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Long-term dynamics of death rates of emphysema, asthma, and pneumonia and improving air quality.

dc.contributor.author Abernethy, Amy Pickar
dc.contributor.author Akushevich, Igor
dc.contributor.author Holman, S
dc.contributor.author Kravchenko, J
dc.contributor.author Lyerly, Herbert Kim
dc.contributor.author Ross, WG
dc.coverage.spatial New Zealand
dc.date.accessioned 2014-06-30T12:34:39Z
dc.date.issued 2014
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/25018627
dc.identifier copd-9-613
dc.identifier.uri https://hdl.handle.net/10161/8919
dc.description.abstract BACKGROUND: The respiratory tract is a major target of exposure to air pollutants, and respiratory diseases are associated with both short- and long-term exposures. We hypothesized that improved air quality in North Carolina was associated with reduced rates of death from respiratory diseases in local populations. MATERIALS AND METHODS: We analyzed the trends of emphysema, asthma, and pneumonia mortality and changes of the levels of ozone, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matters (PM2.5 and PM10) using monthly data measurements from air-monitoring stations in North Carolina in 1993-2010. The log-linear model was used to evaluate associations between air-pollutant levels and age-adjusted death rates (per 100,000 of population) calculated for 5-year age-groups and for standard 2000 North Carolina population. The studied associations were adjusted by age group-specific smoking prevalence and seasonal fluctuations of disease-specific respiratory deaths. RESULTS: Decline in emphysema deaths was associated with decreasing levels of SO2 and CO in the air, decline in asthma deaths-with lower SO2, CO, and PM10 levels, and decline in pneumonia deaths-with lower levels of SO2. Sensitivity analyses were performed to study potential effects of the change from International Classification of Diseases (ICD)-9 to ICD-10 codes, the effects of air pollutants on mortality during summer and winter, the impact of approach when only the underlying causes of deaths were used, and when mortality and air-quality data were analyzed on the county level. In each case, the results of sensitivity analyses demonstrated stability. The importance of analysis of pneumonia as an underlying cause of death was also highlighted. CONCLUSION: Significant associations were observed between decreasing death rates of emphysema, asthma, and pneumonia and decreases in levels of ambient air pollutants in North Carolina.
dc.language eng
dc.relation.ispartof Int J Chron Obstruct Pulmon Dis
dc.relation.isversionof 10.2147/COPD.S59995
dc.subject carbon monoxide
dc.subject chronic obstructive pulmonary disease
dc.subject nitrogen dioxide
dc.subject particulate matter
dc.subject sulfur dioxide
dc.subject Adolescent
dc.subject Adult
dc.subject Aged
dc.subject Air Pollutants
dc.subject Asthma
dc.subject Carbon Monoxide
dc.subject Environmental Monitoring
dc.subject Female
dc.subject Humans
dc.subject Inhalation Exposure
dc.subject Linear Models
dc.subject Male
dc.subject Middle Aged
dc.subject Nitric Oxide
dc.subject North Carolina
dc.subject Ozone
dc.subject Particulate Matter
dc.subject Pneumonia
dc.subject Pulmonary Emphysema
dc.subject Risk Assessment
dc.subject Risk Factors
dc.subject Sulfur Dioxide
dc.subject Time Factors
dc.subject Young Adult
dc.title Long-term dynamics of death rates of emphysema, asthma, and pneumonia and improving air quality.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/25018627
pubs.begin-page 613
pubs.end-page 627
pubs.organisational-group Basic Science Departments
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Cancer Institute
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Duke Population Research Institute
pubs.organisational-group Global Health Institute
pubs.organisational-group Immunology
pubs.organisational-group Institutes and Centers
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Medical Oncology
pubs.organisational-group Pathology
pubs.organisational-group Physics
pubs.organisational-group Sanford School of Public Policy
pubs.organisational-group School of Medicine
pubs.organisational-group School of Nursing
pubs.organisational-group School of Nursing - Secondary Group
pubs.organisational-group Social Science Research Institute
pubs.organisational-group Surgery
pubs.organisational-group Surgery, Surgical Oncology Molecular Theraputics
pubs.organisational-group Trinity College of Arts & Sciences
pubs.organisational-group University Institutes and Centers
pubs.publication-status Published online
pubs.volume 9
dc.identifier.eissn 1178-2005


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