Ambient Air Pollution Exposure and Respiratory, Cardiovascular and Cerebrovascular Mortality in Cape Town, South Africa: 20012006

Janine Wichmann*,Kuku Voyi

doi:10.1289/isee.2014.p1-168

Abstract

Ambient Air Pollution Exposure and Respiratory, Cardiovascular and Cerebrovascular Mortality in Cape Town, South Africa: 20012006Abstract Number:1566 Janine Wichmann* and Kuku Voyi Janine Wichmann* University of Pretoria, South Africa, E-mail Address: [email protected] Search for more papers by this author and Kuku Voyi University of Pretoria, South Africa, E-mail Address: [email protected] Search for more papers by this author AbstractLittle evidence is available on the strength of the association between ambient air pollution exposure and health effects in developing countries such as South Africa. The association between the daily ambient PM10, SO2 and NO2 levels and daily respiratory (RD), cardiovascular (CVD) and cerebrovascular (CBD) mortality in Cape Town (2001–2006) was investigated in an epidemiological case-crossover study – a first for South Africa. An inter-quartile range (IQR) increase in PM10 (12 microgram/m3) and NO2 (12 microgram/m3) significantly increased CBD mortality by 4% and 8%, respectively. A significant increase of 3% in CVD mortality was observed per IQR increase in NO2 and SO2 (8 microgram/m3). Susceptible groups (age and sex) depended on the cause-specific mortality and air pollutant. The study results from Cape Town are very relevant in stressing the importance of improving air quality in South Africa as the observed risks are higher than reported in developed countries.

Highlights

Chronic obstructive airways disease (COPD), cardiovascular disease (CVD) and cerebrovascular disease (CBD) incidence is increasing in South Africa, as in many developing countries [1]
The short-term effects of particles with a 50% cut-off at an aerodynamic diameter of 2.5 μm or less (PM2.5), PM10, carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2) on respiratory disease (RD), CVD and CBD mortality and morbidity were summarized in a meta-analysis [2]
For the >60 year group, the majority of RD deaths were due to pneumonia (36%), chronic obstructive pulmonary disease (COPD) (32%), other diseases of the respiratory (10%), asthma (8%) and emphysema (7%)

Summary

Introduction

Chronic obstructive airways disease (COPD), cardiovascular disease (CVD) and cerebrovascular disease (CBD) incidence is increasing in South Africa, as in many developing countries [1]. The short-term effects of particles with a 50% cut-off at an aerodynamic diameter of 2.5 μm or less (PM2.5), PM10, carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2) on respiratory disease (RD), CVD and CBD mortality and morbidity were summarized in a meta-analysis [2]. The majority of the case-crossover or time series epidemiological studies included in the meta-analysis were conducted in North America and Western Europe, with more from Asia and South America since 2004. There remains a need for similar studies and long-term cohort studies in cities of developing countries, as levels and composition of air pollution are different from North America and Western. Differences in the vulnerability of the population, building characteristics, time-activity patterns and proximity to air pollution sources may modify the effects of exposure. A better understanding is needed of how air pollution from indoor sources contributes to levels of outdoor air pollution and how indoor exposure to air pollution from indoor sources influences risk estimates for outdoor air pollution

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