Respiratory mortality

In a proportional mortality study, exposure to butyl mercaptan, a degradation product of cotton defoliants, did not account for a higher respiratory mortality in cotton-growing areas of California. ... 

Neonate Infant Increased incidence of respiratory mortality following exposure to particulates in the air (Glinianaia et al., 2004) ... 

Figure 5 Estimated percentage increase (95% Cl) in total, cardiovascular, and respiratory mortality associated with each lO-pg/m increase in estimated PMio concentration in studies specifically assessing cause-specific mortality.

Many cross-sectional studies have found increased mortality of long-term exposure associated with air pollution. In 1964, Martin (11) reported that overall annual respiratory mortality (as opposed to episodic mortality) in the Greater London region was significantly related to smoke (particulate) levels. In 1970, Lave and Seskin (74) reported that city-specific mortality rates in the United States were positively correlated with sulfates and other measures of particulate air pollution. 

The large difference in the mortality from respiratory and heart disease may have a simple explanation. Ammonium nitrate is explosive and the fertilizer workers were probably not allowed to smoke at work. 

The effects attributed to air pollutants range from mild eye irritation to mortality. In most cases, the effect is to aggravate preexisting diseases or to degrade the health status, making persons more susceptible to infection or development of a chronic respiratory disease. Some of the effects associated with specific pollutants are listed in Table 7-2. Further information is available in the U.S. Environmental Protection Agency criteria documents summarized in Chapter 22. 

Exposure to sulfur dioxide in the ambient air has been associated with reduced lung function, increased incidence of respiratory symptoms and diseases, irritation of the eyes, nose, and throat, and premature mortality. Children, the elderly, and those already suffering from respiratory ailments, such as asthmatics, are especially at risk. Health impacts appear to be linked especially to brief exposures to ambient concentrations above 1,000 ixg/in (acute exposures measured over 10 minutes). Some epidemiologic studies, however, have shown an association between relatively low annual mean levels and excess mortality. It is not clear whether long-... 

Burning fossil fuels can release air pollutants such as carbon dioxide, sulfur oxides, nitrogen oxides, ozone, and particulate matter. Sulfur and nitrogen oxides contribute to acid rain ozone is a component of urban smog, and particulate matter affects respiratory health. In fact, several studies have documented a disturbing correlation between suspended particulate levels and human mortality. It is estimated that air pollution may help cause 500,000 premature deaths and millions of new respiratory illnesses each year. 

Long-term administration of oxygen (greater than 15 hours per day) to patients with chronic respiratory failure has been shown to reduce mortality and improve quality of life.1,2 Oxygen therapy should be initiated in stable patients with very severe COPD (GOLD stage IV) who are optimized on... 

Patients at greatest risk for mortality from acute pancreatitis are those who have multi-organ failure (e.g., hypotension, respiratory failure, or renal failure), pancreatic necrosis, obesity, volume depletion, greater than 70 years of age, and an elevated APACHE II score.3,4 The Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II score is a rating scale of disease severity in critically ill patients. 

Haemophilus influenzae is a bacterial respiratory pathogen that causes a wide spectrum of disease ranging from colonization of the airways to bacterial meningitis. It causes considerable morbidity and mortality, especially in children less than 5 years of age. H. influenzae is either encapsulated or unencapsulated. The encapsulated strains can be further differentiated into six antigenically distinct serotypes, a through f. H. influenzae type b was primarily found in cerebrospinal fluid and blood of children with meningitis, while the unencapsulated strains were found in the upper respiratory tract of adults. Before the introduction of the vaccine, H. influenzae was responsible for 20,000 to 25,000 cases of invasive disease annually and was the most common cause of bacterial meningitis. Since the introduction of the vaccine, invasive disease due to H. influenzae type b has been nearly eliminated. 

As discussed in more detail in Section 2.2.1.1, Bates et al. (1997) found a significant increase in mortality from diseases of the respiratory system for residents of the Rotorua area of New Zealand for the period of 1981-1990. Rotorua is in an area of high geothermal activity sampling from a campaign in 1978 indicated a median concentration for hydrogen sulfide of about 20 g/m3 with 35% of the measurements >70 g/m3 and 10% >400 g/m3. Problems with the analysis, however, led these authors to conclude that there were no clear indications of excess mortality. 

---