Asthma and low level air pollution in Helsinki.

The effects of relatively low levels of air pollution and weather conditions on the number of patients who had asthma attacks and who were admitted to a hospital were studied in Helsinki during a 3-y period. The number of admissions increased during cold weather (n = 4,209), especially among persons who were of working age but not among children. Even after standardization for temperature, all admissions, including emergency ward admissions, were significantly correlated with ambient air concentrations of nitrogen dioxide (NO2), nitric oxide (NO), sulfur dioxide (SO2), carbon monoxide (CO), ozone (O3), and total suspended particulates (TSP). Regression analysis revealed that NO and O3 were most strongly associated with asthma problems. Effects of air pollutants and cold were maximal if they occurred on the same day, except for O3, which had a more pronounced effect after a 1-d lag. The associations between pollutants, low temperature, and admissions were most significant among adults of working age, followed by the elderly. Among children, only O3 and NO were significantly correlated with admissions. Levels of pollutants were fairly low, the long-term mean being 19.2 micrograms/m3 for SO2, 38.6 micrograms/m3 for NO2, 22.0 micrograms/m3 or O3, and 1.3 mg/m3 for CO. In contrast, the mean concentration of TSP was high (76.3 micrograms/m3), and the mean temperature was low (+ 4.7 degrees C). These results suggest that concentrations of pollutants lower than those given as guidelines in many countries may increase the incidence of asthma attacks.