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Hospital admissions for asthma and chronic obstructive airways disease in East London hospitals and proximity of residence to main roads
  1. S E Morrisa,
  2. R C Saleb,
  3. J C Wakefielda,
  4. S Falconera,
  5. P Elliotta,
  6. B J Boucherb
  1. aDepartment of Epidemiology and Public Health, Imperial College School of Medicine, St Mary's Campus, London W2 1PG, bDepartment of General and Emergency Medicine, Royal London Hospital, London
  1. Professor P Elliott

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We describe a matched case-control study investigating the association between respiratory illness and proximity of residence to main roads. The study was carried out in response to previously inconsistent reports on this question1-3; the null hypothesis was of no association of traffic related air pollution to respiratory illness, hospital admissions for asthma and chronic obstructive airways disease. The study focused on Tower Hamlets, East London where hospital admissions for asthma are 80% above national rates.1 2


The cases were extracted from the medical summaries of sequential emergency medical admissions through the casualty departments at The Royal London Hospitals in 1991–1992. Patient records with a diagnosis of asthma or chronic obstructive airways disease, and resident in Tower Hamlets, were identified. Individually matched controls (also obtained from emergency medical admissions through the casualty departments) with a non-chest related illness were selected based on sex, year of admission and consultant team. The selection method of these controls precludes surgical, orthopaedic or trauma cases. Overall, 82% of the pairs were matched to within five years, the remainder to within 10 years. For each case and control, address, ethnic group, whether there had been treatment in intensive therapy, and whether there had been any re-admission during that year, were extracted. Smoking data were too incomplete to be used.

Using the Address-point software the addresses of cases and controls were expressed as a grid reference for all but eight participants. This software allows each postal address to be located to the “front …

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  • Conflicts of interest: none.

    S E Morris carried out the statistical analysis and helped draft the paper; R C Sale abstracted the data from medical records and approved the paper; J C Wakefield oversaw the statistical analysis and helped draft the paper; S Falconer carried out the GIS analysis; P Elliott helped initiate the study and draft the paper; B J Boucher initiated the study and helped draft the paper.