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Open AccessArticle

Air Health Trend Indicator: Association between Short-Term Exposure to Ground Ozone and Circulatory Hospitalizations in Canada for 17 Years, 1996–2012

1
Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada
2
Department of Mathematics and Statistics, Queen’s University, Kingston, ON K7L 3N6, Canada
3
Department of Mathematics, Trent University, Peterborough, ON K9L 0G2, Canada
4
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1566; https://doi.org/10.3390/ijerph15081566
Received: 10 July 2018 / Accepted: 17 July 2018 / Published: 24 July 2018
(This article belongs to the Special Issue Environmental Health Indicators for Policy Support)
The Air Health Trend Indicator is designed to estimate the public health risk related to short-term exposure to air pollution and to detect trends in the annual health risks. Daily ozone, circulatory hospitalizations and weather data for 24 cities (about 54% of Canadians) for 17 years (1996–2012) were used. This study examined three circulatory causes: ischemic heart disease (IHD, 40% of cases), other heart disease (OHD, 31%) and cerebrovascular disease (CEV, 14%). A Bayesian hierarchical model using a 7-year estimator was employed to find trends in the annual national associations by season, lag of effect, sex and age group (≤65 vs. >65). Warm season 1-day lagged ozone returned higher national risk per 10 ppb: 0.4% (95% credible interval, −0.3–1.1%) for IHD, 0.4% (−0.2–1.0%) for OHD, and 0.2% (−0.8–1.2%) for CEV. Overall mixed trends in annual associations were observed for IHD and CEV, but a decreasing trend for OHD. While little age effect was identified, some sex-specific difference was detected, with males seemingly more vulnerable to ozone for CEV, although this finding needs further investigation. The study findings could reduce a knowledge gap by identifying trends in risk over time as well as sub-populations susceptible to ozone by age and sex. View Full-Text
Keywords: Bayesian hierarchical model; cerebrovascular disease; hospitalizations; ground-ozone; ischemic heart disease; other heart disease; public health risk; trend Bayesian hierarchical model; cerebrovascular disease; hospitalizations; ground-ozone; ischemic heart disease; other heart disease; public health risk; trend
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Shin, H.H.; Burr, W.S.; Stieb, D.; Haque, L.; Kalayci, H.; Jovic, B.; Smith-Doiron, M. Air Health Trend Indicator: Association between Short-Term Exposure to Ground Ozone and Circulatory Hospitalizations in Canada for 17 Years, 1996–2012. Int. J. Environ. Res. Public Health 2018, 15, 1566.

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