Health effects during a smog episode in West Germany in 1985.

Abstract

In January 1985 a smog period occurred for 5 days in parts of West Germany, including the Rhur District. Mortality (24,000 death certificates), morbidity in hospitals (13,000 hospital admissions, 5400 outpatients, 1500 ambulance transports) and consultations in doctors' offices (1,250,000 contacts) were studied for a 6-week period including the smog episode and a time interval before and thereafter. The study region was the State of North Rhine-Westfalia (16 million inhabitants), but the analysis is restricted to the comparison of the polluted area and a control area (6 million inhabitants each). During the smog period, mortality and morbidity in hospitals increased in the polluted area, but there was no substantial increase in the control area. The increases were for the total number of deaths 8 vs. 2% (polluted area vs. control area), for hospital admissions 15 vs. 3%, for outpatients 12 vs. 5% and for deliveries by ambulance to hospitals 28% in the polluted area (not investigated in the control area). The effects were more pronounced for cardiovascular diseases than for respiratory diseases. The consultations in doctors' offices show a slight decrease (-2 vs. -4%). Regression analysis shows a moderate influence of temperature, but a strong influence of ambient air pollution. The maxima of the ambient concentrations are more important on the same day, whereas the influence of the daily averages is more pronounced after a delay of 2 days. The results are discussed considering other possible confounders such as indoor pollution and psychogenic influences of the alarm situation. In total, the study suggests moderate health effects due to increased air pollution during the smog episode.

Why cardiologists should be interested in air pollution

“…Notably, arrhythmia admissions were increased by 50% compared with the periods before and after the smog. 1 More recently Hoek and colleagues 31 studied associations between daily variations in air pollution and specific cardiovascular causes of death in the Netherlands over eight years. Effect sizes were significant for total cardiovascular mortality and deaths caused by myocardial infarction and other ischaemic heart disease, but were most pronounced (three times higher) for deaths caused by heart failure and arrhythmia.…”

“…All have been implicated in time series analyses as causes of adverse cardiovascular health effects (tables 1 and 2). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] …”

Short term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities: results from time series data from the APHEA project

“…Apart from data from a few European studies which used various methodological approaches,6 7 8 9 10 little is known about the short term effects of air pollution on mortality in Europe. There are many differences between Europe and the United States, and within Europe itself, which might influence the health effects of air pollution; these include emission sources, pollution mixes, climate, lifestyle, and the underlying health of the population.…”

Health effects of an air pollution episode in London, December 1991.

“…All the relative risks except for the 15-64 age group were greater than unity and significantly increased relative risks were observed for all respiratory diagnoses: age 65+ (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Significant increases were also observed for obstructive lung diseases: all ages (1.14) and age 65+ (1.43).…”