ORIGINAL ARTICLES

Short-term associations between fine and coarse particles and hospital admissions for cardiorespiratory diseases in six French cities

S Host¹, S Larrieu², L Pascal², M Blanchard², C Declercq³, P Fabre², J-F Jusot², B Chardon¹, A Le Tertre², V Wagner², H Prouvost³, A Lefranc²

¹ Regional Health Observatory Ile-de-France, Paris, France
² Institute of Public Health Surveillance (InVS), Saint-Maurice, France
³ Regional Health Observatory, Nord-Pas-de-Calais, Lille, France

Sabine Host, Observatoire régional de santé d’Ile-de-France, 21-23 rue Miollis, 75732 Paris Cedex 15, France; s.host{at}ors-idf.org

Objectives: Little is known about the potential health effects of the coarse fraction of ambient particles. The aim of this study is to estimate the links between fine (PM_2.5) and coarse particle (PM_2.5–10) levels and cardiorespiratory hospitalisations in six French cities during 2000–2003.

Methods: Data on the daily numbers of hospitalisations for respiratory, cardiovascular, cardiac and ischaemic heart diseases were collected. Associations between exposure indicators and hospitalisations were estimated in each city using a Poisson regression model, controlling for confounding factors (seasons, days of the week, holidays, influenza epidemics, pollen counts, temperature) and temporal trends. City-specific findings were combined to obtain excess relative risks (ERRs) associated with a 10 µg/m³ increase in PM_2.5 and PM_2.5–10 levels.

Results: We found positive associations between indicators of particulate pollution and hospitalisations for respiratory infection, with an ERR of 4.4% (95% CI 0.9 to 8.0) for PM_2.5–10 and 2.5% (95% CI 0.1 to 4.8) for PM_2.5. Concerning respiratory diseases, no association was observed with PM_2.5, whereas positive trends were found with PM_2.5–10, with a significant association for the 0–14-year-old age group (ERR 6.2%, 95% CI 0.4 to 12.3). Concerning cardiovascular diseases, positive associations were observed between PM_2.5 levels and each indicator, although some did not reach significance; trends with PM_2.5–10 were weaker and non-significant except for ischaemic heart disease in the elderly (ERR 6.4%, 95% CI 1.6 to 11.4).

Conclusions: In accordance with other studies, our results indicate that the coarse fraction may have a stronger effect than the fine fraction on some morbidity endpoints, especially respiratory diseases.

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