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Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 2003 Aug;111(10):1312–1317. doi: 10.1289/ehp.5957

Temperature, air pollution, and hospitalization for cardiovascular diseases among elderly people in Denver.

Petra J M Koken 1, Warren T Piver 1, Frank Ye 1, Anne Elixhauser 1, Lola M Olsen 1, Christopher J Portier 1
PMCID: PMC1241612  PMID: 12896852

Abstract

Daily measures of maximum temperature, particulate matter less than or equal to 10 micro m in aerodynamic diameter (PM10), and gaseous pollution (ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide) were collected in Denver, Colorado, in July and August between 1993 and 1997. We then compared these exposures with concurrent data on the number of daily hospital admissions for cardiovascular diseases in men and women > 65 years of age. Generalized linear models, assuming a Poisson error structure for the selected cardiovascular disease hospital admissions, were constructed to evaluate the associations with air pollution and temperature. After adjusting the admission data for yearly trends, day-of-week effects, ambient maximum temperature, and dew point temperature, we studied the associations of the pollutants in single-pollutant models with lag times of 0-4 days. The results suggest that O3 is associated with an increase in the risk of hospitalization for acute myocardial infarction, coronary atherosclerosis, and pulmonary heart disease. SO2 appears to be related to increased hospital stays for cardiac dysrhythmias, and CO is significantly associated with congestive heart failure. No association was found between particulate matter or NO2 and any of the health outcomes. Males tend to have higher numbers of hospital admissions than do females for all of the selected cardiovascular diseases, except for congestive heart failure. Higher temperatures appear to be an important factor in increasing the frequency of hospitalization for acute myocardial infarction and congestive heart failure, and are associated with a decrease in the frequency of visits for coronary atherosclerosis and pulmonary heart disease.

