Air pollutants and health outcomes: Assessment of confounding by influenza
We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996–2002. Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidem...
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| Veröffentlicht in: | Atmospheric environment (1994) 2010-04, Vol.44 (11), p.1437-1442 |
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| creator | Thach, Thuan-Quoc Wong, Chit-Ming Chan, King-Pan Chau, Yuen-Kwan Neil Thomas, G. Ou, Chun-Quan Yang, Lin Peiris, Joseph S.M. Lam, Tai-Hing Hedley, Anthony J. |
| description | We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996–2002.
Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus 0.1% between unadjusted and adjusted excess risks (ER%).
Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO
2 and stroke hospitalization with O
3. Following adjustment, changes in ER% for all pollutants were 0.1% for mortality from stroke with NO
2 and SO
2, cardiac or heart disease with NO
2, PM
10 and O
3, lower respiratory infections with NO
2 and O
3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO
2, SO
2 and O
3 and acute lower respiratory infections hospitalization with PM
10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by influenza. |
| doi_str_mv | 10.1016/j.atmosenv.2010.01.036 |
| format | Article |
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Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ≥2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO
2), sulfur dioxide (SO
2), particulate matter with aerodynamic diameter ≤10 μm (PM
10) and ozone (O
3) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%).
Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO
2 and stroke hospitalization with O
3. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO
2 and SO
2, cardiac or heart disease with NO
2, PM
10 and O
3, lower respiratory infections with NO
2 and O
3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO
2, SO
2 and O
3 and acute lower respiratory infections hospitalization with PM
10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by influenza.</description><identifier>ISSN: 1352-2310</identifier><identifier>EISSN: 1873-2844</identifier><identifier>DOI: 10.1016/j.atmosenv.2010.01.036</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Applied sciences ; Atmospheric pollution ; Confounding ; Earth, ocean, space ; Exact sciences and technology ; External geophysics ; Hong Kong ; Hospitalization ; Influenza activity ; Meteorology ; Mortality ; Particles and aerosols ; Pollution</subject><ispartof>Atmospheric environment (1994), 2010-04, Vol.44 (11), p.1437-1442</ispartof><rights>2010 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-42f95f25197868b635f7213163296d12c71b587bcde0f8cc44790cb0eac33ab43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1352231010000853$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22566840$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>Thach, Thuan-Quoc</creatorcontrib><creatorcontrib>Wong, Chit-Ming</creatorcontrib><creatorcontrib>Chan, King-Pan</creatorcontrib><creatorcontrib>Chau, Yuen-Kwan</creatorcontrib><creatorcontrib>Neil Thomas, G.</creatorcontrib><creatorcontrib>Ou, Chun-Quan</creatorcontrib><creatorcontrib>Yang, Lin</creatorcontrib><creatorcontrib>Peiris, Joseph S.M.</creatorcontrib><creatorcontrib>Lam, Tai-Hing</creatorcontrib><creatorcontrib>Hedley, Anthony J.</creatorcontrib><title>Air pollutants and health outcomes: Assessment of confounding by influenza</title><title>Atmospheric environment (1994)</title><description>We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996–2002.
Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ≥2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO
2), sulfur dioxide (SO
2), particulate matter with aerodynamic diameter ≤10 μm (PM
10) and ozone (O
3) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%).
Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO
2 and stroke hospitalization with O
3. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO
2 and SO
2, cardiac or heart disease with NO
2, PM
10 and O
3, lower respiratory infections with NO
2 and O
3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO
2, SO
2 and O
3 and acute lower respiratory infections hospitalization with PM
