Effects of Air Pollution on Adverse Health Outcomes in Taiwan

• Main Authors: Shang-Shyue Tsai, 蔡尚學
• Other Authors: Chun-Yuh Yang
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/4fj9tz

博士 === 高雄醫學大學 === 醫學研究所 === 91 === 　　The tiny island of Taiwan is densely populated and the distances between industrial districts and residential regions are commonly short. Therefore, comparatively speaking, it is even more important to investigate the effects of air pollution on adverse health outcomes in Taiwan. 　　The objectives of this study were (1) to determine whether women living in the specific air-polluted vicinity are highly correlated with increasing incidences of preterm births, and (2) to investigate whether air pollution is associated with daily mortality and daily hospital admission for stroke. 　　In a vicinity of industrial districts where emission levels of air contaminants from multiple sources including petrochemical, petroleum, steel and shipbuilding industries, we found that the prevalence of delivery of preterm birth infants was significantly higher in comparing the control regions. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, infant gender and birthplace), the adjusted odds ratio was 1.11 (95% CI=1.02-1.21) for delivery of preterm infants in this industrial area. 　　Moreover, the prevalence of delivery of preterm birth infants was also significantly higher in mothers living within 0-3 km of thermal power plants compared to mothers living within 3-4 km. The adjusted odds ratio was 1.14 (95% CI=1.01-1.30). 　　To examine the relationship between air pollution and daily mortality/hospital admission in Kaohsiung, the largest industrial city in Taiwan, we used a case-crossover design which is an alternative to Poisson time series regression for studying the short-term adverse health effects of air pollution. For the period of 1994-2000, no significant effects were found between five pollutants (PM10, SO2, CO, NO2, O3) and non-accidental deaths, respiratory-related deaths and cardiovascular disease deaths. 　　For the period of 1997-2000, statistically significant positive associations were found between levels of PM10, NO2, CO, and O3, and both intracerebral haemorrhagic stroke (IHS) and ischemic stroke (IS) admissions on warm days (20C) in the single pollutant models. On cool days (<20C), only CO levels and IS admissions were significantly associated. The two-pollutant models, PM10 and NO2 remained consistently and significantly associated with admissions for both types of stroke on warm days. We observed estimated relative risks of 1.552 (1.336-1.804) and 1.589 (1.364-1.852) for IHS for each interquartile range increase in PM10 and NO2. The values for IS were 1.461 (1.323-1.613) and 1.545 (1.398-1.708) respectively. 　　Our data provide further supports for the hypothesis that air pollution can affect the outcome of pregnancy, although a semi-ecological study cannot confirm a direct causal relationship. 　　The factors such as differences in meteorological condition, pollutant mixtures or underlying health of the population may explain the lack of a strong association between air pollution levels and daily mortality in Kaohsiung. Further studies of this type in cities with varying climates and cultures are needed. Nevertheless, this study provides an association between exposure to air pollution and hospital admissions for stroke.