pmc logo image
Logo of envhperEHP WebsiteAbout EHPPublicationsNews By TopicAuthorsSubscribePressEmail AlertsSearch EHP

Formats:

Environ Health Perspect. 1996 December; 104(12): 1354–1360.
PMCID: PMC1469538
Research Article
Association between ozone and asthma emergency department visits in Saint John, New Brunswick, Canada.
D M Stieb, R T Burnett, R C Beveridge, and J R Brook
Air Quality Health Effects Research Section, Health Canada, Ottawa, Ontario, Canada.
Abstract
This study examines the relationship of asthma emergency department (ED) visits to daily concentrations of ozone and other air pollutants in Saint John, New Brunswick, Canada. Data on ED visits with a presenting complaint of asthma (n = 1987) were abstracted for the period 1984-1992 (May-September). Air pollution variables included ozone, sulfur dioxide, nitrogen dioxide, sulfate, and total suspended particulate (TSP); weather variables included temperature, humidex, dewpoint, and relative humidity. Daily ED visit frequencies were filtered to remove day of the week and long wave trends, and filtered values were regressed on air pollution and weather variables for the same day and the 3 previous days. The mean daily 1-hr maximum ozone concentration during the study period was 41.6 ppb. A positive, statistically significant (p < 0.05) association was observed between ozone and asthma ED visits 2 days later, and the strength of the association was greater in nonlinear models. The frequency of asthma ED visits was 33% higher (95% CI, 10-56%) when the daily 1-hr maximum ozone concentration exceeded 75 ppb (the 95th percentile). The ozone effect was not significantly influenced by the addition of weather or other pollutant variables into the model or by the exclusion of repeat ED visits. However, given the limited number of sampling days for sulfate and TSP, a particulate effect could not be ruled out. We detected a significant association between ozone and asthma ED visits, despite the vast majority of sampling days being below current U.S. and Canadian standards.
Full text
Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
  • Kinney PL, Ozkaynak H. Associations of daily mortality and air pollution in Los Angeles County. Environ Res. 1991 Apr;54(2):99–120. [PubMed]
  • Bates DV, Sizto R. Air pollution and hospital admissions in Southern Ontario: the acid summer haze effect. Environ Res. 1987 Aug;43(2):317–331. [PubMed]
  • Burnett RT, Dales RE, Raizenne ME, Krewski D, Summers PW, Roberts GR, Raad-Young M, Dann T, Brook J. Effects of low ambient levels of ozone and sulfates on the frequency of respiratory admissions to Ontario hospitals. Environ Res. 1994 May;65(2):172–194. [PubMed]
  • Thurston GD, Ito K, Kinney PL, Lippmann M. A multi-year study of air pollution and respiratory hospital admissions in three New York State metropolitan areas: results for 1988 and 1989 summers. J Expo Anal Environ Epidemiol. 1992 Oct–Dec;2(4):429–450. [PubMed]
  • Weisel CP, Cody RP, Lioy PJ. Relationship between summertime ambient ozone levels and emergency department visits for asthma in central New Jersey. Environ Health Perspect. 1995 Mar;103 Suppl 2:97–102. [PubMed]
  • Cody RP, Weisel CP, Birnbaum G, Lioy PJ. The effect of ozone associated with summertime photochemical smog on the frequency of asthma visits to hospital emergency departments. Environ Res. 1992 Aug;58(2):184–194. [PubMed]
  • White MC, Etzel RA, Wilcox WD, Lloyd C. Exacerbations of childhood asthma and ozone pollution in Atlanta. Environ Res. 1994 Apr;65(1):56–68. [PubMed]
  • Romieu I, Meneses F, Sienra-Monge JJ, Huerta J, Ruiz Velasco S, White MC, Etzel RA, Hernandez-Avila M. Effects of urban air pollutants on emergency visits for childhood asthma in Mexico City. Am J Epidemiol. 1995 Mar 15;141(6):546–553. [PubMed]
