Anna Petroeschevsky

The effects of air pollution on hospitalizations for cardiovascular disease in elderly people in Australian and New Zealand cities.

Objective The goal of this study was to estimate the associations between outdoor air pollution and cardiovascular hospital admissions for the elderly Design Associations were assessed using the case–crossover method for seven cities: Auckland and Christchurch, New Zealand; and Brisbane, Canberra, Melbourne, Perth, and Sydney Australia. Results were combined across cities using a random-effects meta-analysis and stratified for two adult age groups: 15–64 years and ≥ 65 years of age (elderly). Pollutants considered were nitrogen dioxide, carbon monoxide, daily measures of particulate matter (PM) and ozone. Where multiple pollutant associations were found, a matched case–control analysis was used to identify the most consistent association. Results In the elderly, all pollutants except O3 were significantly associated with five categories of cardiovascular disease admissions. No associations were found for arrhythmia and stroke. For a 0.9-ppm increase in CO, there were significant increases in elderly hospital admissions for total cardiovascular disease (2.2%), all cardiac disease (2.8%), cardiac failure (6.0%), ischemic heart disease (2.3%), and myocardial infarction (2.9%). There was some heterogeneity between cities, possibly due to differences in humidity and the percentage of elderly people. In matched analyses, CO had the most consistent association. Conclusions The results suggest that air pollution arising from common emission sources for CO, NO2, and PM (e.g., motor vehicle exhausts) has significant associations with adult cardiovascular hospital admissions, especially in the elderly, at air pollution concentrations below normal health guidelines. Relevance to clinical and professional practice Elderly populations in Australia need to be protected from air pollution arising from outdoor sources to reduce cardiovascular disease.

Associations between outdoor air pollution and hospital admissions in Brisbane, Australia

Abstract The authors investigated the effects of ambient air pollution on hospital admissions in Brisbane, Australia. The authors used the Air Pollution on Health: European Approach protocol to examine the effects of particles, ozone, sulfur dioxide, and nitrogen dioxide on daily hospital admissions for asthma and respiratory, cardiovascular, and digestive disorders (control diagnosis) that occurred during the period 1987-1994. Ozone was consistently associated with admissions for asthma and respiratory disease—with little evidence of a threshold. In two-pollutant models, the ozone effect was relatively unaffected by the control for high levels of other pollutants. Particulate pollution (measured by nephelometry) was associated positively with admissions for respiratory disease and admissions for asthma in summer, whereas a negative association was observed for cardiovascular admissions. Although sulfur dioxide was associated significantly with admissions for respiratory and cardiovascular disease, a significant association was also found for the control diagnosis of digestive disorders. No significant associations were found for nitrogen dioxide over the study period, although significantly positive seasonal interactions were found for asthma and respiratory disease in autumn, winter, and spring. It was concluded that current levels of ambient air pollution in Brisbane make a significant contribution to the variation in daily hospital admissions for asthma and respiratory disease.

Associations between Outdoor Air Pollution and Daily Mortality in Brisbane, Australia

The results of several studies have indicated significant associations between daily mortality and air pollution, with little evidence of a threshold. In the current study, the authors examined daily mortality during the period 1987-1993 for the Brisbane region, which is the fastest-growing urban region in Australia (annual average concentration of particulate matter less than 10 microm in diameter = 27 microg/m3, maximum hourly sulfur dioxide level = 60 ppb, and maximum daily ozone hourly level = 118 ppb). The authors conducted a general estimating equation analysis, and they used autoregressive Poisson models for daily mortality to examine associations with air pollution variables. The authors used research methods developed in the Air Pollution on Health, European Approach (APHEA), project to control confounding effects of weather and temporal trends. The air pollutants examined included particulate pollution (measured by nephelometry [bsp data]), sulfur dioxide, ozone, and nitrogen dioxide. The results indicated that the associations between total daily mortality and particulate levels found in studies in the United States and other countries may be applicable in Brisbane, Australia. Ozone levels were also associated significantly with total daily mortality. There was little evidence of interaction between the ozone effects (mainly in summer) and particulates or with sulfur dioxide and nitrogen dioxide. The associations between pollutants (ozone, bsp) and daily mortality were significant only for individuals who were older than 65 y of age; positive associations were also found with cardiovascular disease categories, and the regression coefficients--when significant--were higher than those for total mortality. The results indicated a possible threshold for ozone levels, but a similar result for particulate levels was not apparent.