10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by influenza.</description><subject>Applied sciences</subject><subject>Atmospheric pollution</subject><subject>Confounding</subject><subject>Earth, ocean, space</subject><subject>Exact sciences and technology</subject><subject>External geophysics</subject><subject>Hong Kong</subject><subject>Hospitalization</subject><subject>Influenza activity</subject><subject>Meteorology</subject><subject>Mortality</subject><subject>Particles and aerosols</subject><subject>Pollution</subject><issn>1352-2310</issn><issn>1873-2844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNqFkE1v1DAQhiNEJUrhLyBfEKcs44_YCSdWVflSJS7t2XKcMfUqsRePU6n99aTawpXTjEbPO6N5muYdhx0Hrj8edq4umTDd7wRsQ-A7kPpFc857I1vRK_Vy62UnWiE5vGpeEx0AQJrBnDc_9rGwY57ntbpUibk0sTt0c71jea0-L0if2J4IiRZMleXAfE4hr2mK6RcbH1hMYV4xPbo3zVlwM-Hb53rR3H65urn81l7__Pr9cn_demlUbZUIQxdExwfT637UsgtGcMm1FIOeuPCGj11vRj8hhN57pcwAfgR0Xko3KnnRfDjtPZb8e0WqdonkcZ5dwrySNUoDiIEPG6lPpC-ZqGCwxxIXVx4sB_vkzh7sX3f2yZ0Fbjd3W_D98wlH3s2huOQj_UsL0WndK9i4zycOt3_vIxZLPmLyOMWCvtopx_-d-gOJ2YiA</recordid><startdate>20100401</startdate><enddate>20100401</enddate><creator>Thach, Thuan-Quoc</creator><creator>Wong, Chit-Ming</creator><creator>Chan, King-Pan</creator><creator>Chau, Yuen-Kwan</creator><creator>Neil Thomas, G.</creator><creator>Ou, Chun-Quan</creator><creator>Yang, Lin</creator><creator>Peiris, Joseph S.M.</creator><creator>Lam, Tai-Hing</creator><creator>Hedley, Anthony J.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7ST</scope><scope>7T2</scope><scope>7TG</scope><scope>7TV</scope><scope>7U1</scope><scope>7U2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>KL.</scope><scope>SOI</scope></search><sort><creationdate>20100401</creationdate><title>Air pollutants and health outcomes: Assessment of confounding by influenza</title><author>Thach, Thuan-Quoc ; Wong, Chit-Ming ; Chan, King-Pan ; Chau, Yuen-Kwan ; Neil Thomas, G. ; Ou, Chun-Quan ; Yang, Lin ; Peiris, Joseph S.M. ; Lam, Tai-Hing ; Hedley, Anthony J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-42f95f25197868b635f7213163296d12c71b587bcde0f8cc44790cb0eac33ab43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Applied sciences</topic><topic>Atmospheric pollution</topic><topic>Confounding</topic><topic>Earth, ocean, space</topic><topic>Exact sciences and technology</topic><topic>External geophysics</topic><topic>Hong Kong</topic><topic>Hospitalization</topic><topic>Influenza activity</topic><topic>Meteorology</topic><topic>Mortality</topic><topic>Particles and aerosols</topic><topic>Pollution</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thach, Thuan-Quoc</creatorcontrib><creatorcontrib>Wong, Chit-Ming</creatorcontrib><creatorcontrib>Chan, King-Pan</creatorcontrib><creatorcontrib>Chau, Yuen-Kwan</creatorcontrib><creatorcontrib>Neil Thomas, G.</creatorcontrib><creatorcontrib>Ou, Chun-Quan</creatorcontrib><creatorcontrib>Yang, Lin</creatorcontrib><creatorcontrib>Peiris, Joseph S.M.</creatorcontrib><creatorcontrib>Lam, Tai-Hing</creatorcontrib><creatorcontrib>Hedley, Anthony J.</creatorcontrib><collection>Pascal-Francis</collection><collection>CrossRef</collection><collection>Environment Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Pollution Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>Environment Abstracts</collection><jtitle>Atmospheric environment (1994)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thach, Thuan-Quoc</au><au>Wong, Chit-Ming</au><au>Chan, King-Pan</au><au>Chau, Yuen-Kwan</au><au>Neil Thomas, G.</au><au>Ou, Chun-Quan</au><au>Yang, Lin</au><au>Peiris, Joseph S.M.</au><au>Lam, Tai-Hing</au><au>Hedley, Anthony J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Air pollutants and health outcomes: Assessment of confounding by influenza</atitle><jtitle>Atmospheric environment (1994)</jtitle><date>2010-04-01</date><risdate>2010</risdate><volume>44</volume><issue>11</issue><spage>1437</spage><epage>1442</epage><pages>1437-1442</pages><issn>1352-2310</issn><eissn>1873-2844</eissn><abstract>We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996–2002.
Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ≥2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO
2), sulfur dioxide (SO
2), particulate matter with aerodynamic diameter ≤10 μm (PM
10) and ozone (O
3) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%).
Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO
2 and stroke hospitalization with O
3. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO
2 and SO
2, cardiac or heart disease with NO
2, PM
10 and O
3, lower respiratory infections with NO
2 and O
3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO
2, SO
2 and O
3 and acute lower respiratory infections hospitalization with PM
10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by influenza.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><doi>10.1016/j.atmosenv.2010.01.036</doi><tpages>6</tpages></addata></record> |
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| source | Elsevier ScienceDirect Journals Complete |
| subjects | Applied sciences Atmospheric pollution Confounding Earth, ocean, space Exact sciences and technology External geophysics Hong Kong Hospitalization Influenza activity Meteorology Mortality Particles and aerosols Pollution |
| title | Air pollutants and health outcomes: Assessment of confounding by influenza |
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