1887
Volume 2012, Issue 1
  • ISSN: 2223-0440
  • EISSN:

Abstract

Levels of daily particulates (PM) were monitored at two sites in Karachi, Pakistan. One site (Korangi) is an industrial and residential neighborhood, while the other (Tibet Center) is a commercial and residential area near a major highway. Monitoring was done daily for a period of six weeks during spring, summer, fall and winter. Particulate levels were extraordinarily high, with the great majority of days falling into the “unhealthy for sensitive groups” or “very unhealthy” categories. The mean PM levels in Karachi exceeded the WHO's 24 h air quality guideline almost every day and often by a factor of greater than 5-fold. Daily emergency room (ER) visits and hospital admissions for cardiovascular diseases were obtained by review of medical records at three major tertiary and specialized hospitals. ER and hospitalizations were reported relative to days in which the concentration of PM was less than 50 μg/m3, and by 50 μg/m3 increments up to 300 μg/m3. There were statistically significant elevations in rates of hospital admissions at each of the PM categories at the Korangi site, and at concentrations >150 μg/m3 at the Tibet Center site. ER visits were significantly elevated only at PM concentrations of between 151 and 200 μg/m3 at both sites. These results show that the extremely elevated concentrations of PM in Karachi, Pakistan are, as expected, associated with significantly elevated rates of hospital admission, and to a lesser extent, ER visits for cardiovascular disease.

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References

  1. Atkinson RW, Anderson HR, Strachan DP, Bland JM, Bremner SA, Ponce de Leon A. Short-term associations between outdoor air pollution and visits to accident and emergency departments in London for respiratory complaints. Eur Respir J. 1999; 13::257265
    [Google Scholar]
  2. Bell ML, Samet JM, Dominici F. Time-series studies of particulate matter. Annu Rev Public Health. 2004; 25::247280
    [Google Scholar]
  3. Bell ML, Ebisu K, Peng RD, Walker J, Samet JM, Zeger SL, Dominici F. Seasonal and regional short-term effects of fine particles on hospital admissions in 202 US counties, 1999–2005. Am J Epidemiol. 2008; 168::13011310
    [Google Scholar]
  4. Brunekreef B. Health effects of air pollution observed in cohort studies in Europe. J Expo Sci Environ Epidemiol. 2007; 17:Suppl 2:S61S65
    [Google Scholar]
  5. Burnett RT, Smith-Doiron M, Stieb D, Cakmak S, Brook JR. Effects of particulate and gaseous air pollution on cardiorespiratory hospitalizations. Arch Environ Health. 1999; 54::130139
    [Google Scholar]
  6. Burnett RT, Brook J, Dann T, Delocla C, Philips O, Cakmak S, Vincent R, Goldberg MS, Krewski D. Association between particulate- and gas-phase components of urban air pollution and daily mortality in eight Canadian cities. Inhal Toxicol. 2000; 12::1539
    [Google Scholar]
  7. Burnett RT, Goldberg MS. Size fractionated particulate mass and daily mortality in eight Canadian cities. Revised Analyses of Time-Series of Air Pollution and Health. Boston, MA: Special Report; Health Effects Institute 2003;:8590
    [Google Scholar]
  8. Dockery DW, Pope AC III, Xu X, Spengler JD, Ware JH, Fay ME. An association between air pollution and mortality in six U.S. cities. N Engl J Med. 1999; 329::17531759
    [Google Scholar]
  9. Dockery DW. Health effects of particulate air pollution. Ann Epidemiol. 2009; 19::257263
    [Google Scholar]
  10. Goldberg MS, Burnett RT, Bailar JC III, Brook J, Bonvalot Y, Tamblyn R, Singh R, Valois MF, Vincent R. The association between daily mortality and ambient air particle pollution in Montreal, Quebec. 2. Cause-specific mortality. Environ Res. 2001; 86::2636
    [Google Scholar]
  11. Health Effects Institute. 2000;. National Morbidity, mortality, and air pollution study. HEI Report 94, Part 2
  12. Ibald-Mulli A, Timonen KL, Peters A, Heinrich J, Wölke G, Lanki T, Buzorius G, Kreyling WG, de Hartog J, Hoek G, ten Brink HM, Pekkanen J. Effects of particulate air pollution on blood pressure and heart rate in subjects with cardiovascular disease: a multicenter approach. Environ Health Perspect. 2004; 112::369377
    [Google Scholar]
