Environmental Health and Biostatistics and Computing GroupsDepartment of Community MedicineThe University of Hong Kong

Table F1: Relative risks (RR) and 95% confidence interval (95% CI) for 50 microgram per cubic metre increase in the concentration of air pollutants for hospital admissions of (i) combined circulatory and respiratory, (ii) circulatory, (iii) respiratory, (iv) asthma, (v) chronic obstructive pulmonary diseases and (vi) ischaemic heart diseases (1995-96)
(i) Circulatory + Respiratory      
    HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities
CUHK (Lag 0-n)*
Pollutant   RR (95% CI) Lag :RR (95% CI) RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) (a) 1.07 (1.04,1.09) 0 :1.07 (1.04,1.09) - 0-1 :1.11 (1.09,1.14)
SO2 (24-hr) (a) 1.04 (1.01,1.07) 0 :1.04 (1.01,1.07) - 0 :1.07 (1.03,1.10)
RSP (24-hr) (a) 1.04 (1.01,1.07) 0-1 :1.04 (1.02,1.06) - 0-3 :1.10 (1.07,1.23)
O3 (8-hr) (a) 1.03 (1.01,1.05) 0-2 :1.07 (1.05,1.10) - 0-5 :1.14 (1.10,1.17)
           
(ii) Circulatory      
    HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities
CUHK (Lag 0-n)*
Pollutant   :RR (95% CI) Lag :RR (95% CI) RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) (a) 1.06 (1.03,1.08) 0-2 :1.08 (1.04,1.11) - 0-1 :1.06 (1.03,1.10)
  (b) 0.93 (0.80,1.08) 0-1 :0.92 (0.77,1.10) -  
-
  (c) 1.03 (1.00,1.07) 0-2 :1.04 (0.99,1.10) -  
-
  (d) 1.08 (1.05,1.11) 0-1 :1.10 (1.06,1.13) - 0-1 :1.08 (1.05,1.12)
SO2 (24-hr) (a) 1.04 (1.00,1.08) 0-1 :1.05 (1.01,1.10) - 0-1 :1.09 (1.03,1.14)
  (b) 0.94 (0.76,1.15) 0-1 :0.91 (0.71,1.17) -  
-
  (c) 0.99 (0.94,1.04) 0 :0.99 (0.94,1.04) -  
-
  (d) 1.08 (1.03,1.13) 0 :1.08 (1.03,1.13) - 0-1 :1.12 (1.06,1.18)
RSP (24-hr) (a) 1.02 (1.00,1.04) 0-3 :1.03 (1.00,1.06) - 0-2 :1.03 (1.00,1.06)
  (b) 0.93 (0.83,1.05) 0 :0.93 (0.83,1.05) -  
-
  (c) 1.00 (0.97,1.02) 0-1 :0.99 (0.96,1.02) -  
-
  (d) 1.03 (1.01,1.06) 0-1 :1.05 (1.02,1.07) 1.06 (1.01, 1.12)# 0-2 :1.04 (1.00,1.07)
O3 (8-hr) (a) 1.02 (1.00,1.04) 0-5 :1.07 (1.03,1.10) - 0-5 :1.06 (1.02,1.11)
  (b) 1.00 (0.88,1.13) 0-3 :0.95 (0.80,1.12) -  
-
  (c) 1.03 (1.00,1.07) 0-5 :1.07 (1.01,1.12) -  
-
  (d) 1.01 (0.98,1.04) 0-5 :1.08 (1.04,1.12) - 0-5 :1.06 (1.01,1.11)


(iii) Respiratory        
    HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities17-22
CUHK (Lag 0-n)*
Pollutant   RR (95% CI) Lag :RR (95% CI) RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) (a) 1.08 (1.05,1.11) 0 :1.08 (1.05,1.11) (a) - 0-3 :1.18 (1.14, 1.23)
  (b) 1.04 (1.00,1.08) 0 :1.04 (1.00,1.08) (b) -  
-
  (c) 1.06 (1.01,1.10) 0 :1.06 (1.01,1.10) (c) 1.01 (0.99, 1.04)  
-
  (d) 1.11 (1.07,1.15) 0-1 :1.14 (1.09,1.19) (d) 1.02 (0.98, 1.06) 0-3 :1.18 (1.12, 1.25)
SO2 (24-hr) (a) 1.03 (1.00,1.08) 0 :1.03 (1.00,1.08) (a) - 0 :1.06 (1.02, 1.11)
  (b) 0.98 (0.93,1.04) 0-2 :0.93 (0.86,1.00) (b) -  
-
  (c) 0.99 (0.94,1.06) 0-3 :0.90 (0.82,0.99) (c) 1.01 (0.99, 1.03)  
-
  (d) 1.10 (1.04,1.16) 0 :1.10 (1.04,1.16) (d) 1.02 (1.01, 1.05) 0 :1.13 (1.07, 1.20)
RSP (24-hr) (a) 1.04 (1.02,1.07) 0-1 :1.05 (1.02,1.07) (a) - 0-3 :1.15 (1.12, 1.19)
  (b) 1.04 (1.01,1.07) 0-3 :1.08 (1.03,1.12) (b) -  
-
  (c) 1.02 (0.99,1.06) 0 :1.02 (0.99,1.06) TSP: (c) 1.01 (0.99, 1.03)  
-
  (d) 1.05 (1.02,1.08) 0-1 :1.06 (1.03,1.10) TSP: (d) 1.02 (0.99, 1.04) 0-3 :1.14 (1.09, 1.19)
O3 (8-hr) (a) 1.04 (1.02,1.06) 0-2 :1.10 (1.07,1.13) (a) - 0-3 :1.18 (1.14, 1.22)
  (b) 1.04 (1.01,1.08) 0-2 :1.08 (1.03,1.12) (b) -  
-
  (c) 1.01 (0.98,1.05) 0-2 :1.06 (1.01,1.11) (c) 1.03 (1.01, 1.05)  
-
  (d) 1.06 (1.02,1.09) 0-5 :1.19 (1.14,1.25) (d) 1.04 (1.02, 1.06) 0-3 :1.22 (1.15, 1.28)
             
(iv) Asthma            
    HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities17-22
CUHK (Lag 0-n)*
Pollutant   RR (95% CI) Lag :RR (95% CI) RR (95% CI) Lag RR (95% CI)
NO2 (24-hr) (a) 1.06 (1.00,1.14) 0-3 :1.12 (1.02,1.22) 1.02 (1.00, 1.06) 0-3 :1.27 (1.17, 1.37)
SO2 (24-hr) (a) 0.99 (0.89,1.09) 0-3 :0.91 (0.78,1.06) Not associated 0 :1.12 (1.01, 1.23)
RSP (24-hr) (a) 1.02 (0.97,1.07) 0-3 :1.10 (1.03,1.18) Not associated 0-3 :1.16 (1.08, 1.24)
O3 (8-hr) (a) 1.05 (1.00,1.11) 0-2 :1.16 (1.08,1.24) Not associated 0-2 :1.23 (1.14, 1.33)


(v) Chronic obstructive pulmonary diseases    
    HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities17-22
Pollutant   RR (95% CI) Lag :RR (95% CI) RR (95% CI)
NO2 (24-hr) (a) 1.13 (1.09,1.17) 0 :1.13 (1.09,1.17) 1.02 (1.00, 1.05)
SO2 (24-hr) (a) 1.12 (1.06,1.18) 0 :1.12 (1.06,1.18) 1.02 (0.98, 1.06)
RSP (24-hr) (a) 1.05 (1.02,1.08) 0-3 :1.08 (1.04,1.13) 1.02 (1.00, 1.05)
O3 (8-hr) (a) 1.04 (1.01,1.07) 0-2 :1.14 (1.09,1.18) 1.04 (1.02, 1.07)
         
(vi) Ischaemic heart diseases    
    HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities
Pollutant   RR (95% CI) Lag :RR (95% CI) RR (95% CI)
NO2 (24-hr) (a) 1.06 (1.01,1.11) 0-2 :1.09 (1.03,1.16) -
SO2 (24-hr) (a) 1.00 (0.93,1.07) 0-1 :1.03 (0.95,1.12) -
RSP (24-hr) (a) 1.03 (0.99,1.07) 0-1 :1.04 (1.00,1.09) -
O3 (8-hr) (a) 1.01 (0.97,1.05) 0-2 :1.04 (0.99,1.10) -
  •  
*Notes: Lag0-n denotes the mean of cumulative effects of lag from day 0 (same day) up to previous n days using up to 5 days (Lag0-5) for ozone and up to 3 days (Lag0-3) for other pollutants
# Schwartz (1997) ICD 390-429

- Estimates for the disease categories not available

(a) All ages

(b) 0-14 years age

(c) 15-64 years age

(d) >=65 years age


Table F2: Relative risks (RR) and 95% confidence interval (95% CI) for 50 microgram per cubic metre increase in the concentration of air pollutants for hospital deaths of combined circulatory and respiratory, respiratory and circulatory diseases (1995-96)

(i) Circulatory + Respiratory          
  HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities (Total death)17-22
CUHK (Lag 0-n)*
Pollutant :RR (95% CI) Lag :RR (95% CI) RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) :1.09 (1.03,1.16) 0-1 :1.12 (1.05,1.20) 1.01 (1.01, 1.02) 0-3 :1.14 (1.05,1.24)
SO2 (24-hr) :1.03 (0.94,1.12) 0-3 :0.93 (0.81,1.06) 1.04 (1.02, 1.05) 0-1 :1.11 (0.99,1.24)
RSP(24-hr) :1.02 (0.97,1.06) 0-1 :1.04 (0.99,1.09) 1.02 (1.01, 1.03) 0-3 :1.06 (0.99,1.14)
O3 (8-hr) :1.05 (1.00,1.10) 0-2 :1.07 (1.05,1.10) 1.03 (1.01, 1.05) 0-5 :1.20 (1.10,1.32)
           
(ii) Circulatory          
  HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities17-22
CUHK (Lag 0-n)*
Pollutant :RR (95% CI) Lag :RR (95% CI) RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) :1.08 (1.00,1.17) 0-1 :1.10 (1.01,1.21) Positive/Not sig. 0-3 :1.10 (0.98,1.24)
SO2 (24-hr) :0.97 (0.86,1.09) 0-3 :0.89 (0.74,1.07) 1.04 (1.01, 1.06) 0-2 :1.10 (0.92,1.31)
RSP (24-hr) :1.01 (0.95,1.07) 0-3 :1.05 (0.96,1.14) 1..01 (1.00, 1.03) 0-3 :1.03 (0.96,1.10)
O3 (8-hr) :1.04 (0.97,1.12) 0-5 :1.15 (1.03,1.28) 1.02 (1.01, 1.03) 0-5 :1.13 (1.04,1.22)
           
(iii) Respiratory          
  HKU (Lag 0)
HKU (Lag 0-n)*
Western European Cities17-22
CUHK (Lag 0-n)*
Pollutant :RR (95% CI) Lag :RR (95% CI) RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) :1.10 (1.01,1.20) 0-1 :1.14 (1.04,1.25) Not associated 0-3 :1.14 (1.04,1.26)
SO2 (24-hr) :1.08 (0.96,1.22) 0 :1.08 (0.96,1.22) 1.05 (1.03, 1.07) 0-1 :1.16 (0.98,1.37)
RSP (24-hr) :1.03 (0.97,1.10) 0-1 :1.05 (0.97,1.13) 1.03 (0.98, 1.09) 0-3 :1.10 (0.99,1.22)
O3 (8-hr) :1.05 (0.98,1.12) 0-5 :1.22 (1.09,1.35) 1.04 (1.02, 1.06) 0-5 :1.27 (1.11,1.46)
    •  
* Note: 1) Lag0-n denotes the mean of cumulative lag from day 0 (same day) up to previous n days

2) the cumulative lag days were up to 5 days for ozone and up to 3 days for other pollutants

Table G: Effect in relative risk (95% confidence interval) per 50 ug/m3 of each pollutant at high and low level of each other co-pollutant (using median concentration as cut-off) of hospital admissions due to circulatory/respiratory diseases

(a) Effect of NO2 on circulatory and respiratory diseases

SO2 Relative risk (95% CI)
High 1.061 (1.035, 1.088)
Low 1.122 (1.079, 1.166)

(b) Effect of RSP on circulatory and respiratory diseases

O3 Relative risk (95% CI)
High 1.013 (0.992, 1.034)
Low 1.041 (1.016, 1.066)

(c) Effect of NO2 on respiratory disease

SO2 Relative risk (95% CI)
High 1.068 (1.034, 1.103)
Low 1.133 (1.077, 1.192)

(d) Effect of NO2 on circulatory disease

SO2 Relative risk (95% CI)
High 1.054 (1.023, 1.087)
Low 1.111 (1.059, 1.164)

Table H: Relative risk (RR) with 95% confidence interval (95% CI) for composite score of air pollutant concentrations for 50 micrograms per cubic metre increase on (1) hospital admissions (2) hospital deaths ¡V lag effects not analysed

(1) Hospital admissions due to:   RR (95% CI)
Circulatory and respiratory diseases (a) 1.06 (1.04, 1.08)
     
Circulatory diseases (a) 1.04 (1.01, 1.07)
  (b) 0.92 (0.78, 1.09)
  (c) 1.02 (0.98, 1.06)
  (d) 1.06 (1.03, 1.10)
     
Respiratory diseases (a) 1.08 (1.04, 1.11)
  (b) 1.06 (1.02, 1.11)
  (c) 1.04 (1.00, 1.09)
  (d) 1.10 (1.06, 1.15)
     
Asthma (a) 1.06 (0.99, 1.14)
     
Chronic obstructive pulmonary diseases (a) 1.11 (1.07, 1.16)
     
Ischaemic heart diseases (a) 1.05 (0.99, 1.10)
     
(2) Hospital deaths due to:    
Circulatory and respiratory diseases (a) 1.07 (1.00, 1.14)
Circulatory diseases (a) 1.05 (0.96, 1.15)
Respiratory diseases (a) 1.09 (0.99, 1.19)
# Composite score is generated from four pollutants (NO2, SO2, TEOM and O3) by principal components analysis and the first principal component was used which explained 68% of the variance and corresponds to the loadings with 0.491, 0.105, 0.726 and 0.469 respectively.
(a) All ages

(b) 0-14 years old

(c) 15-64 years old

(d) 65 years or older

 

APPENDIX B

    •  
Table 18a: Relative risks (RR) and 95% confidence interval (95% CI) for 100 micrograms per cubic metre increase in the concentration of air pollutants for hospital admissions of (i) combined circulatory and respiratory, (ii) circulatory, (iii) respiratory, (iv) asthma, (v) chronic obstructive pulmonary diseases and (vi) ischaemic heart diseases (1995-96)
(i) Circulatory + Respiratory  
 
HKU (Lag 0-n)#
CUHK (Lag 0-n)#
Pollutant Lag :RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) 0 :1.14 (1.09,1.19)*** 0-1 :1.24 (1.18,1.30)***
SO2 (24-hr) 0 :1.08 (1.01,1.14)* 0 :1.14 (1.07,1.22)***
RSP (24-hr) 0-1 :1.07 (1.03,1.11)*** 0-3 :1.21 (1.15,1.27)***
O3 (8-hr) 0-2 :1.15 (1.10,1.21)*** 0-5 :1.29 (1.21,1.37)***
     
(ii) Circulatory  
 
HKU (Lag 0-n)#
CUHK (Lag 0-n)#
Pollutant Lag :RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) 0-2 :1.16 (1.08,1.23)*** 0-1 :1.14 (1.07,1.22)***
SO2 (24-hr) 0-1 :1.11 (1.01,1.21)* 0-1 :1.18 (1.07,1.30)***
RSP (24-hr) 0-3 :1.06 (1.00,1.12)* 0-2 :1.06 (1.00,1.12)*
O3 (8-hr) 0-5 :1.14 (1.07,1.22)*** 0-5 :1.13 (1.04,1.23)**
   
(iii) Respiratory  
 
HKU (Lag 0-n)#
CUHK (Lag 0-n)#
Pollutant Lag :RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) 0 :1.16 (1.09,1.22)*** 0-3 :1.40 (1.30, 1.51)***
SO2 (24-hr) 0 :1.07 (0.99,1.16) 0 :1.13 (1.04, 1.24)**
RSP (24-hr) 0-1 :1.09 (1.04,1.15)*** 0-3 :1.33 (1.25, 1.42) ***
O3 (8-hr) 0-2 :1.21 (1.14,1.28)*** 0-3 :1.39 (1.29, 1.50)***
     
(iv) Asthma    
 
HKU (Lag 0-n)#
CUHK (Lag 0-n)#
Pollutant Lag :RR (95% CI) Lag RR (95% CI)
NO2 (24-hr) 0-3 :1.25 (1.04,1.49)* 0-3 :1.61 (1.36, 1.89)***
SO2 (24-hr) 0-3 :0.82 (0.61,1.12) 0 :1.25 (1.03, 1.52)*
RSP (24-hr) 0-3 :1.21 (1.06,1.39)** 0-3 :1.34 (1.17, 1.53)***
O3 (8-hr) 0-2 :1.34 (1.17,1.54)*** 0-2 :1.51 (1.30, 1.76)***
(v) Chronic obstructive pulmonary diseases
  HKU (Lag 0-n)#
Pollutant Lag :RR (95% CI)
NO2 (24-hr) 0 :1.28 (1.19,1.38)***
SO2 (24-hr) 0 :1.25 (1.13,1.40)***
RSP (24-hr) 0-3 :1.17 (1.08,1.27)***
O3 (8-hr) 0-2 :1.29 (1.19,1.40)***
 
(vi) Ischaemic heart diseases
 
HKU (Lag 0-n)#
Pollutant Lag :RR (95% CI)
NO2 (24-hr) 0-2 :1.19 (1.05,1.34)**
SO2 (24-hr) 0-1 :1.07 (0.91,1.26)
RSP (24-hr) 0-1 :1.09 (1.00,1.19)
O3 (8-hr) 0-2 :1.09 (0.98,1.21)
  •  
* p < 0.05; ** p < 0.01; *** p < 0.001

#Notes: Lag0-n denotes the mean of cumulative effects of lag from day 0 (same day) up to previous n days using up to 5 days (Lag0-5) for ozone and up to 3 days (Lag0-3) for other pollutants

Table 19a: Relative risks (RR) and 95% confidence interval (95% CI) for 100 micrograms per cubic metre increase in the concentration of air pollutants for hospital deaths of (i) combined circulatory and respiratory, (ii) circulatory and (iii) respiratory diseases (1995-96)
(i) Circulatory + Respiratory  
 
HKU (Lag 0-n)#
CUHK (Lag 0-n)#
Pollutant Lag :RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) 0-1 :1.26 (1.10,1.43)*** 0-3 :1.31 (1.10,1.55)**
SO2 (24-hr) 0-3 :0.87 (0.66,1.13) 0-1 :1.24 (0.99,1.55)
RSP(24-hr) 0-1 :1.08 (0.98,1.20) 0-3 :1.13 (0.98,1.30)
O3 (8-hr) 0-2 :1.15 (1.10,1.21)*** 0-5 :1.44 (1.20,1.74)***
     
(ii) Circulatory  
 
HKU (Lag 0-n)#
CUHK (Lag 0-n)#
Pollutant Lag :RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) 0-1 :1.21 (1.01,1.46)* 0-3 :1.22 (0.97,1.54)
SO2 (24-hr) 0-3 :0.80 (0.55,1.15) 0-2 :1.21 (0.85,1.71)
RSP (24-hr) 0-3 :1.10 (0.92,1.30) 0-3 :1.06 (0.93,1.21)
O3 (8-hr) 0-5 :1.32 (1.07,1.63)** 0-5 :1.27 (1.09,1.48)**
     
