Skip to main content
NCBI home page
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 2002 Jun;110(6):575–581. doi: 10.1289/ehp.02110575

The influence of ambient coarse particulate matter on asthma hospitalization in children: case-crossover and time-series analyses.

Mei Lin 1, Yue Chen 1, Richard T Burnett 1, Paul J Villeneuve 1, Daniel Krewski 1
PMCID: PMC1240873  PMID: 12055048

Abstract

In this study, we used both case-crossover and time-series analyses to assess the associations between size-fractionated particulate matter and asthma hospitalization among children 6-12 years old living in Toronto between 1981 and 1993. Specifically, we used exposures averaged over periods varying from 1 to 7 days to assess the effects of particulate matter on asthma hospitalization. We calculated estimates of the relative risk of asthma hospitalization adjusted for daily weather conditions (maximum and minimum temperatures, and average relative humidity) for an incremental exposure corresponding to the interquartile range in particulate matter. Both bidirectional case-crossover and time-series analyses revealed that coarse particulate matter (PM10-2.5) averaged over 5-6 days was significantly associated with asthma hospitalization in both males and females. The magnitude of this effect appeared to increase with increasing number of days of exposure averaging for most models, with the relative risk estimates stabilizing at about 6 days. Using a bidirectional case-crossover analysis, the estimated relative risks were 1.14 [95% confidence interval (CI), 1.02, 1.28] for males and 1.18 (95% CI, 1.02, 1.36) for females, for an increment of 8.4 microg/m(3) in 6-day averages of PM10-2.5. The corresponding relative risk estimates were 1.10 and 1.18, respectively, when we used time-series analysis. The effect of PM10-2.5 remained positive after adjustment for the effects of the gaseous pollutants carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3). We did not find significant effects of fine particulate matter (PM2.5) or of thoracic particulate matter (PM10) on asthma hospitalizations using either of these two analytic approaches. For the most part, relative risk estimates from the unidirectional case-crossover analysis were more pronounced compared with both bidirectional case-crossover and time-series analyses.

