International Journal of Epidemiology, Vol 28, 859-864, Copyright © 1999 by International Epidemiological Association
CM Wong, ZG Hu, TH Lam, AJ Hedley and J Peters
BACKGROUND: Two-thirds of complaints received by the Hong Kong
Environmental Protection Department in 1988 were related to poor air
quality. In July 1990 legislation was implemented to reduce fuel sulphur
levels. The intervention led to a reduction in respiratory symptoms and
bronchial hyperresponsiveness of primary school children. The objectives of
this study were to investigate the differences in respiratory health
between non-smoking women living in the more polluted district (Kwai Tsing)
and those living in the less polluted district (Southern); to assess the
impact of the government air quality intervention; and to study the effect
of environmental tobacco smoke on respiratory health in non-smoking women
in both districts. METHOD: A total of 3405 non-smoking women, aged 36.5
years (standard deviation = 3.0), from two districts with good and poor air
quality respectively before the intervention were followed yearly from 1989
to 1991. Binary latent variable modelling was used to summarize the six
respiratory symptoms and to estimate the effects of risk factors. RESULTS:
In 1989, living in the polluted district was associated with poor
respiratory health (odds ratio [OR] = 1.55, 95% confidence interval [CI]:
1.11- 2.17, P < 0.01). After the intervention, in the polluted district
only, sulphur dioxide levels fell by up to 80% and sulphate concentrations
in respirable particulates by 38%. Between 1989 and 1990-1991, there was no
significantly greater decline (P > 0.241) in the more polluted compared
with the less polluted district for poor respiratory health. In 1989, the
effects on poor respiratory health for exposure to two or more categories
of smokers relative to none in the home (OR = 1.80, 95% CI: 1.15-2.83, P
< 0.01) were higher but not significantly than those for living in
polluted relative to less polluted district (95% CI of the two effects
overlapping each other). CONCLUSIONS: Environmental tobacco smoke (ETS) and
outdoor air pollution had independent adverse effects on respiratory health
of non-smoking women and improvement in air quality had produced some but
non-significant benefits.
ARTICLES
Effects of ambient air pollution and environmental tobacco smoke on respiratory health of non-smoking women in Hong Kong
Department of Community Medicine, The University of Hong Kong, Hong Kong.
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