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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1996 Apr;50(Suppl 1):s71–s75. doi: 10.1136/jech.50.suppl_1.s71

Short term effects of urban air pollution on respiratory health in Milan, Italy, 1980-89.

M A Vigotti 1, G Rossi 1, L Bisanti 1, A Zanobetti 1, J Schwartz 1
PMCID: PMC1060893  PMID: 8758228

Abstract

STUDY OBJECTIVE: To investigate the association between daily urban air pollution and acute effects on respiratory health. STUDY DESIGN: Time series analysis following the procedure defined in the APHEA protocol. SETTING: City of Milan, Italy, from 1980-89. Two air pollutants, total suspended particulates (TSP) and sulphur dioxide (SO2), and two health outcomes, deaths and hospital admissions were considered. The last was analysed according to two age groups. SUBJECTS: Daily deaths and general hospital admissions for respiratory causes in residents who died in Milan or were admitted to local hospitals in that city. MAIN RESULTS: There was an increased risk of respiratory death and of hospital admission associated with increased concentrations of SO2 and TSP. The relative risks were similar for both pollutants, and were higher for respiratory deaths than for hospital admissions. No changes in relation to season were seen in the SO2 effect on respiratory deaths, but there was a suggestion of a higher effect on hospital admissions in the cool months. The seasonal pattern of the TSP effect was inconsistent: for mortality it was higher in the warm period while for hospital admissions it seemed to be higher in the cool months. This last result might be due to chance, although some role could have been played by the hospital admission data on all general admissions for respiratory causes (ICD-9: 460-519) as these are a much less specific end point. CONCLUSION: In Milan, a positive association was found between the daily SO2 or TSP concentrations and the number of deaths or hospital admissions for respiratory causes. This confirms results from other European and North American cities.