Full Text

The Full Text of this article is available as a PDF (774.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bateson T. F., Schwartz J. Control for seasonal variation and time trend in case-crossover studies of acute effects of environmental exposures. Epidemiology. 1999 Sep;10(5):539–544. [PubMed] [Google Scholar]
  2. Burnett R. T., Cakmak S., Raizenne M. E., Stieb D., Vincent R., Krewski D., Brook J. R., Philips O., Ozkaynak H. The association between ambient carbon monoxide levels and daily mortality in Toronto, Canada. J Air Waste Manag Assoc. 1998 Aug;48(8):689–700. doi: 10.1080/10473289.1998.10463718. [DOI] [PubMed] [Google Scholar]
  3. Burnett R. T., Dales R. E., Brook J. R., Raizenne M. E., 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. doi: 10.1097/00001648-199703000-00007. [DOI] [PubMed] [Google Scholar]
  4. Burnett R. T., Smith-Doiron M., Stieb D., Cakmak S., Brook J. R. Effects of particulate and gaseous air pollution on cardiorespiratory hospitalizations. Arch Environ Health. 1999 Mar-Apr;54(2):130–139. doi: 10.1080/00039899909602248. [DOI] [PubMed] [Google Scholar]
  5. Cakmak S., Burnett R. T., Krewski D. Methods for detecting and estimating population threshold concentrations for air pollution-related mortality with exposure measurement error. Risk Anal. 1999 Jun;19(3):487–496. doi: 10.1023/a:1007008914354. [DOI] [PubMed] [Google Scholar]
  6. Cakmak S., Burnett R., Krewski D. Adjusting for temporal variation in the analysis of parallel time series of health and environmental variables. J Expo Anal Environ Epidemiol. 1998 Apr-Jun;8(2):129–144. [PubMed] [Google Scholar]
  7. Koenig J. Q., Larson T. V., Hanley Q. S., Rebolledo V., Dumler K., Checkoway H., Wang S. Z., Lin D., Pierson W. E. Pulmonary function changes in children associated with fine particulate matter. Environ Res. 1993 Oct;63(1):26–38. doi: 10.1006/enrs.1993.1123. [DOI] [PubMed] [Google Scholar]
  8. Koren H. S. Associations between criteria air pollutants and asthma. Environ Health Perspect. 1995 Sep;103 (Suppl 6):235–242. doi: 10.1289/ehp.95103s6235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lee J. T., Schwartz J. Reanalysis of the effects of air pollution on daily mortality in Seoul, Korea: A case-crossover design. Environ Health Perspect. 1999 Aug;107(8):633–636. doi: 10.1289/ehp.99107633. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lipsett M., Hurley S., Ostro B. Air pollution and emergency room visits for asthma in Santa Clara County, California. Environ Health Perspect. 1997 Feb;105(2):216–222. doi: 10.1289/ehp.97105216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Loomis D. Sizing up air pollution research. Epidemiology. 2000 Jan;11(1):2–4. doi: 10.1097/00001648-200001000-00002. [DOI] [PubMed] [Google Scholar]
  12. Maclure M. The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol. 1991 Jan 15;133(2):144–153. doi: 10.1093/oxfordjournals.aje.a115853. [DOI] [PubMed] [Google Scholar]
  13. Martinez F. D., Wright A. L., Taussig L. M., Holberg C. J., Halonen M., Morgan W. J. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995 Jan 19;332(3):133–138. doi: 10.1056/NEJM199501193320301. [DOI] [PubMed] [Google Scholar]
  14. Mittleman M. A., Maclure M., Robins J. M. Control sampling strategies for case-crossover studies: an assessment of relative efficiency. Am J Epidemiol. 1995 Jul 1;142(1):91–98. doi: 10.1093/oxfordjournals.aje.a117550. [DOI] [PubMed] [Google Scholar]
  15. Moolgavkar S. H., Luebeck E. G., Hall T. A., Anderson E. L. Air pollution and daily mortality in Philadelphia. Epidemiology. 1995 Sep;6(5):476–484. doi: 10.1097/00001648-199509000-00003. [DOI] [PubMed] [Google Scholar]
  16. Morgan G., Corbett S., Wlodarczyk J. Air pollution and hospital admissions in Sydney, Australia, 1990 to 1994. Am J Public Health. 1998 Dec;88(12):1761–1766. doi: 10.2105/ajph.88.12.1761. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Navidi W. Bidirectional case-crossover designs for exposures with time trends. Biometrics. 1998 Jun;54(2):596–605. [PubMed] [Google Scholar]
  18. Neas L. M., Schwartz J., Dockery D. A case-crossover analysis of air pollution and mortality in Philadelphia. Environ Health Perspect. 1999 Aug;107(8):629–631. doi: 10.1289/ehp.99107629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Norris G., YoungPong S. N., Koenig J. Q., Larson T. V., Sheppard L., Stout J. W. An association between fine particles and asthma emergency department visits for children in Seattle. Environ Health Perspect. 1999 Jun;107(6):489–493. doi: 10.1289/ehp.99107489. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Ostro B. D., Hurley S., Lipsett M. J. Air pollution and daily mortality in the Coachella Valley, California: a study of PM10 dominated by coarse particles. Environ Res. 1999 Oct;81(3):231–238. doi: 10.1006/enrs.1999.3978. [DOI] [PubMed] [Google Scholar]
  21. Pope C. A., 3rd Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys. Arch Environ Health. 1991 Mar-Apr;46(2):90–97. doi: 10.1080/00039896.1991.9937434. [DOI] [PubMed] [Google Scholar]
  22. Scarlett J. F., Abbott K. J., Peacock J. L., Strachan D. P., Anderson H. R. Acute effects of summer air pollution on respiratory function in primary school children in southern England. Thorax. 1996 Nov;51(11):1109–1114. doi: 10.1136/thx.51.11.1109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Schwartz J., Neas L. M. Fine particles are more strongly associated than coarse particles with acute respiratory health effects in schoolchildren. Epidemiology. 2000 Jan;11(1):6–10. doi: 10.1097/00001648-200001000-00004. [DOI] [PubMed] [Google Scholar]
  24. 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]
  25. Schwartz J., Spix C., Touloumi G., Bachárová L., Barumamdzadeh T., le Tertre A., Piekarksi T., Ponce de Leon A., Pönkä A., Rossi G. Methodological issues in studies of air pollution and daily counts of deaths or hospital admissions. J Epidemiol Community Health. 1996 Apr;50 (Suppl 1):S3–11. doi: 10.1136/jech.50.suppl_1.s3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sheppard L., Levy D., Norris G., Larson T. V., Koenig J. Q. Effects of ambient air pollution on nonelderly asthma hospital admissions in Seattle, Washington, 1987-1994. Epidemiology. 1999 Jan;10(1):23–30. [PubMed] [Google Scholar]
  27. Sunyer J., Schwartz J., Tobías A., Macfarlane D., Garcia J., Antó J. M. Patients with chronic obstructive pulmonary disease are at increased risk of death associated with urban particle air pollution: a case-crossover analysis. Am J Epidemiol. 2000 Jan 1;151(1):50–56. doi: 10.1093/oxfordjournals.aje.a010121. [DOI] [PubMed] [Google Scholar]
  28. Wordley J., Walters S., Ayres J. G. Short term variations in hospital admissions and mortality and particulate air pollution. Occup Environ Med. 1997 Feb;54(2):108–116. doi: 10.1136/oem.54.2.108. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES