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Chemical Properties of Air Pollutants and Cause-Specific Hospital Admissions among the Elderly in Atlanta, Georgia

Suh, Helen H ; Zanobetti, Antonella ; Schwartz, Joel ; Coull, Brent A

Environmental Health Perspectives, 2011, Vol.119(10), p.1421-1428 [Peer Reviewed Journal]

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  • Title:
    Chemical Properties of Air Pollutants and Cause-Specific Hospital Admissions among the Elderly in Atlanta, Georgia
  • Author/Creator: Suh, Helen H ; Zanobetti, Antonella ; Schwartz, Joel ; Coull, Brent A
  • Subjects: Research ; Air Pollution ; Chemical Properties ; Hospital Admissions ; Multipollutant Analysis ; Transition Metals
  • Is Part Of: Environmental Health Perspectives, 2011, Vol.119(10), p.1421-1428
  • Description: Background: Health risks differ by fine particle (aerodynamic diameter ≤ 2.5 μm) component, although with substantial variability. Traditional methods to assess component-specific risks are limited, suggesting the need for alternative methods. Objectives: We examined whether the odds of daily hospital admissions differ by pollutant chemical properties. Methods: We categorized pollutants by chemical properties and examined their impacts on the odds of daily hospital admissions among Medicare recipients > 64 years of age in counties in Atlanta, Georgia, for 1998–2006. We analyzed data in two stages. In the first stage we applied a case-crossover analysis to simultaneously estimate effects of 65 pollutants measured in the Aerosol Research and Inhalation Epidemiology Study on cause-specific hospital admissions, controlling for temperature and ozone. In the second stage, we regressed pollutant-specific slopes from the first stage on pollutant properties. We calculated uncertainty estimates using a bootstrap procedure. We repeated the two-stage analyses using coefficients from first-stage models that included single pollutants plus ozone and meteorological variables only. We based our primary analyses on exposures on day of admission. Results: We found that 24-hr transition metals and alkanes were associated with increased odds [0.26%; 95% confidence interval (CI), 0.02–0.48; and 0.37%; 95% CI, 0.04–0.72, respectively] of hospital admissions for cardiovascular disease (CVD). Transition metals were significantly associated with increased hospital admissions for ischemic heart disease, congestive heart failure, and atrial fibrillation. Increased respiratory-related hospital admissions were significantly associated with alkanes. Aromatics and microcrystalline oxides were significantly associated with decreased CVD- and respiratory-related hospital admissions. Conclusions: The two-stage approach showed transition metals to be consistently associated with increased odds of CVD-related hospital admissions.
  • Identifier: ISSN: 0091-6765 ; E-ISSN: 1552-9924 ; DOI: 10.1289/ehp.1002646 ; PMCID: 3230427 ; PMID: 21708510