Distributed lag associations between respiratory illnesses and mortality with suspended particle concentration in Tula, a highly polluted industrial region in Central Mexico.

ABSTRACT

PURPOSE: We aimed to evaluate the association between changes in airborne particulate matter concentration (PM) with changes in cases of mortality, acute respiratory infections (ARI) and asthma over 2004-2008 in an industrialized and polluted region in central Mexico. METHODS: A generalized linear model with a Poisson distribution and a negative binomial analysis was used to evaluate the influence of PM and temperature on all-cause mortality (All-cause-M), cause-specific mortality (Cause-specific-M), ARI and asthma, using cubic spline functions and distributed lags of PM. Estimated changes in relative risk were calculated for an exposure corresponding to each increase of 10 µg/m(3) in PM level. RESULTS: Associations between PM and mortality and morbidity were statistically most consistent for total suspended particulate (TSP) than for particulate matter <10 µM aerodynamic diameter (PM10). The greatest effects in mortality were observed with a 3-week lag, and effects were greater for Cause-specific-M. We also found a displacement effect up to 4-week lag for Cause-specific-M and TSP. The greatest effects in morbidity were observed at 0-week lag, yet they were statistically marginal and were greater for asthma. We found a displacement effect at 4-5-6-week lag for asthma and TSP. All associations of mortality and morbidity, expressed as change in relative risk, were greater with PM10; however, all of them were statistically marginal. CONCLUSIONS: Increased respiratory morbidity and mortality is associated with weekly changes of PM air pollution in the region. A reduction in air pollutants from industrial sources would benefit life quality and health of the exposed population.