Urban air pollution, and asthma and COPD hospital emergency room visits.

BACKGROUND There is little previous information of the effects of size fractioned particulate air pollution and source specific fine particles (PM(2.5); <2.5 microm) on asthma and chronic obstructive pulmonary disease (COPD) among children, adults and the elderly. OBJECTIVES To determine the effects of daily variation in levels of different particle size fractions and gaseous pollutants on asthma and COPD by age group. METHODS Levels of particulate air pollution, NO(2) and CO were measured from 1998 to 2004 at central outdoor monitoring sites in Helsinki, Finland. Associations between daily pollution levels and hospital emergency room visits were evaluated for asthma (ICD10: J45+J46) in children <15 years old, and for asthma and COPD (ICD10: J41+J44) in adults (15-64 years) and the elderly (>or=65 years). RESULTS Three to 5 day lagged increases in asthma visits were found among children in association with nucleation (<0.03 microm), Aitken (0.03-0.1 microm) and accumulation (0.1-0.29 microm) mode particles, gaseous pollutants and traffic related PM(2.5) (7.8% (95% CI 3.5 to 12.3) for 1.1 microg/m(3) increase in traffic related PM(2.5) at lag 4). Pooled asthma-COPD visits among the elderly were associated with lag 0 of PM(2.5), coarse particles, gaseous pollutants and long range transported and traffic related PM(2.5) (3.9% (95% CI 0.28 to 7.7) at lag 0). Only accumulation mode and coarse particles were associated with asthma and COPD among adults. CONCLUSIONS Among children, traffic related PM(2.5) had delayed effects, whereas among the elderly, several types of particles had effects that were more immediate. These findings suggest that the mechanisms of the respiratory effects of air pollution, and responsible pollutants, differ by age group.