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Air pollution and doctors' house calls : results from the ERPURS system for monitoring the effects of air pollution on public health in Greater Paris, France, 1991-1995
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International audience. This study examines short-term relationships between doctors' house calls and urban air pollution in Greater Paris for the period 1991-1995. Poisson regressions using nonparametric smoothing functions controlled for time trend, seasonal patterns, pollen counts, influenza epidemics, and weather. The relationship between asthma visits and air pollution was stronger for children. A relative risk (RR P95/P5 ) of 1.32 [95% confidence interval (CI) = 1.17-1.47)] was observed for an increase from the 5th to the 95th percentile (7-51 g/m 3 ) in daily concentrations of black smoke (BS). The risks for 24-hr sulfur dioxide and nitrogen dioxide levels were in the same range. Cardiovascular conditions, considered globally, showed weaker associations than angina pectoris/myocardial infarction, for which RR P95/P5 was 1.63 (95% CI = 1.10-2.41) in relation to ozone ambient levels. Eye conditions were exclusively related to ozone (RR P95/P5 = 1.17, 95% CI 1.02-1.33). Asthma visits and ozone showed an interaction with minimum temperature: an effect was observed only at 10°C or higher. In two-pollutant models including BS with, successively, SO 2 , NO 2 , and O 3 , only BS and O 3 effects remained stable. Along with mortality and hospital admissions, house call activity data, available on a regular basis, may be a sensitive indicator for monitoring health effects related to air pollution.
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