The short-term effects of air pollution on daily mortality in four Australian cities

Objective: To examine the short‐term health effects of air pollution on daily mortality in four Australian cities (Brisbane, Melbourne, Perth and Sydney), where more than 50% of Australians reside.

An Ecological Footprint Analysis for Australia

An Ecological Footprint is defined as the area of land needed to produce the natural resources a population consumes and to assimilate the waste that population produces. By providing a link between consumption and lifestyle and available ecological space, the Ecological Footprint illustrates the concepts of carrying capacity and sustainability. This article presents the results of a detailed study of Australia. The results indicate the Ecological Footprint of the average Australian is approximately 6 hectares per capita. This is more than 4 times the globally available ‘fair share’, placing Australia among the top five consuming nations in the world. This result highlights the unsustainable global nature of the Australian lifestyle, particularly the level of consumption of energy and animal products, with large inequities between Western countries such as Australia, and developing countries.

Effects of ambient particle pollution on daily mortality in Melbourne, 1991-1996.

This paper presents the results of a study in Melbourne, Australia, of the short-term effects of ambient fine particle pollution on daily mortality occurring between 1991 and 1996. The methodological approach used Poisson regression and Generalized Additive Models (GAM) with LOESS smoothing to control for temporal and meteorological effects. The association between particles and increases in daily mortality was examined using nephelometry data (bsp, mean 24 h average=0.26×10−4 m−1, mean 1 h maximum=0.60×10−4 m−1), PM2.5 (24 h mean=9.42 µg/m3) and PM10 (24 h mean=19 µg/m3). Both the PM10 and PM2.5 data were estimated from nephelometry data using previously derived relationships for the Melbourne airshed. Significant positive associations between the particle measures considered and all cause and respiratory mortality were found in the warm season (November–March). A 1×10−4 m−1 increase in maximum 1-h bsp levels was associated with a 2.19% (95% CI=0.01–4.43%) increase in risk of death for all cause mortality and a 10.40% (95% CI=2.44–18.97%) increase in risk for respiratory mortality in the warm season. A 1 µg/m3 increase in 24-h PM2.5 in the warm season was associated with a 0.38% (95% CI=0.06–0.70%) increase in risk of death for all cause mortality and a 1.18% (95% CI=0.05–2.32%) increase in risk for respiratory mortality. For PM10, a 1 µg/m3 increase was associated with an increased risk of 0.18% (95% CI=0.03–0.33%) for all cause mortality and 0.59% (95% CI=0.06–1.13%) for respiratory mortality. Significant associations were also found in the 65+ age group in the warm season. However, for these warm periods, the effects of ozone (average 1 h maximum=127 ppb) and nitrogen dioxide (average 1 h maximum=70.7 ppb) were also significant and, due to high correlations between these pollutants, it was not possible to separate the particle effects from those of O3 and NO2. Sulfur dioxide was not examined as concentrations of this pollutant in Melbourne are very low (max 1 h=15–24 ppb, annual average 0.8 ppb). Comparison with other Australian studies in Sydney and Brisbane indicates different results for particle pollution.

Multi-city studies in Australia and New Zealand: The impact of air pollution on daily mortality and morbidity

We evaluated the short-term effect of Particle Number Concentration (a proxy for ultrafine particles) and PM10 on mortality and hospital admissions between 1998–2002 in a large Italian city. Mortality data were classified by cause of death into three groups: total (ICD9 0–799), respiratory (ICD9 460–519) and cardiovascular (ICD9 390–459) diseases. Hospital admissions data concerns subjects with a primary diagnosis of respiratory or cardiovascular diseases. The collection of PNC data is ongoing since April 2001 with a Condensation Particle Counter (CPC 3022A, TSI Inc). For the period 1998–2000, however, daily PNC values were retrospectively estimated using values of other pollutants and meteorological variables as predictors in a regression model. During the study period, PM10 data were collected in the context of the air quality monitoring system of Rome. A Poisson Generalized Additive Model (GAM) was fitted for each outcome using penalized regression splines of time, pressure, apparent temperature and average apparent temperature of the last four days. Day of the week, holidays, influenza epidemics and an indicator of population reduction were considered as confounders. Lagged effects were accounted for by studying the effect of up to 3 lags, the average of the last two days, and the average of the last 5 days. Stratified analysis was also performed by age groups. To evaluate the sensitivity of our results, Generalized Linear Models using Epidemiology • Volume 15, Number 4, July 2004 Abstracts