Proximity to coke works and hospital admissions for respiratory and cardiovascular disease in England and Wales
- The Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Imperial College School of Medicine, St Mary's Campus, Norfolk Place, London W2 1PG, UK
- Dr P Aylinp.aylin{at}ic.ac.uk
- Received 12 June 2000
- Revision requested 11 August 2000
- Revised 16 October 2000
- Accepted 10 December 2000
Abstract
BACKGROUND The incidence of hospital admissions for respiratory and cardiovascular diseases in areas close to operating coke works in England and Wales was investigated.
METHODS A small area study using distance from source as a proxy for exposure was undertaken in subjects aged 65 or over and children under 5 years within 7.5 km of four coke works (1991 estimated populations 87 760 and 43 932, respectively). The main outcome measures were emergency hospital admissions in 1992/3–1994/5 with a primary diagnosis of coronary heart disease (ICD 410–414), stroke (ICD 431–438), all respiratory diseases (ICD 460–519), chronic obstructive pulmonary disease (ICD 491–492), and asthma (ICD 493) in those aged 65 or over, and all respiratory and asthma admissions in children under 5 years of age.
RESULTS At age 65 or over the combined estimate of relative risk with proximity to coke works (per km) ranged from 0.99 (95% CI 0.90 to 1.09) for chronic obstructive pulmonary disease to 1.03 (95% CI 0.94 to 1.13) for asthma. For children under 5 years the combined estimate of risk was 1.08 (95% CI 0.98 to 1.20) for all respiratory disease and 1.07 (95% CI 0.98 to 1.18) for asthma. There was evidence of significant heterogeneity in risk estimates between coke work groups, especially in children under 5 years (p<0.001 and p=0.004 for respiratory disease and asthma, respectively). For the Teesside coke works in North East England the relative risk with proximity (per km) was 1.09 (95% CI 1.06 to 1.12) for respiratory disease and 1.09 (95% CI 1.04 to 1.15) for asthma.
CONCLUSIONS No evidence overall was found for an association between hospital admissions and living near operational coke works in England and Wales. Trends of a higher risk of hospital admission for respiratory disease and asthma among children with proximity to the Teesside plant require further investigation.
Footnotes
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Funding: The Small Area Health Statistics Unit is funded by a grant from the Department of Health, Department of the Environment, Transport and The Regions, Health and Safety Executive, Scottish Executive, National Assembly for Wales, and Northern Ireland Assembly. We thank the Office for National Statistics (formerly Office of Population, Censuses and Surveys), the Department of Health and Welsh Health Information Services (NHS Wales), for provision of and permission to use vital registration and health event data.
This work is based on data provided with the support of the ESRC and JISC and uses census and boundary material which are copyright of the Crown, the Post Office and the ED-LINE Consortium. This research was supported, in part, by an equipment grant from the Wellcome Trust (0455051/Z/95/Z). The views expressed in this publication are those of the authors and not necessarily of the funding departments.
