Journal Information
Vol. 12. Issue 5.
Pages 223-230 (September - October 1998)
Vol. 12. Issue 5.
Pages 223-230 (September - October 1998)
Open Access
Impacto de la contaminación atmosférica sobre la mortalidad y las urgencias por enfermedad pulmonar obstructiva crónica y asma en Barcelona
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A. Tobías Garcés*, J. Sunyer Deu, J. Castellsagué Piqué, M. Sáez Zafra, J. M.ª Antó Boqué, Financiado por: Commission of the European Communities (CEC), Directorate General for Science, Research and Development, Environment 1991–1994 Programme.
Unitat de Recerca Respiratòria i Ambiental. Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona
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Resumen
Objetivos

La contaminación atmosféerica se ha asociado con un aumento de la mortalidad según estudios realizados en EE.UU. El proyecto APHEA (Air Pollution on Health: an European Approach) analiza los efectos a corto plazo en 15 ciudades Europeas. Evaluamos el impacto derivado de la relación aguda entre contaminación atmosférica y mortalidad y urgencias hospitalarias por causas respiratorias en Barcelona, una de las ciudades participantes en el proyecto APHEA.

Métodos

Se relacionaron las variaciones diarias en la mortalidad total, mortalidad cardiovascular, mortalidad por causas respiratorias, urgencias hospitalarias por enfermedad pulmonar obstructiva crónica (EPOC) y asma con las variaciones diarias en los contaminantes aéreos durante el período 1985–1991, utilizando regresión de Poisson, controlando por temperatura, humedad relativa y epidemias de asma y gripe, y tratando las variables de tendencia temporal y los términos autorregresivos.

Resultados

Una reducción de 50 μg/m3 de partículas y de dióxido de azufre representa una reducción de alrededor de un 4% y un 6% (p < 0,05), respectivamente, de las muertes diarias por causa respiratoria y cardiovascular, y de las urgencias por EPOC. Los contaminantes oxidantes (dióxido de nitrógeno y ozono) se relacionaron positivamente con la mortalidad cardiovascular, y las urgencias por EPOC y asma. Destacando el papel del ozono, donde una reducción de 50 μg/m3 da lugar a una reducción del 4% de las urgencias por EPOC y asma (p < 0,05).

Conclusiones

Los actuales niveles de contaminantes aéreos tienen un impacto medible epidemiológicamente en la mortalidad y las urgencias por EPOC y asma en Barcelona. Estos resultados son consistentes con estudios similares en otras ciudades europeas y americanas y con estudios previos con admisiones en urgencias en Barcelona, y son coherentes con la posible toxicidad de los contaminantes atmosféricos.

Palabras clave:
Contaminación atmosférica
Series temporales
Regresión de Poisson
Autocorrelación
Riesgo Atribuible
Mortalidad
Morbilidad
Asma
EPOC
Summary
Objectives

Air pollution has been associated with increased mortality according to studies carried out in the US. The APHEA project (Air Pollution on Health: a European Approach) analyzes the short-term effects in 15 european cities. We evaluated the acute relation between air pollution, mortality, and hospital emergency-room visits in Barcelona, one of the cities participating in the APHEA project.

Methods

Daily variations in total mortality, cardiovascular mortality, respiratory mortality, and emergency-room visits for chronic obstructive pulmonary disease (COPD), and asthma were studied in relation to daily variations in air pollution levels in 1985–1991. Poisson regression was done and temperature, relative humidity, and epidemics of asthma and flu were controlled. Temporal trends and auto-regressive terms were examined.

Results

A reduction of about 50 μg/m3 in particles and sulfur dioxide was accompanied by a reduction of about 4% and 6% (p < 0.05), respectively, in daily deaths from respiratory and cardiovascular causes and emergency-room visits for COPD. Oxidant pollutants (nitrogen dioxide and ozone) were related positively with cardiovascular mortality and emergency visits for COPD and asthma. The role of ozone was notable, with a reduction in ozone levels of 50 μg/m3 originating a 4% reduction in emergency-room visits for COPD and asthma (p < 0.05).

Conclusions

Current levels of air pollutants had an epidemiologically measurable impact on mortality and emergency-room visits in Barcelona. These results were consistent with the findings of similar studies in other european and american cities and with previous studies of emergency-room admissions in Barcelona. These studies suggest the possible toxicity of air pollution.

Key words:
Air pollution
Time series
Poisson regression
Autocorrelation
Attributable risk
Mortality
Morbidity
Asthma
COPD
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