  • Jones GN, Sletten C, Mandry C, Brantley PJ. Ozone level effect on respiratory illness: an investigation of emergency department visits. South Med J. 1995 Oct;88(10):1049–1056. [PubMed]
  • Horstman DH, Folinsbee LJ, Ives PJ, Abdul-Salaam S, McDonnell WF. Ozone concentration and pulmonary response relationships for 6.6-hour exposures with five hours of moderate exercise to 0.08, 0.10, and 0.12 ppm. Am Rev Respir Dis. 1990 Nov;142(5):1158–1163. [PubMed]
  • Spektor DM, Lippmann M, Lioy PJ, Thurston GD, Citak K, James DJ, Bock N, Speizer FE, Hayes C. Effects of ambient ozone on respiratory function in active, normal children. Am Rev Respir Dis. 1988 Feb;137(2):313–320. [PubMed]
  • Crapo J, Miller FJ, Mossman B, Pryor WA, Kiley JP. NHLBI workshop summary. Environmental lung diseases. Relationship between acute inflammatory responses to air pollutants and chronic lung disease. Am Rev Respir Dis. 1992 Jun;145(6):1506–1512. [PubMed]
  • Devlin RB, McDonnell WF, Mann R, Becker S, House DE, Schreinemachers D, Koren HS. Exposure of humans to ambient levels of ozone for 6.6 hours causes cellular and biochemical changes in the lung. Am J Respir Cell Mol Biol. 1991 Jan;4(1):72–81. [PubMed]
  • Bates DV, Baker-Anderson M, Sizto R. Asthma attack periodicity: a study of hospital emergency visits in Vancouver. Environ Res. 1990 Feb;51(1):51–70. [PubMed]
  • Castellsague J, Sunyer J, Sáez M, Antó JM. Short-term association between air pollution and emergency room visits for asthma in Barcelona. Thorax. 1995 Oct;50(10):1051–1056. [PubMed]
  • Schwartz J, Slater D, Larson TV, Pierson WE, Koenig JQ. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis. 1993 Apr;147(4):826–831. [PubMed]
  • Sunyer J, Antó JM, Murillo C, Saez M. Effects of urban air pollution on emergency room admissions for chronic obstructive pulmonary disease. Am J Epidemiol. 1991 Aug 1;134(3):277–289. [PubMed]
  • Samet JM, Bishop Y, Speizer FE, Spengler JD, Ferris BG., Jr The relationship between air pollution and emergency room visits in an industrial community. J Air Pollut Control Assoc. 1981 Mar;31(3):236–240. [PubMed]
  • Goldsmith JR, Griffith HL, Detels R, Beeser S, Neumann L. Emergency room admissions, meteorologic variables, and air pollutants: a path analysis. Am J Epidemiol. 1983 Nov;118(5):759–778. [PubMed]
  • Rossi OV, Kinnula VL, Tienari J, Huhti E. Association of severe asthma attacks with weather, pollen, and air pollutants. Thorax. 1993 Mar;48(3):244–248. [PubMed]
  • Chidley KE, Wood-Baker R, Town GI, Sleet RA, Holgate ST. Reassessment of asthma management in an accident and emergency department. Respir Med. 1991 Sep;85(5):373–377. [PubMed]
  • Reed S, Diggle S, Cushley MJ, Sleet RA, Tattersfield AE. Assessment and management of asthma in an accident and emergency department. Thorax. 1985 Dec;40(12):897–902. [PubMed]
  • Fitzgerald JM, Hargreave FE. Acute asthma: emergency department management and prospective evaluation of outcome. CMAJ. 1990 Mar 15;142(6):591–595. [PubMed]
  • O'Halloran SM, Heaf DP. Accident and emergency department attendance by asthmatic children. Thorax. 1989 Sep;44(9):700–705. [PubMed]
  • Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995 Jan 19;332(3):133–138. [PubMed]
  • Yaacob I, Omar R, Mustafa WN. The outcome of patients with acute bronchial asthma presenting to the emergency room. Singapore Med J. 1991 Jun;32(3):166–168. [PubMed]
  • Newcomb RW, Akhter J. Outcomes of emergency room visits for asthma. I. Patient determinants. J Allergy Clin Immunol. 1986 Feb;77(2):309–315. [PubMed]