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. 2012 Nov 5;9(11):3978-4016.
doi: 10.3390/ijerph9113978.

Ambient air pollution exposure and respiratory, cardiovascular and cerebrovascular mortality in Cape Town, South Africa: 2001–2006

Janine Wichmann  1 , Kuku Voyi
Affiliations

Ambient air pollution exposure and respiratory, cardiovascular and cerebrovascular mortality in Cape Town, South Africa: 2001–2006

Janine Wichmann et al. Int J Environ Res Public Health. .

Abstract

Little 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 24-h average ambient PM(10), SO(2) and NO(2) levels and daily respiratory (RD), cardiovascular (CVD) and cerebrovascular (CBD) mortality in Cape Town (2001-2006) was investigated with a case-crossover design. For models that included entire year data, an inter-quartile range (IQR) increase in PM(10) (12 mg/m3) and NO(2) (12 mg/m3) significantly increased CBD mortality by 4% and 8%, respectively. A significant increase of 3% in CVD mortality was observed per IQR increase in NO(2) and SO(2) (8 mg/m3). In the warm period, PM(10) was significantly associated with RD and CVD mortality. NO(2) had significant associations with CBD, RD and CVD mortality, whilst SO(2) was associated with CVD mortality. None of the pollutants were associated with any of the three outcomes in the cold period. Susceptible groups depended on the cause-specific mortality and air pollutant. There is significant RD, CVD and CBD mortality risk associated with ambient air pollution exposure in South Africa, higher than reported in developed countries.

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Figures

Figure A1
Figure A1
Map of the air quality monitoring network in Cape Town, South Africa during 2012 [4].
Figure A2
Figure A2
Time series of respiratory (a), cardiovascular (b) and cerebrovascular mortality (c) in Cape Town during 1 January 2001–31 December 2006.
Figure A3
Figure A3
Time series of PM10 (a), NO2 (b) and SO2 (c) in Cape Town during 1 January 2001–31 December 2006.
Figure A4
Figure A4
Time series of Tapp (a), rainfall (b) and wind speed (c) in Cape Town during 1 January 2001–31 December 2006.
Figure A5
Figure A5
Percentage change (95% CI) in cause-specific mortality in Cape Town per inter-quartile range increase in PM10, NO2 and SO2 during 2001–2006 (entire year), adjusted for Tapp, rainfall, wind speed and public holidays.
Figure A6
Figure A6
Percentage change (95% CI) in cause-specific mortality in Cape Town per inter-quartile range increase in PM10, NO2 and SO2 during 2001–2006 (warm period), adjusted for Tapp, rainfall, wind speed and public holidays.
Figure A7
Figure A7
Percentage change (95% CI) in cause-specific mortality in Cape Town per inter-quartile range increase in PM10, NO2 and SO2 during 2001–2006 (cold period), adjusted for Tapp, rainfall, wind speed and public holidays.
Figure A8
Figure A8
Smoothed relationship between the 2-day cumulative average of Tapp (entire year) and (a) RD, (b) CVD and (c) CBD mortality in Cape Town, South Africa during 2001–2006. Adjusted for the 2-day cumulative average of PM10, NO2 or SO2, and long term seasonal trends, public holidays, day of the week, 2-day cumulative averages of 24-h wind and rain. K = 3 for Tapp, K = 30 for time, i.e. 5df/year.
Figure A9
Figure A9
Partial autocorrelation function residuals for the generalised additive Poisson time-series regression models (entire year): 2-day cumulative average of PM10 and RD (a), CVD (b) and CBD (c) mortality in Cape Town, South Africa during 2001–2006. Adjusted for the 2-day cumulative average of PM10, NO2 or SO2, and long term seasonal trends, public holidays, day of the week, 2-day cumulative averages of 24-h apparent temperature, wind and rain. K = 30 for time, i.e. 5df/year.
Figure A10
Figure A10
Normal Q-Q plot for the generalised additive Poisson time-series regression models (entire year): RD (a), CVD (b) and CBD (c) mortality in Cape Town, South Africa during 2001–2006. Adjusted for the 2-day cumulative average of PM10, NO2 or SO2, and long term seasonal trends, public holidays, day of the week, 2-day cumulative averages of 24-h apparent temperature, wind and rain. K = 30 for time, i.e. 5df/year.
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References

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