High pollution may increase SARS death rate

November 19, 2003

Air pollution is associated with an increased risk of dying from SARS, according to a report published this week in Environmental Health: A Global Access Science Source. The study shows that patients with SARS are more than twice as likely to die from the disease if they come from areas where pollution levels are high.

5,327 cases of SARS have been diagnosed in mainland China since November 2002 and so far 349 patients have died from the disease. SARS death rates vary between regions of China, with higher rates in the north of the country. A team of researchers from the University of California in Los Angeles, the Jiangsu Provincial Center for Disease Control and Prevention, and Fudan University School of Public Health investigated whether these differences could be explained by differences in air pollution levels.

Using publicly available SARS data, the researchers assessed the death rates of patients with SARS in five different regions of China. They used data published by the Chinese National Environmental Protection Agency, to assess the air pollution levels in these different regions between April and May 2003. These dates coincide with the time when the majority of SARS cases were diagnosed.

Data analysis revealed a strong positive correlation between air pollution and SARS fatality. The researchers write: "Our studies demonstrated a positive association between levels of air pollution and SARS case fatality in the Chinese population."

The researchers categorised the regions according to their level of air pollution. Guangdong, with an air pollution index of 75, was said to have a low level of pollution, Tianjin, with an air pollution index of over 100, a high level of pollution and Shanxi, Hebei and Beijing, moderate pollution levels.

Mortality rates of patients with SARS increased as pollution levels increased. In regions with low air pollution, the death rate was 4.08%, whereas in areas with moderate or high air pollution levels, the death rates were 7.49% and 8.9%, respectively.

The authors suggest that, "long-term or short-term exposure to certain air pollutants could compromise lung function, therefore increasing SARS fatality."

The researchers acknowledge that their study is limited. They were not able to take into account the socioeconomic status or the smoking habits of the SARS patients, nor did they consider the treatment that the patients were given. All of these may have contributed to the patients' outcome.

However, the two regions with the highest case fatality rates were Beijing and Tianjin. The researchers suspect that patients would probably have received better clinical support in these areas. If this is the case, then air pollution may play an even greater role in increasing death rates than their data suggests.
-end-
This press release is based on the following article: Air pollution and case fatality of SARS in the People's Republic of China. Yan Cui, Zuo-Feng Zhang, John Froines, Jinkou Zhao, Hua Wang, Shun-Zhang Yu, Roger Detels Environmental Health: A Global Access Science Source, 2003 2:15 Once published this article will be accessible online, without charge at http://www.ehjournal.net/content/2/1/15/abstract as per BioMed Central's open access policy. Please quote this URL in any articles you write, to enable your readers to view the original research.

For more information about this article, please contact the authors Professor Zuo-Feng Zhang by email at zfzhang@ucla.edu, by phone on 310-825-8418 or by fax on 310-206-6039, or Professor Roger Detels by email at detels@ucla.edu or phone on 310-206-2837.

Alternatively, or for more information about the journal or open access publishing, contact Gemma Bradley by email at press@biomedcentral.com or by phone on 44-0-20-7323-0323.

Environmental Health: A Global Access Science Source (http://www.ehjournal.net) is published by BioMed Central (http://www.biomedcentral.com), an independent online publishing house committed to providing immediate free access to peer-reviewed biological and medical research. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science. BioMed Central currently publishes over 100 open access journals across biology and medicine. In addition to open-access original research, BioMed Central also publishes reviews and other subscription-based content.

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