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

dc.contributor.author

Kravchenko, J

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Akushevich, I

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Abernathy, AP

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Holman, S

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Ross, WG

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Lyerly, HK

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New Zealand

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2014-06-30T12:34:39Z

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2014

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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.

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http://www.ncbi.nlm.nih.gov/pubmed/25018627

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copd-9-613

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1178-2005

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https://hdl.handle.net/10161/8919

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eng

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Dovepress

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Int J Chron Obstruct Pulmon Dis

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10.2147/COPD.S59995

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carbon monoxide

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chronic obstructive pulmonary disease

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nitrogen dioxide

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particulate matter

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sulfur dioxide

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Adolescent

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Adult

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Aged

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Air Pollutants

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Asthma

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Carbon Monoxide

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Environmental Monitoring

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Female

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Humans

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Inhalation Exposure

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Linear Models

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Male

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Middle Aged

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Nitric Oxide

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North Carolina

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Ozone

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Particulate Matter

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Pneumonia

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Pulmonary Emphysema

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Risk Assessment

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Risk Factors

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Sulfur Dioxide

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Time Factors

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Young Adult

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

dc.type

Journal article

duke.contributor.orcid

Lyerly, HK|0000-0002-0063-4770

pubs.author-url

http://www.ncbi.nlm.nih.gov/pubmed/25018627

pubs.begin-page

613

pubs.end-page

627

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Basic Science Departments

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Clinical Science Departments

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Duke

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Duke Cancer Institute

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Duke Clinical Research Institute

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Duke Population Research Institute

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Global Health Institute

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Immunology

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Institutes and Centers

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Institutes and Provost's Academic Units

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Medicine

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Medicine, Medical Oncology

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Pathology

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Physics

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Sanford School of Public Policy

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School of Medicine

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School of Nursing

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School of Nursing - Secondary Group

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Social Science Research Institute

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Surgery

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Surgery, Surgical Oncology Molecular Theraputics

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Trinity College of Arts & Sciences

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University Institutes and Centers

pubs.publication-status

Published online

pubs.volume

9

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