Multi-pollutant case-crossover models of all-cause and cause-specific mortality and hospital admissions by age group in 47 Canadian cities
- DOI
- Language of the publication
- English
- Date
- 2023-03-01
- Type
- Article
- Author(s)
- Huang, Guowen
- Brown, Patrick
- Shin, Hwashin Hyun
- Publisher
- Elsevier
Abstract
Most of the existing epidemiological studies have investigated adverse health effects of multiple air pollutants for a limited number of cities, thus the evidence of the health impacts is limited and it is challenging to compare these results because of different modeling approaches and potential publication bias. In this paper, we expand the number of Canadian cities, with the use of the most recent available health data. A multi-pollutant model in a case-crossover design is used to investigate the short-term impacts of air pollution on various health outcomes in 47 Canadian main cities, comparing three age groups (all-age, senior (age 66+), non-senior). The main findings are that a 14 ppb increase of O3 was associated with a 0.17%–2.78% (0.62%–1.46%) increase in the odds of all-age respiratory mortality (hospitalization). A 12.8 ppb increase of NO2 was associated with a 0.57%–1.47% (0.68%–1.86%) increase in the odds of all-age (non-senior) respiratory hospitalization. A 7.6 increase of PM2.5 was associated with a 0.19%–0.69% (0.33%–1.1%) increase in the odds of all-age (non-senior) respiratory hospitalization.
Plain language summary
Health Canada is responsible for assessing the health risks of air pollution, and identifying specific vulnerable populations as part of the Addressing Air Pollution Horizontal Initiative (AAPHI), which is federal government's efforts to address air pollution. Most of the existing epidemiological studies have investigated the adverse health effect of single air pollutant on Canadian population for a limited number of cities, thus the evidence of the health impacts can be insufficient. In this study, we expanded Canadian cities, using the most recent available health data, for three major outdoor air pollutants: ground-level ozone (O3), nitrogen dioxide (NO2), and fine particulate matter (PM2.5). Specifically, we applied multi-pollutant models to investigate the impacts of short-term exposure to the three air pollutants on public health based on 47 urban cities of at least 40,000 population, covering about 60% of total Canadian population. The health outcomes include deaths and hospitalizations caused by respiratory and circulatory system of human body, excluding injuries. We found that: NO2 was the main pollutant affecting circulatory hospitalizations; O3 was the main pollutant affecting respiratory deaths and hospitalizations both; and PM2.5 slightly affected respiratory hospitalizations. These study findings provide Health Canada with some evidence on the adverse health effect of outdoor air pollution, which can lead to improved Canadian population health.
Subject
- Health,
- Health and safety