THE ALLEGHENY COUNTY SHORT-TERM AIR POLLUTION EFFECTS (SHAPE) STUDY ON THE ELDERLY

摘要

A few studies have assessed the effects of the current levels of air quality in relation to stationary and indoor emission sources, monitoring sites and susceptible populations. To address this issue, first, an ecological evaluation of admissions of the elderly aged ≥65 years and the PM10 for the period 1995-2000 was carried out to assess vulnerability of this population. Secondly, a longitudinal study was conducted during the period of May 2003 to May 2004 among adults aged 50 to 79 years who had a cardiopulmonary diagnosis and resided in Allegheny County. Each participant maintained a diary of symptoms, peak expiratory flow rates and daily activities for up to two months.The ecological data showed high rates of admissions among the elderly. Individuals admitted multiple times often had a diagnosis related to acute conditions compared to the chronic diagnoses among those admitted only one-time. The admission category of whether an individual was admitted multiple times or one-time appeared to be significantly related to the PM10. The longitudinal study included a total of 32 participants, mean age 66. The average 24-hr PM10 level was 24.36 µg/m3. The results showed an association between PM10 and the cardiopulmonary symptoms suggesting a possible effect of air pollution. Additionally, the results of the continuous monitoring sites were highly correlated during both study periods. This finding proposes a review of the current federal and county air pollution monitoring strategies. Efforts should be re-directed at appropriate apportionment of individuals' exposure levels and examining possible sources of emissions that impact the living environments. This can be achieved through personal monitoring in conjunction with physiological assessments for improved exposure-outcome extrapolation. The public health significance of this study is that the less severe incidences reported by participants do not often require urgent medical support, but can eventually burden the body's physiological mechanism leading to hospitalization or death. The implication of the results is that the current ambient air quality standards do not appear to be entirely protective of all different population groups. The elderly who have underlying health conditions appear to be susceptible to the current exposure levels.