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Public Health Classics: assessing air pollution and health in six U.S. cities, researchers’ findings changed the air we breathe [The Pump Handle]
I was eight years old on the first Earth Day (April 22, 1970). “Give a hoot, don’t pollute!” was the slogan for us kids. I sure my catholic school marked the occasion by showing us a filmstrip about pollution and learning ways to keep the environment clean. When we’d see factory smokestacks spewing thick smoke we’d say “yuck” and hold our noses when tailpipes of junker cars belched exhuast. Air pollution was a bad thing because of what we could see and smell, but nobody thought about it as cutting short people’s lives.
I wonder whether the towns of Steubenville, Ohio, St. Louis, Missouri and Topeka, Kansas understand the part their residents played in ground-breaking air pollution research? I wonder if the people of Harriman, Tennessee, Watertown, Massachusetts and Portage, Wisconsin know in which homes the study subjects resided? These are the cities where 8,111 residents were randomly selected and enrolled beginning in 1974 for the landmark Six Cities Study.
Objective: estimate effects of air pollution on mortality, controlling for smoking, sex, age and other risk factors
Randomly selected adults from Watertown, MA; Harriman, TN; St. Louis, MO; Steubenville, OH; Portage, WI; and Topeka, KS.
8,111 subjects (white, age 25-74 at enrollment (1974-77)
Spirometry & questionnaire
Prospective cohort study: Follow-up 14-16 years; 17% deceased (1,364 deaths)
Air pollution data (exposure): TSM/PM, SO2, O3 (from air monitoring stations set-up in 1970’s); through 1991.
Portage, WI (lowest air pollution levels) used as reference category
Mortality rates, adjusted for other health risk factors, was associated with air pollution levels, in particular, with fine inhalable sulfate particles, than with total PM, SO2, NOx.
All cause mortality; cardiovascular & respiratory disease.
Association between air pollution levels and mortality were observed after controlling for age, sex, smoking, education, BMI, and occupational exposures.
“An association between air pollution and mortality in six U.S. cities,”
Follow-up study
*Laden F, Schwartz J, Speizer F, Dockery. Reduction in Fine Particulate Air Pollution and Mortality: Extended Follow-up of the Harvard Six Cities Study. Am J Resp Crit Care Med. 2006; 173: 667-672.
Extended follow-up for 8 years (1998)*; additional 1,368 deaths (now 34% of cohort)
Air pollution levels decreased over time, especially in most-polluted cities.
Increase in overall mortality associated with each 10ug/m3 increase in PM2.5; Consistent with previous study.
Mortality risk from cardiovascular and respiratory disease declined with each 10ug/m3 reduction in PM2.5.
2012-10-28 11:40:54
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