Urban air pollution, and asthma and COPD hospital emergency room visits

BACKGROUND

There is little previous information of the effects of size fractioned particulate air pollution and source specific fine particles (PM(2.5); <2.5 microm) on asthma and chronic obstructive pulmonary disease (COPD) among children, adults and the elderly.

OBJECTIVES

To determine the effects of daily variation in levels of different particle size fractions and gaseous pollutants on asthma and COPD by age group.

METHODS

Levels of particulate air pollution, NO(2) and CO were measured from 1998 to 2004 at central outdoor monitoring sites in Helsinki, Finland. Associations between daily pollution levels and hospital emergency room visits were evaluated for asthma (ICD10: J45+J46) in children <15 years old, and for asthma and COPD (ICD10: J41+J44) in adults (15-64 years) and the elderly (>or=65 years).

RESULTS

Three to 5 day lagged increases in asthma visits were found among children in association with nucleation (<0.03 microm), Aitken (0.03-0.1 microm) and accumulation (0.1-0.29 microm) mode particles, gaseous pollutants and traffic related PM(2.5) (7.8% (95% CI 3.5 to 12.3) for 1.1 microg/m(3) increase in traffic related PM(2.5) at lag 4). Pooled asthma-COPD visits among the elderly were associated with lag 0 of PM(2.5), coarse particles, gaseous pollutants and long range transported and traffic related PM(2.5) (3.9% (95% CI 0.28 to 7.7) at lag 0). Only accumulation mode and coarse particles were associated with asthma and COPD among adults.

CONCLUSIONS

Among children, traffic related PM(2.5) had delayed effects, whereas among the elderly, several types of particles had effects that were more immediate. These findings suggest that the mechanisms of the respiratory effects of air pollution, and responsible pollutants, differ by age group.

Reduction potential of urban PM2.5 mortality risk using modern ventilation systems in buildings

Urban PM2.5 (particulate matter with aerodynamic diameter smaller than 2.5 microm) is associated with excess mortality and other health effects. Stationary sources are regulated and considerable effort is being put into developing low-pollution vehicles and environment-friendly transportation systems. While waiting for technological breakthroughs in emission controls, the current work assesses the exposure reductions achievable by a complementary means: efficient filtration of supply air in buildings. For this purpose infiltration factors for buildings of different ages are quantified using Exposures of Adult Urban Populations in Europe Study (EXPOLIS) measurements of indoor and outdoor concentrations in a population-based probability sample of residential and occupational buildings in Helsinki, Finland. These are entered as inputs into an evaluated simulation model to compare exposures in the current scenario with an alternative scenario, where the distribution of ambient PM2.5 infiltration factors in all residential and occupational buildings are assumed to be similar to the subset of existing occupational buildings using supply air filters. In the alternative scenario exposures to ambient PM2.5 were reduced by 27%. Compared with source controls, a significant additional benefit is that infiltration affects particles from all outdoor sources. The large fraction of time spent indoors makes the reduction larger than what probably can be achieved by local transport policies or other emission controls in the near future.

PRACTICAL IMPLICATIONS

It has been suggested that indoor concentrations of ambient particles and the associated health risks can be reduced by using mechanical ventilation systems with supply air filtering in buildings. The current work quantifies the effects of these concentration reductions on population exposures using population-based data from Helsinki and an exposure model. The estimated exposure reductions suggest that correctly defined building codes may reduce annual premature mortality by hundreds in Finland and by tens of thousands in the developed world altogether.