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Selected References

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  1. Atkinson R. W., Bremner S. A., Anderson H. R., Strachan D. P., Bland J. M., de Leon A. P. Short-term associations between emergency hospital admissions for respiratory and cardiovascular disease and outdoor air pollution in London. Arch Environ Health. 1999 Nov-Dec;54(6):398–411. doi: 10.1080/00039899909603371. [DOI] [PubMed] [Google Scholar]
  2. Ballester F., Tenías J. M., Pérez-Hoyos S. Air pollution and emergency hospital admissions for cardiovascular diseases in Valencia, Spain. J Epidemiol Community Health. 2001 Jan;55(1):57–65. doi: 10.1136/jech.55.1.57. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bernard S. M., Samet J. M., Grambsch A., Ebi K. L., Romieu I. The potential impacts of climate variability and change on air pollution-related health effects in the United States. Environ Health Perspect. 2001 May;109 (Suppl 2):199–209. doi: 10.1289/ehp.109-1240667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Braga A. L., Zanobetti A., Schwartz J. The time course of weather-related deaths. Epidemiology. 2001 Nov;12(6):662–667. doi: 10.1097/00001648-200111000-00014. [DOI] [PubMed] [Google Scholar]
  5. Burnett R. T., Cakmak S., Brook J. R., Krewski D. The role of particulate size and chemistry in the association between summertime ambient air pollution and hospitalization for cardiorespiratory diseases. Environ Health Perspect. 1997 Jun;105(6):614–620. doi: 10.1289/ehp.97105614. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. 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]
  7. Díaz J., Alberdi J. C., Pajares M. S., López C., López R., Lage M. B., Otero A. A model for forecasting emergency hospital admissions: effect of environmental variables. J Environ Health. 2001 Oct;64(3):9–15. [PubMed] [Google Scholar]
  8. Hoek G., Brunekreef B., Fischer P., van Wijnen J. The association between air pollution and heart failure, arrhythmia, embolism, thrombosis, and other cardiovascular causes of death in a time series study. Epidemiology. 2001 May;12(3):355–357. doi: 10.1097/00001648-200105000-00017. [DOI] [PubMed] [Google Scholar]
  9. Katsouyanni K., Pantazopoulou A., Touloumi G., Tselepidaki I., Moustris K., Asimakopoulos D., Poulopoulou G., Trichopoulos D. Evidence for interaction between air pollution and high temperature in the causation of excess mortality. Arch Environ Health. 1993 Jul-Aug;48(4):235–242. doi: 10.1080/00039896.1993.9940365. [DOI] [PubMed] [Google Scholar]
  10. Keatinge W. R., Coleshaw S. R., Easton J. C., Cotter F., Mattock M. B., Chelliah R. Increased platelet and red cell counts, blood viscosity, and plasma cholesterol levels during heat stress, and mortality from coronary and cerebral thrombosis. Am J Med. 1986 Nov;81(5):795–800. doi: 10.1016/0002-9343(86)90348-7. [DOI] [PubMed] [Google Scholar]
  11. Kunst A. E., Looman C. W., Mackenbach J. P. Outdoor air temperature and mortality in The Netherlands: a time-series analysis. Am J Epidemiol. 1993 Feb 1;137(3):331–341. doi: 10.1093/oxfordjournals.aje.a116680. [DOI] [PubMed] [Google Scholar]
  12. Lipsitz S. R., Fitzmaurice G. M., Orav E. J., Laird N. M. Performance of generalized estimating equations in practical situations. Biometrics. 1994 Mar;50(1):270–278. [PubMed] [Google Scholar]
  13. Morris R. D., Naumova E. N. Carbon monoxide and hospital admissions for congestive heart failure: evidence of an increased effect at low temperatures. Environ Health Perspect. 1998 Oct;106(10):649–653. doi: 10.1289/ehp.98106649. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Morris R. D., Naumova E. N., Munasinghe R. L. Ambient air pollution and hospitalization for congestive heart failure among elderly people in seven large US cities. Am J Public Health. 1995 Oct;85(10):1361–1365. doi: 10.2105/ajph.85.10.1361. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Peters A., Liu E., Verrier R. L., Schwartz J., Gold D. R., Mittleman M., Baliff J., Oh J. A., Allen G., Monahan K. Air pollution and incidence of cardiac arrhythmia. Epidemiology. 2000 Jan;11(1):11–17. doi: 10.1097/00001648-200001000-00005. [DOI] [PubMed] [Google Scholar]
  16. Piver W. T., Ando M., Ye F., Portier C. J. Temperature and air pollution as risk factors for heat stroke in Tokyo, July and August 1980-1995. Environ Health Perspect. 1999 Nov;107(11):911–916. doi: 10.1289/ehp.99107911. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Prescott G. J., Cohen G. R., Elton R. A., Fowkes F. G., Agius R. M. Urban air pollution and cardiopulmonary ill health: a 14.5 year time series study. Occup Environ Med. 1998 Oct;55(10):697–704. doi: 10.1136/oem.55.10.697. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Saez M., Sunyer J., Castellsagué J., Murillo C., Antó J. M. Relationship between weather temperature and mortality: a time series analysis approach in Barcelona. Int J Epidemiol. 1995 Jun;24(3):576–582. doi: 10.1093/ije/24.3.576. [DOI] [PubMed] [Google Scholar]
  19. 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]
  20. Schwartz J., Morris R. Air pollution and hospital admissions for cardiovascular disease in Detroit, Michigan. Am J Epidemiol. 1995 Jul 1;142(1):23–35. doi: 10.1093/oxfordjournals.aje.a117541. [DOI] [PubMed] [Google Scholar]
  21. 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]
  22. Seaton A., MacNee W., Donaldson K., Godden D. Particulate air pollution and acute health effects. Lancet. 1995 Jan 21;345(8943):176–178. doi: 10.1016/s0140-6736(95)90173-6. [DOI] [PubMed] [Google Scholar]
  23. Styer P., McMillan N., Gao F., Davis J., Sacks J. Effect of outdoor airborne particulate matter on daily death counts. Environ Health Perspect. 1995 May;103(5):490–497. doi: 10.1289/ehp.95103490. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Wong T. W., Lau T. S., Yu T. S., Neller A., Wong S. L., Tam W., Pang S. W. Air pollution and hospital admissions for respiratory and cardiovascular diseases in Hong Kong. Occup Environ Med. 1999 Oct;56(10):679–683. doi: 10.1136/oem.56.10.679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Yang L., Zhang W., He H. Z., Zhang G. G. Experimental studies on combined effects of high temperature and carbon monoxide. J Tongji Med Univ. 1988;8(1):60–65. doi: 10.1007/BF02887781. [DOI] [PubMed] [Google Scholar]
  26. Zanobetti A., Schwartz J., Dockery D. W. Airborne particles are a risk factor for hospital admissions for heart and lung disease. Environ Health Perspect. 2000 Nov;108(11):1071–1077. doi: 10.1289/ehp.001081071. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Zeger S. L., Thomas D., Dominici F., Samet J. M., Schwartz J., Dockery D., Cohen A. Exposure measurement error in time-series studies of air pollution: concepts and consequences. Environ Health Perspect. 2000 May;108(5):419–426. doi: 10.1289/ehp.00108419. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. van der Bom J. G., de Maat M. P., Bots M. L., Hofman A., Kluft C., Grobbee D. E. Seasonal variation in fibrinogen in the Rotterdam Study. Thromb Haemost. 1997 Sep;78(3):1059–1062. [PubMed] [Google Scholar]

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