  13. Ito K, Mathes R, Ross Z, Nadas A, Thurston G, Matte T. Fine particulate matter constituents associated with cardiovascular hoapitalizations and mortality in New York city. Environ Health Perspect. 2011; 119::467473
    [Google Scholar]
  14. Lin M, Chen Y, Villeneuve PJ, Burnett RT, Lemyre L, Hertzman C. Gaseous air pollutants and asthma hospitalization of children with low household income in Vancouver, British Columbia, Canada. Am J Epidemiol. 2004; 159::294303
    [Google Scholar]
  15. Luginaah IN, Fung KY, Gorey KM, Webster G, Wills C. Association of ambient air pollution with respiratory hospitalization in a government-designated “area of concern”: the case of Windsor, Ontario. Environ Health Perspect. 2005; 113::290295
    [Google Scholar]
  16. Mann JK, Tager IB, Lurmann F, Segal M, Quesenberry CP Jr, Lugg MM, Shan J, Van Den Eeden SK. Air pollution and hospital admissions for ischeamic heart disease in persons with congestive heart failure or arrhythmia. Environ Health Perspect. 2002; 110::12471252
    [Google Scholar]
  17. NRC (National Research Council). Committee on Research Priorities for Airborne Particulate Matter. Research Priorities for Airborne Particulate Matter, IV: Continuing Research Progress. Washington, DC: National Academies Press 2004;
    [Google Scholar]
  18. Pope CA III, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K, Thurston GD. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. J Med Assoc. 2002; 287::11321141
    [Google Scholar]
  19. Pope CA III, Dockery DW. Health effects of fine particulate air pollution: lines that connect. J Air Waste Manage Assoc. 2006; 56::709742
    [Google Scholar]
  20. Samet JM, Zeger SL, Dominici F, Curriero F, Coursac I, Dockery DW, Schwartz J, Zanobetti A. The National morbidity, mortality, and air pollution study. Part II: morbidity and mortality from air pollution in the United States. Res Rep Health Eff Inst. 2000; 94::570
    [Google Scholar]
  21. Schwartz J, Marcus A. Mortality and air pollution in London: a time series analysis. Am J Epidemiol. 1990; 131::185194
    [Google Scholar]
  22. Schwartz J. What are people dying of on high air pollution days? Environ Res. 1994; 64::2635
    [Google Scholar]
  23. Schwartz J. Airborne particles and daily deaths in 10 US cities. Revised Analyses of Time-Series of Air Pollution and Health. Special Report. Boston, MA: Health Effects Institute 2003;:211218
    [Google Scholar]
  24. Sunyer J, Ballester F, Tertre AL, Atkinson R, Ayres JG, Forastiere F, Forsberg B, Vonk JM, Bisanti L, Tenias JM, Medina S, Schwartz J, Katsouyanni K. The association of sulfur dioxide air pollution levels with hospital admissions for cardiovascular diseases in Europe (The APHEA 2 study). Eur Heart J. 2003; 24::752760
    [Google Scholar]
  25. WHO (World Health Organization). Air Quality Guidelines for Europe. WHO Regional Publications, European Series, No. 91. 2nd ed. Copenhagen: WHO Regional Office for Europe 2000;
    [Google Scholar]
  26. Zanobetti A, Schwartz J. Cardiovascular damage by airborne particles: are diabetics more susceptible? Epidemiology. 2002; 13::588592
    [Google Scholar]
  27. Atkinson RW, Anderson HR, Sunyer J, Ayres J, Baccini M, Vonk JM, Boumghar A, Forastiere F, Forsberg B, Touloumi G, Schwartz J, Katsouyanni K. Acute effects of particulate air pollution on respiratory admissions: results from APHEA 2 project. Air pollution and health: a European approach. Am J Respir Crit Care Med. 2001; 164::18601866
    [Google Scholar]
  28. Chen L, Verrall K, Tong S. Air particulate pollution due to bushfires and respiratory hospital admissions in Brisbane, Australia. Int J Environ Health Res. 2006; 16::181191
    [Google Scholar]
  29. Klemm RJ, Mason R. Replication of reanalysis of Harvard six-city mortality study. Revised Analyses of Time-Series of Air Pollution and Health, Special Report. Boston, MA: Health Effects Institute 2003;:165172
    [Google Scholar]
  30. Liu X, Lessner L, Carpenter DO. Association between residential proximity to fuel-fired power plants and hospitalization rate for respiratory diseases. Environ Health Perspect. 2012; 120::807810
    [Google Scholar]
