Short-term Associations between Fine and Coarse Particles and Cardiorespiratory Hospitalizations in Six French Cities

¹ Regional Health Observatory (ORS) Ile-de-France, France
² Institute of Public Health Surveillance (InVS), France
³ Regional Health Observatory (ORS) Nord-Pas-de-Calais, France
⁴ Regional Health Observatory (ORS ) Ile-de-France, France

^* To whom correspondence should be addressed. E-mail: s.host{at}ors-idf.org.

Accepted 21 November 2007

	Abstract

Objectives: Little is known about the potential health effects of the coarse fraction of ambient particle matters. The aim of this study is to estimate the links between both fine particles (PM2.5) and coarse particles (PM2.5-10) levels and cardiorespiratory hospitalizations in six French cities during the 2000-2003 period for general population and subgroups as children and elderly. Methods: Daily numbers of hospitalizations for respiratory, cardiovascular, cardiac and ischemic heart diseases were extracted from the French hospital information system. Associations between exposure indicators and hospitalizations were estimated in each city using a Poisson regression model, controlling for well-known 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 PM2.5 and PM2.5-10 levels. Results: We found positive associations between indicators of particulate pollution and hospitalizations for respiratory infection, with an ERR of 4.4 % [95% IC: 0.9; 8.0] for PM2.5-10 and of 2.5 % [0.1; 4.8] for PM2.5. Concerning respiratory diseases, no association was observed with PM2.5 whereas positive trends were found with PM2.5-10, with a significant association in the 0-14 age group (ERR=6.2 % [0.4; 12.3]). Concerning cardiovascular diseases, positive associations were observed between PM2.5 levels and each indicator, although some did not reach significance; trends with PM2.5-10 were weaker and non-significant except for ischemic heart diseases in the elderly (ERR =6.4 % [1.6; 11.4]). Conclusions: In accordance with others, our results point out that the coarse fraction may have a stronger effect than the fine one on some morbidity endpoints, especially respiratory diseases, and should therefore not be neglected.

Keywords: air pollution, hospitalizations, meta-analysis, particulate matter, time series

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