TAILIEUCHUNG - Urban air pollution and emergency room admissions for respiratory symptoms: a case- crossover study in Palermo, Italy

Throughout the entire project many assumptions and methodological decisions had to be made along the various calculation steps in the domains of air pollution, epidemiology and economics. On each level, the method of dealing with uncertainty had to be defined. The research group decided that the main calculation ought to apply an “at least” approach, thus consistently selecting methodological assumptions in a way to get a result which may be expected to be “at least” attributable to air pollution. Accordingly, the overall impact of air pollution is expected to be greater than the final estimates. To unambiguously communicate the uncertainty in the common methodological framework, the. | Tramuto et al. Environmental Health 2011 10 31 http content 10 1 31 ENVIRONMENTAL HEALTH RESEARCH Open Access Urban air pollution and emergency room admissions for respiratory symptoms a casecrossover study in Palermo Italy 1 1 4 1 Fabio Tramuto Rosanna Cusimano Giuseppe Cerame Marcello Vultaggio Giuseppe Calamusa Carmelo M Maida1 and Francesco Vitale1 Abstract Background Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo the largest metropolitan area in Sicily urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute respiratory symptoms. Methods From January 2004 through December 2007 air pollutant concentrations and emergency room visits were collected for a case-crossover study conducted in Palermo Sicily. Risk estimates of short-term exposures to particulate matter and gaseous ambient pollutants including carbon monoxide nitrogen dioxide and sulfur dioxide were calculated by using a conditional logistic regression analysis. Results Emergency departments provided data on 48 519 visits for respiratory symptoms. Adjusted case-crossover analyses revealed stronger effects in the warm season for the most part of the pollutants considered with a positive association for PM10 odds ratio 95 confidence interval - SO2 OR 95 CI - nitrogen dioxide NO2 OR 95 CI - and CO OR 95 CI - especially among females according to an increase of 10 pg m3 in PM10 NO2 SO2 and 1 mg m3 in CO exposure . A positive association was observed either in warm or in cold season only for PM10. Conclusions Our findings suggest that in our setting exposure to ambient levels of air .

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