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Spatial patterns in cardiovascular and respiratory disease rates around Schiphol airport

Gebruik van ziekenhuisgegevens voor het beschrijven van ruimtelijke patronen in ziekte rondom Schiphol


Within the framework of the Evaluation and Monitoring programme Schiphol spatial patterns in hospital admission data on seven cardiovascular and six respiratory diseases were analysed for three years (1991-1993). This report is a supplement to a similar analysis for the Environmental Impact Assessment Schiphol (EIA), in 1993. The purpose of this study was to evaluate the feasibility for future use of the Dutch Information System for Hospital Care and Day Nursing (LMR) for environmental health monitoring around Schiphol airport and to investigate spatial patterns in disease rates around Schiphol airport. Disease rates and their 95% confidence intervals were calculated and mapped for each study area, using an empirical Bayes model to reduce random variation and to account for small area variability and spatial interdependence in the data. The analyses were adjusted for age and sex. At this moment, the LMR is not considered suitable to monitor cardiovascular and respiratory diseases in relation to (developments in) environmental pollution around Schiphol airport. For a final conclusion data must be studied for a longer time period (e.g. 5 years). It should also be possible to include time (in addition to spatial interdependence) in the analytical model, and preferably also data on exposure and important determinants of the diseases of interest. Currently, such a model is being developed at RIVM. The availability of data on important determinants will improve future analyses with LMR data, and will improve the feasibility of the LMR as a monitoring instrument. Analysis of LMR data showed a wide spatial variation in disease rates for cardiovascular and respiratory diseases. In most cases this variation was not statistically significant (95% confidence interval) and differed over the years (1991-1993). For the majority of the diseases studied there was no consistent spatial pattern that would suggest a relation with environmental pollution from Schiphol airport. The disease pattern varied per year and differed between men and women. These results are consistent with the results described in the EIA. For three of the 14 diseases studied ('all cardiovascular diseases', 'upper airway disease' and 'acute airway infections') a spatial pattern could be seen in a few study areas. This pattern was consistent for time and for both sexes. However, there was no clustering of these diseases around the airport.

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