The temporal pattern of respiratory and heart disease mortality in response to air pollution.

Abstract

Short-term changes in ambient particulate matter with aerodynamic diameters < 10 micro m (PM10) have been associated with short-term fluctuations in mortality or morbidity in many studies. In this study, we tested whether those deaths are just advanced by a few days or weeks using a multicity hierarchical modeling approach for all-cause, respiratory, and cardiovascular deaths, for all ages and stratifying by age groups, within the APHEA-2 (Air Pollution and Health: A European Approach) project. We fit a Poisson regression and used an unconstrained distributed lag to model the effect of PM10 exposure on deaths up to 40 days after the exposure. In baseline models using PM10 the day of and day before the death, we found that the overall PM10 effect (per 10 micro g/m3) was 0.74% [95% confidence interval (95% CI), -0.17 to 1.66] for respiratory deaths and 0.69% (95% CI, 0.31-1.08) for cardiovascular deaths. In unrestricted distributed lag models, the effect estimates increased to 4.2% (95% CI, 1.08-7.42) for respiratory deaths and to 1.97% (95% CI, 1.38-2.55) for cardiovascular deaths. Our study confirms that most of the effect of air pollution is not simply advanced by a few weeks and that effects persist for more than a month after exposure. The effect size estimate for PM10 doubles when we considered longer-term effects for all deaths and for cardiovascular deaths and becomes five times higher for respiratory deaths. We found similar effects when stratifying by age groups. These larger effects are important for risk assessment.

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Cited by papers we hold 7

• Oxidative stress and the cardiovascular effects of air pollution · 2020
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• Diesel exhaust: current knowledge of adverse effects and underlying cellular mechanisms · 2016
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• Associations between Fine and Coarse Particles and Mortality in Mediterranean Cities: Results from the MED-PARTICLES Project · 2013
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• The Temporal Lag Structure of Short-term Associations of Fine Particulate Matter Chemical Constituents and Cardiovascular and Respiratory Hospitalizations · 2012
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• A 10-year time-series analysis of respiratory and cardiovascular morbidity in Nicosia, Cyprus: the effect of short-term changes in air pollution and dust storms · 2008
  No notice
• Fine Particulate Air Pollution and Mortality in Nine California Counties: Results from CALFINE · 2005
  No notice
• Potential Role of Ultrafine Particles in Associations between Airborne Particle Mass and Cardiovascular Health · 2005
  No notice

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