchical modelling approach was used. In the first stage generalised additive Poisson regression models were fitted in each city controlling for weather and season. These results were then combined across cities in a second stage ecological regression that looked at potential effect modifiers.Results: For an increase of 10 mug/m(3) Of SO2 the daily number of admissions for asthma in children increased 1.3% (95% Cl 0.4% to 2.2%). Effect modification among cities by levels of other air pollutants or temperature was not found. The SO2 effect disappeared after controlling for PM,, or CO, but correlation among these pollutants was very high. Other respiratory admissions were not associated with SO2.Conclusion: SO2 is associated with asthma admissions in children, indicating that reduction in current air pollution levels could lead to a decrease in the number of asthma admissions in children in Europe.