Health service based morbidity indicators as a measure of health effects of air pollution

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Abstract
We review 15 epidemiological studies published between September 1979 and March 1991 and assess the short-term impact of air pollution on health service-based morbidity indicators. Overall hospital activity indicators are more strongly associated with temperature than with pollution levels. A relationship between hospital respiratory admission indicators and acid-particulate pollution is observed at mean daily levels of 100–150 μg/m 3 /day for total suspended particulates (TSP) and < 100 μg/m 3 /day for sulphur dioxide. Hospital cardiovascular admission indicators are correlated to acid-particulate pollution and hospital psychiatric admission indicators appear to be linked to oxidant pollution. Findings on general medicine-based morbidity indicators are contrasted. Though the particulate pollution appears to have a significant impact on visits related to respiratory and cardiovascular conditions, temperature is seen to be the most important factor. On the other hand, such indicators seem to be more sensitive to low levels of air pollution than the hospital-based morbidity indicators. Most of the studies show a link between air pollution and health service-based morbidity indicators at a level of exposure below present standards. Such studies contribute to a better evaluation of the impact of air pollution on human health.

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