Luchtvervuiling geeft veel hogere kans op longontsteking*
Uit een Canadese studie blijkt dat ouderen die langdurig aan hogere concentraties luchtvervuiling hebben blootgestaan veel meer kans lopen in het ziekenhuis te belanden met een longontsteking. De wetenschappers deden onderzoek onder 365 in het ziekenhuis opgenomen 65-plussers met longontsteking, en een controlegroep van 494 leeftijdgenoten. De mensen die in het ziekenhuis terechtkwamen, bleken langdurig (meer dan een jaar) in hun woonomgeving blootgesteld te zijn aan vuile lucht. Zij hadden ook hogere concentraties stikstofdioxide en fijnstof in het bloed dan de mensen uit de controlegroep. Ze hadden twee keer zoveel risico op longontsteking waarbij ziekenhuisopname nodig was. Langdurige blootstelling aan zwaveldioxide heeft volgens de Canadezen niet direct invloed op de ontwikkeling van ernstige longontsteking.
Long-Term Exposure to Ambient Air Pollution and Risk of Hospitalization with Community-acquired Pneumonia in Older Adults
Binod Neupane1, Michael Jerrett2, Richard T. Burnett3, Thomas Marrie4, Altaf Arain5 and Mark Loeb6
1 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; 2 Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California; 3 Environmental Health Directorate, Health Canada, Ottawa, Ontario; 4 Department of Medicine, University of Alberta, Edmonton, Alberta; 5 School of Geography and Earth Sciences, McMaster University, Hamilton, Ontario; and 6 Departments of Pathology and Molecular Medicine, Michael DeGroote Institute for Infectious Diseases, McMaster University, Hamilton, Ontario, Canada
Correspondence and requests for reprints should be addressed to Mark Loeb, M.D., McMaster University, MDCL 3200, 1200 Main St. W., Hamilton, ON, L8N 3Z5 Canada. E-mail: loebm@mcmaster.ca
Rationale: Little is known about the long-term effects of air pollution on pneumonia hospitalization in the elderly.
Objectives: To assess the effect of long-term exposure to ambient nitrogen dioxide, sulfur dioxide, and fine particulate matter with diameter equal to or smaller than 2.5 µm (PM2.5) on hospitalization for community-acquired pneumonia in older adults.
Methods: We used a population-based case–control study in Hamilton, Ontario, Canada. We enrolled 345 hospitalized patients aged 65 years or more for community-acquired pneumonia and 494 control participants, aged 65 years and more, randomly selected from the same community as cases from July 2003 to April 2005. Health data were collected by personal interview. Annual average levels of nitrogen dioxide, sulfur dioxide, and PM2.5 before the study period were estimated at the residential addresses of participants by inverse distance weighting, bicubic splined and land use regression methods and merged with participants' health data.
Measurements and Main Results: Long-term exposure to higher levels of nitrogen dioxide and PM2.5 was significantly associated with hospitalization for community-acquired pneumonia (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.25 to 4.21; P = 0.007 and OR, 2.26; 95% CI, 1.20 to 4.24; P = 0.012, respectively, over the 5th–95th percentile range increase of exposure). Sulfur dioxide did not appear to have any association (OR, 0.97; 95% CI, 0.59 to 1.61; P = 0.918). Results were somewhat sensitive to the choice of methods used to estimate air pollutant levels at residential addresses, although all risks from nitrogen dioxide and PM2.5 exposure were positive and generally significant.
Conclusions: In older adults, exposure to ambient nitrogen dioxide and PM2.5 was associated with hospitalization for community-acquired
pneumonia.
Am J Respir Crit Care Med 2010; 181: 47-53 (Januari 2010)