  31. Ostro B, Broadwin R, Green S, Feng WY, Lipsett MJ. Fine particulate air pollution and mortality in nine California counties: results from CALFINE. Environ Health Perspect. 2006; 114::2933
    [Google Scholar]
  32. Ostro B, Roth L, Malig B, Marty M. The effects of fine particle components on respiratory hospital admissions in children. Environ Health Perspect. 2009; 117::475480
    [Google Scholar]
  33. Analitis A, Katsouyanni K, Dimakopoulou K, Samoli E, Nikoloulopoulos AK, Petasakis Y, Touloumi G, Schwartz J, Anderson HR, Cambra K, Forastiere F, Zmirou D, Vonk JM, Clancy L, Kriz B, Bobvos J, Pekkanen J. Short-term effects of ambient particles on cardiovascular and respiratory mortality. Epidemiology. 2006; 17::230233
    [Google Scholar]
  34. COMEAP. Cardiovascular Disease and Air Pollution. A Report by the Committee on the Medical Effects of Air Pollutant's Cardiovascular Sub-Group. London, United Kingdom: United Kingdom Department of health 2006;
    [Google Scholar]
  35. Dominici F, Peng RD, Bell ML, Pham L, McDermott A, Zeger SL, Samet JM. Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. J Am Med Assoc. 2006; 295::11271134
    [Google Scholar]
  36. Haley VB, Talbot TO, Felton HD. Surveillance of the short-term impact of fine particle air pollution on cardiovascular disease hospitalizations in New York State. Environ Health. 2009; 8::42
    [Google Scholar]
  37. Le Tertre A, Medina S, Samoli E, Forsberg B, Michelozzi P, Boumghar A, Vonk JM, Bellini A, Atkinson R, Ayres JG, Sunyer J, Schwartz J, Katsouyanni K. Short-term effects of particulate air pollution on cardiovascular diseases in eight European cities. J Epidemiol Community Health. 2002; 56::773779
    [Google Scholar]
  38. Park SK, O'Neill MS, Vokonas PS, Sparrow D, Schwartz J. Effects of air pollution on heart rate variability: the VA normative aging study. Environ Health Perspect. 2005; 113::304309
    [Google Scholar]
  39. Peng RD, Chang HH, Bell ML, McDermott A, Zeger SL, Samet JM, Dominici F. Coarse particulate matter air pollution and hospital admissions for cardiovascular and respiratory diseases among Medicare patients. J Am Med Assoc. 2008; 299::21722179
    [Google Scholar]
  40. Peng RD, Bell ML, Geyh AS, McDermott A, Zeger SL, Samet JM, Dominici F. Emergency admissions for cardiovascular and respiratory diseases and the chemical composition of fine particle air pollution. Environ Health Perspect. 2009; 117::957963
    [Google Scholar]
  41. Samet JM, Dominici F, Curriero F, Coursac I, Zeger SL. Fine particulate air pollution and mortality in 20 US cities, 1987–1994. N Engl J Med. 2000; 343::17421749
    [Google Scholar]
  42. Schwartz J. Air pollution and hospital admissions for heart disease in eight U.S. counties. Epidemiology. 1999; 10::1722
    [Google Scholar]
  43. Simpson R, Williams G, Petroeschevsky A, Best T, Morgan G, Denison L, Hinwood A, Neville G, Neller A. The short-term effecst of air pollution on daily mortality in four Australian cities. Aust N Z J Public Health. 2005; 29::205212
    [Google Scholar]
  44. Zanobetti A, Schwartz J. The effect of particulate air pollution on emergency admissions for myocardial infarction: a multicity case-crossover analysis. Environ Health Perspect. 2005; 113::978982
    [Google Scholar]
  45. Zanobetti A, Schwartz J. The effect of fine and coarse particulate air pollution on mortality: a national analysis. Environ Health Perspect. 2009; 117::898903
    [Google Scholar]
  46. Chen R, Chu C, Tan J, Cao J, Song W, Xu X, Jiang C, Ma W, Yang C, Chen B, Gui Y, Kan H. Ambient air pollution and hospital admission in Shanghai, China. J Hazard Mater. 2010; 181::234240
    [Google Scholar]
  47. Dominici F, Samet JM, Zeger SL. Combining evidence on air pollution and daily mortality from the twenty largest US cities: a hierarchical modeling strategy. J R Stat Soc Ser A. 2000; 163::263302
    [Google Scholar]
  48. Ostro B, Broadwin R, Lipsett MJ. Coarse and fine particles and daily mortality in the Coachella Valley, California: a follow-up study. J Expo Anal Environ Epidemiol. 2000; 10::412419
    [Google Scholar]
  49. Zeka A, Zanobetti A, Schwartz J. Short term effects of particulate matter on cause specific mortality: effects of lags and modification by city characteristics. Occup Environ Med. 2005; 62::718725