(iii) Respiratory  
 
HKU (Lag 0-n)#
CUHK (Lag 0-n)#
Pollutant Lag :RR (95% CI) Lag :RR (95% CI)
NO2 (24-hr) 0-1 :1.30 (1.08,1.57)** 0-3 :1.31 (1.08,1.58)**
SO2 (24-hr) 0 :1.17 (0.93,1.48) 0-1 :1.35 (0.97,1.88)
RSP (24-hr) 0-1 :1.10 (0.95,1.27) 0-3 :1.21 (0.99,1.48)
O3 (8-hr) 0-5 :1.48 (1.20,1.83)*** 0-5 :1.62 (1.23,2.14)***
  •  
* p < 0.05; ** p < 0.01; *** p < 0.001 # Note: 1) Lag0-n denotes the mean of cumulative lag from day 0 (same day) up to previous n days

2) the cumulative lag days were up to 5 days for ozone and up to 3 days for other pollutants

 

Table 20a: Effect in relative risk (95% confidence interval) per 100 ug/m3 of each pollutant at high and low level of each other co-pollutant (using median concentration as cut-off) of hospital admissions due to circulatory/respiratory diseases

(a) Effect of NO2 on circulatory and respiratory diseases

SO2 Relative risk (95% CI)
High 1.125 (1.071, 1.183)***
Low 1.258 (1.163, 1.360)***
    •  
*** p < 0.001(b) Effect of RSP on circulatory and respiratory diseases
O3 Relative risk (95% CI)
High 1.026 (0.985, 1.069)
Low 1.084 (1.032, 1.137)***
    •  
*** p < 0.001(c) Effect of NO2 on respiratory disease
SO2 Relative risk (95% CI)
High 1.141 (1.070, 1.217)***
Low 1.284 (1.161, 1.420)***
    •  
*** p < 0.001(d) Effect of NO2 on circulatory disease
SO2 Relative risk (95% CI)
High 1.112 (1.046, 1.181)***
Low 1.233 (1.122, 1.356)***
    •  
*** p < 0.001Table 21a: Relative risk (RR) with 95% confidence interval (95% CI) for composite score of air pollutant concentrations for 100 micrograms per cubic metre increase on (1) hospital admissions (2) hospital deaths ¡V lag effects not analysed
(1) Hospital admissions due to:   RR (95% CI)
Circulatory and respiratory diseases (a) 1.12 (1.07, 1.18)***
     
Circulatory diseases (a) 1.09 (1.03, 1.15)**
  (b) 0.85 (0.61, 1.18)
  (c) 1.04 (0.96, 1.13)
  (d) 1.13 (1.05, 1.20)***
     
Respiratory diseases (a) 1.16 (1.09, 1.23)***
  (b) 1.13 (1.04, 1.23)**
  (c) 1.09 (0.99, 1.19)
  (d) 1.22 (1.12, 1.32)***
     
Asthma (a) 1.13 (0.98, 1.30)
     
Chronic obstructive pulmonary diseases (a) 1.23 (1.13, 1.34)***
     
Ischaemic heart diseases   1.10 (0.99, 1.22)
     
(2) Hospital deaths due to:    
Circulatory and respiratory diseases   1.14 (1.00, 1.30)*
Circulatory diseases   1.10 (0.92, 1.32)
Respiratory diseases   1.18 (0.99, 1.42)
  •  

* p < 0.05; ** p < 0.01; *** p < 0.001
# Composite score was generated from four pollutants (NO2, SO2, TEOM and O3) by principal components analysis and the first principal component was used which explained 68% of the variance with loadings of 0.491, 0.105, 0.726 and 0.469 respectively.
(a) All ages

(b) 0-14 years old

(c) 15-64 years old

(d) 65 years or older

Figures

 

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