The association between daily mortality and ambient air particle pollution in Montreal, Quebec 2. Cause-specific mortality

被引:114
作者
Goldberg, MS [1 ]
Burnett, RT
Bailar, JC
Brook, J
Bonvalot, Y
Tamblyn, R
Singh, R
Valois, MF
Vincent, R
机构
[1] McGill Univ, Royal Victoria Hosp, Dept Med, Montreal, PQ H3A 1A2, Canada
[2] McGill Univ, Royal Victoria Hosp, Joint Dept Epidemiol & Biostat & Occupat Hlth, Montreal, PQ H3A 1A2, Canada
[3] McGill Univ, Royal Victoria Hosp, Div Clin Epidemiol, Montreal, PQ H3A 1A2, Canada
[4] Hlth Canada, Environm Hlth Directorate, Ottawa, ON K1A 0L2, Canada
[5] Univ Chicago, Dept Hlth Studies, Chicago, IL 60637 USA
[6] Univ Chicago, Harris Sch Publ Policy, Chicago, IL 60637 USA
[7] Environm Canada, Meteorol Serv Canada, Air Qual Proc Res Div, Toronto, ON, Canada
[8] Univ Toronto, Dept Publ Hlth Sci, Toronto, ON, Canada
[9] Montreal Publ Hlth Dept, Montreal, PQ, Canada
关键词
cause-specific mortality; respiratory diseases; cardiovascular diseases; diabetes mellitus; cancer; ambient air pollution; particulates; total suspended particles; PM10; PM2.5; sulfate; coefficient of haze; time series; epidemiology;
D O I
10.1006/enrs.2001.4243
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
This study was undertaken to determine whether variations in concentrations of particulates in the ambient air of Montreal, Quebec, during the period 1984 to 1993, were associated with daily variations in cause-specific daily mortality. Fixed-site air pollution monitors in Montreal provided daily mean levels of various measures of particles and gaseous pollutants. Total sulfate was also measured daily (1986-1993) at a monitoring station 150 km southeast of the city (Sutton, Quebec). We used coefficient of haze (COH), extinction coefficient, and sulfate from the Sutton station to predict fine particles and sulfate from fine particles for days that were missing. We estimated associations between cause-specific mortality and PM2.5, PM10, predicted fine particles and fine sulfate particles, total suspended particles, coefficient of haze, extinction coefficient, and total sulfate measured at the Sutton station. We selected a set of underlying causes of death, as recorded on the death certificates, as the endpoint and then regressed the logarithm of daily counts of cause-specific mortality on the daily mean levels for the above measures of particulates, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and gaseous pollutants. We found positive and statistically significant associations between the daily measures of ambient particle mass and sulfate mass and the deaths from respiratory diseases and diabetes. The mean percentage change in daily mortality (MPC), evaluated at the interquartile range for pollutants averaged over the day of death and the preceding 2 days, for deaths from respiratory diseases was MPCOH = 6.90% (95% CI: 3.69-10.21%), MPCPredicted (PM2.5) = 9.03% (95% CI: 5.83-12.33%), and MPCSutton sulfate = 4,64% (95% CI: 2.46-6.86%). For diabetes, the corresponding estimates were MPCCOH = 7.50% (95% CI: 1.96-13.34%), MPCPredicted (PM2.5) = 7,59% (95% CI: 2.36-13.09%), and MPCSutton sulfate = 4.48% (95% CI: 1.08-7.99%). Among individuals older than 65 years at time of death, we found consistent associations across our metrics of particles for neoplasms and coronary artery diseases. Associations with sulfate mass were also found among elderly persons who died of cardiovascular diseases and of lung cancer. These associations were consistent with linear relationships. The associations found for respiratory diseases and for cardiovascular diseases, especially in the elderly, are in line with some of the current hypotheses regarding mechanisms by which ambient particles may increase daily mortality. The positive associations found for cancer and for diabetes may be understood through a general hypothesis proposed by Frank and Tankersley, who suggested that persons in failing health may be at higher risk for external insults through the failure of regulating physiological set points. The association with diabetes may be interpreted in light of recent toxicological findings that inhalation of urban particles in animals increases blood pressure and plasmatic levels of endothelins that enhance vasoconstriction and alter electrophysiology. Further research to confirm these findings and to determine whether they are causal is warranted. (C) 2001 Academic Press.
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页码:26 / 36
页数:11
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