    [Google Scholar]
  50. Cifuentes LA, Vega J, Kopfer K, Lave LB. Effect of the fine fraction of particulate matter versus the coarse mass and other pollutants on daily mortality in Santiago, Chile. J Air Waste Manage Assoc. 2000; 50::12871298
    [Google Scholar]
  51. Dockery DW, Schwartz J, Spengler JD. Air pollution and daily mortality: association with particulates and acid aerosols. Environ Res. 1992; 59::362373
    [Google Scholar]
  52. Dominici F, Peng RD, Zeger SL, White RH, Samet JM. Particulate air pollution and mortality in the United States: did the risks change from 1987 to 2000? Am J Epidemiol. 2007; 166::880888
    [Google Scholar]
  53. Schwartz J, Dockery DW, Neas LM. Is daily mortality associated specifically with fine particles? J Air Waste Manage Assoc. 1996; 46::927939
    [Google Scholar]
  54. Lee JT, Kim H, Hong YC, Kwong HJ, Schwartz J, Christiani DC. Air pollution and daily mortality in seven major cities of Korea, 1991–1997. Environ Res Sect A. 2000; 84::247254
    [Google Scholar]
  55. Li X, Gilmour PS, Donaldson K, MacNee W. In vivo and in vitro proinflammatory effects of particulate air pollution (PM10). Environ Health Perspect. 1997; 105::12791283
    [Google Scholar]
  56. WHO (World Health Organization). World Health Report 2002. Reducing Risk, Promoting Healthy Life. Geneva, Switzerland: WHO 2002;
    [Google Scholar]
  57. Parekh PP, Khwaja HA, Khan AR, Naqvi RR, Malik A, Shah SA, Khan K, Hussain G. Ambient air quality of two metropolitan cities of Pakistan and its health implications. Atmos Environ. 2001; 35::59715978
    [Google Scholar]
  58. Barletta B, Meinardi S, Simpson IJ, Khwaja HA, Blake DR, Rowland FS. Mixing ratios of volatile organic compounds (VOCs) in the atmosphere of Karachi, Pakistan. Atmos Environ. 2002; 36::34293443
    [Google Scholar]
  59. Gurjar BR, Jain A, Sharma A, Agarwal A, Gupta P, Nagpure AS, Lelieveld J. Human health risks in megacities due to air pollution. Atmos Environ. 2010; 44::46064613
    [Google Scholar]
  60. Linn WS, Szlachcic Y, Gong H Jr, Kinney P, Berhane K. Air pollution and daily hospital admissions in metropolitan Los Angeles. Environ Health Perspect. 2000; 108::427434
    [Google Scholar]
  61. Sinclair AH, Edgerton ES, Wyzga R, Tolsma D. A two-time-period comparison of the effects of ambient air pollution on outpatient visits for acute respiratory illnesses. J Air Waste Manage Assoc. 2010; 60::163175
    [Google Scholar]
  62. Krzyzanowski M, Cohen A, Anderson R, and the WHO Working Group . Quantification of health effects of exposure to air pollution. Occup Environ Med. 2002; 59::791793
    [Google Scholar]
  63. Stone E, Schauer J, Quraishi TA, Mahmood A. Chemical characterization and source apportionment of fine and coarse particulate matter in Lahore, Pakistan. Atmos Environ. 2010; 44::10621070
    [Google Scholar]
  64. Hilbe JM. Negative Binomial Regression. Cambridge, UK: Cambridge University Press 2007;. ISBN-13:9780521857727
    [Google Scholar]
  65. Schwartz J, Dockery DW. Increased mortality in Philadelphia associated with daily air pollution concentrations. Am Rev Respir Dis. 1992; 145::600604
    [Google Scholar]
  66. Schwartz J. Air pollution and hospital admissions for the elderly in Detroit, Michigan. Am J Respir Crit Care Med. 1994; 150::648655
    [Google Scholar]
  67. Zhao X, Zhang X, Xu X, Xu J, Meng W, Pu W. Seasonal and diurnal variations of ambient PM2.5 concentration in urban and rural environments in Beijing. Atmos Environ. 2009; 43::28932900
    [Google Scholar]
  68. Gurjar BR, Butler TM, Lawrence MG, Lelieveld J. Evaluation of emissions and air quality in megacities. Atmos Environ. 2008; 42::15931606
    [Google Scholar]
  69. WHO (World Health Organization). Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide. Global update 2005: Summary of risk assessment. Geneva, Switzerland: WHO 2006;
    [Google Scholar]
  70. Ito K, De Leon SF, Lippmann M. Associations between ozone and daily mortality: analysis and meta-analysis. Epidemiology. 2005; 16::446457
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): air monitoringcardiovascular diseasedeveloping countrymega-cityparticulates and respiratory disease
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