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Selected References

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  1. Bates D. V., Sizto R. Air pollution and hospital admissions in Southern Ontario: the acid summer haze effect. Environ Res. 1987 Aug;43(2):317–331. doi: 10.1016/s0013-9351(87)80032-4. [DOI] [PubMed] [Google Scholar]
  2. Burnett R. T., Dales R. E., Raizenne M. E., Krewski D., Summers P. W., Roberts G. R., 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. doi: 10.1006/enrs.1994.1030. [DOI] [PubMed] [Google Scholar]
  3. Derriennic F., Richardson S., Mollie A., Lellouch J. Short-term effects of sulphur dioxide pollution on mortality in two French cities. Int J Epidemiol. 1989 Mar;18(1):186–197. doi: 10.1093/ije/18.1.186. [DOI] [PubMed] [Google Scholar]
  4. Dockery D. W., Pope C. A., 3rd Acute respiratory effects of particulate air pollution. Annu Rev Public Health. 1994;15:107–132. doi: 10.1146/annurev.pu.15.050194.000543. [DOI] [PubMed] [Google Scholar]
  5. Dockery D. W., Schwartz J., Spengler J. D. Air pollution and daily mortality: associations with particulates and acid aerosols. Environ Res. 1992 Dec;59(2):362–373. doi: 10.1016/s0013-9351(05)80042-8. [DOI] [PubMed] [Google Scholar]
  6. Fairley D. The relationship of daily mortality to suspended particulates in Santa Clara County, 1980-1986. Environ Health Perspect. 1990 Nov;89:159–168. doi: 10.1289/ehp.9089159. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Greenland S. Tests for interaction in epidemiologic studies: a review and a study of power. Stat Med. 1983 Apr-Jun;2(2):243–251. doi: 10.1002/sim.4780020219. [DOI] [PubMed] [Google Scholar]
  8. Hatzakis A., Katsouyanni K., Kalandidi A., Day N., Trichopoulos D. Short-term effects of air pollution on mortality in Athens. Int J Epidemiol. 1986 Mar;15(1):73–81. doi: 10.1093/ije/15.1.73. [DOI] [PubMed] [Google Scholar]
  9. Kinney P. L., Ozkaynak H. Associations of daily mortality and air pollution in Los Angeles County. Environ Res. 1991 Apr;54(2):99–120. doi: 10.1016/s0013-9351(05)80094-5. [DOI] [PubMed] [Google Scholar]
  10. Pope C. A., 3rd, Bates D. V., Raizenne M. E. Health effects of particulate air pollution: time for reassessment? Environ Health Perspect. 1995 May;103(5):472–480. doi: 10.1289/ehp.95103472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pope C. A., 3rd, Schwartz J., Ransom M. R. Daily mortality and PM10 pollution in Utah Valley. Arch Environ Health. 1992 May-Jun;47(3):211–217. doi: 10.1080/00039896.1992.9938351. [DOI] [PubMed] [Google Scholar]
  12. Saldiva P. H., Pope C. A., 3rd, Schwartz J., Dockery D. W., Lichtenfels A. J., Salge J. M., Barone I., Bohm G. M. Air pollution and mortality in elderly people: a time-series study in Sao Paulo, Brazil. Arch Environ Health. 1995 Mar-Apr;50(2):159–163. doi: 10.1080/00039896.1995.9940893. [DOI] [PubMed] [Google Scholar]
  13. Schwartz J. Air pollution and daily mortality in Birmingham, Alabama. Am J Epidemiol. 1993 May 15;137(10):1136–1147. doi: 10.1093/oxfordjournals.aje.a116617. [DOI] [PubMed] [Google Scholar]
  14. Schwartz J. Air pollution and hospital admissions for respiratory disease. Epidemiology. 1996 Jan;7(1):20–28. doi: 10.1097/00001648-199601000-00005. [DOI] [PubMed] [Google Scholar]
  15. Schwartz J. Air pollution and hospital admissions for the elderly in Birmingham, Alabama. Am J Epidemiol. 1994 Mar 15;139(6):589–598. doi: 10.1093/oxfordjournals.aje.a117048. [DOI] [PubMed] [Google Scholar]
  16. 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. doi: 10.1164/ajrccm.150.3.8087333. [DOI] [PubMed] [Google Scholar]
  17. Schwartz J., Dockery D. W. Increased mortality in Philadelphia associated with daily air pollution concentrations. Am Rev Respir Dis. 1992 Mar;145(3):600–604. doi: 10.1164/ajrccm/145.3.600. [DOI] [PubMed] [Google Scholar]
  18. Schwartz J., Marcus A. Mortality and air pollution in London: a time series analysis. Am J Epidemiol. 1990 Jan;131(1):185–194. doi: 10.1093/oxfordjournals.aje.a115473. [DOI] [PubMed] [Google Scholar]
  19. Schwartz J. PM10, ozone, and hospital admissions for the elderly in Minneapolis-St. Paul, Minnesota. Arch Environ Health. 1994 Sep-Oct;49(5):366–374. doi: 10.1080/00039896.1994.9954989. [DOI] [PubMed] [Google Scholar]
  20. Schwartz J. Particulate air pollution and daily mortality in Detroit. Environ Res. 1991 Dec;56(2):204–213. doi: 10.1016/s0013-9351(05)80009-x. [DOI] [PubMed] [Google Scholar]
  21. Schwartz J. Short term fluctuations in air pollution and hospital admissions of the elderly for respiratory disease. Thorax. 1995 May;50(5):531–538. doi: 10.1136/thx.50.5.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Schwartz J., Slater D., Larson T. V., Pierson W. E., Koenig J. Q. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis. 1993 Apr;147(4):826–831. doi: 10.1164/ajrccm/147.4.826. [DOI] [PubMed] [Google Scholar]
  23. Schwartz J., Spix C., Wichmann H. E., Malin E. Air pollution and acute respiratory illness in five German communities. Environ Res. 1991 Oct;56(1):1–14. doi: 10.1016/s0013-9351(05)80104-5. [DOI] [PubMed] [Google Scholar]
  24. Schwartz J. Total suspended particulate matter and daily mortality in Cincinnati, Ohio. Environ Health Perspect. 1994 Feb;102(2):186–189. doi: 10.1289/ehp.94102186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Spix C., Heinrich J., Dockery D., Schwartz J., Völksch G., Schwinkowski K., Cöllen C., Wichmann H. E. Air pollution and daily mortality in Erfurt, east Germany, 1980-1989. Environ Health Perspect. 1993 Nov;101(6):518–526. doi: 10.1289/ehp.93101518. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sunyer J., Antó J. M., Murillo C., Saez M. Effects of urban air pollution on emergency room admissions for chronic obstructive pulmonary disease. Am J Epidemiol. 1991 Aug 1;134(3):277–289. doi: 10.1093/oxfordjournals.aje.a116081. [DOI] [PubMed] [Google Scholar]
  27. Sunyer J., Sáez M., Murillo C., Castellsague J., Martínez F., Antó J. M. 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. doi: 10.1093/oxfordjournals.aje.a116730. [DOI] [PubMed] [Google Scholar]
  28. Thurston G. D., Ito K., Kinney P. L., Lippmann M. A multi-year study of air pollution and respiratory hospital admissions in three New York State metropolitan areas: results for 1988 and 1989 summers. J Expo Anal Environ Epidemiol. 1992 Oct-Dec;2(4):429–450. [PubMed] [Google Scholar]
  29. Touloumi G., Pocock S. J., Katsouyanni K., Trichopoulos D. Short-term effects of air pollution on daily mortality in Athens: a time-series analysis. Int J Epidemiol. 1994 Oct;23(5):957–967. doi: 10.1093/ije/23.5.957. [DOI] [PubMed] [Google Scholar]
  30. Xu X., Gao J., Dockery D. W., Chen Y. Air pollution and daily mortality in residential areas of Beijing, China. Arch Environ Health. 1994 Jul-Aug;49(4):216–222. doi: 10.1080/00039896.1994.9937470. [DOI] [PubMed] [Google Scholar]

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