PM 2.5 and Mortality in Long-Term Prospective Cohort Studies: Cause-Effect or Statistical Associations?

Gamble, John F.

doi:10.2307/3434228

Cited by 41 publications

(30 citation statements)

References 18 publications

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“…However, some reviewers of the literature remain troubled by the issue of biological plausibility and argue that there is inadequate consistency across the toxicological and epidemiologic evidence. [495][496][497][498][499] Toxicology is playing a crucial role in understanding the health effects of PM, 500 but there are substantial challenges, especially when it comes to dealing with exposures to complex mixtures. 104,501,502 Another reason for skepticism is at least implied by Phalen 88 in his book dealing with the particulate air pollution controversy.…”

Section: Continued Skepticismmentioning

confidence: 99%

Health Effects of Fine Particulate Air Pollution: Lines that Connect

Pope

Dockery²

2006

Journal of the Air & Waste Management Association

5,661

3,159

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Efforts to understand and mitigate the health effects of particulate matter (PM) air pollution have a rich and interesting history. This review focuses on six substantial lines of research that have been pursued since 1997 that have helped elucidate our understanding about the effects of PM on human health. There has been substantial progress in the evaluation of PM health effects at different time-scales of exposure and in the exploration of the shape of the concentration-response function. There has also been emerging evidence of PM-related cardiovascular health effects and growing knowledge regarding interconnected general pathophysiological pathways that link PM exposure with cardiopulmonary morbidity and mortality. Despite important gaps in scientific knowledge and continued reasons for some skepticism, a comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonary health. Although much of this research has been motivated by environmental public health policy, these results have important scientific, medical, and public health implications that are broader than debates over legally mandated air quality standards.

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Section: Continued Skepticismmentioning

confidence: 99%

Health Effects of Fine Particulate Air Pollution: Lines that Connect

Pope

Dockery²

2006

Journal of the Air & Waste Management Association

5,661

3,159

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Section: Retired Agronomist New Zealandmentioning

confidence: 99%

“…Given that the ambient PM 10 could add about only 1% to the daily intake of PM 10 by smokers even on highly polluted days, 5 it could be expected that if the extra admissions were caused by inhaling ambient PM 10 , the number of smokers admitted would not have increased on or after high pollution days, as they would not have been affected by the relatively small increases in ambient concentrations. There was no indication that the results for smokers were different from the results for non-smokers.…”

Section: Letters To the Editormentioning

confidence: 99%

“…4 People smoking 30 cigarettes a day inhale as much PM 10 as they would if they were continually breathing air containing 24,000 µg/m 3 of PM 10 . 5 There is no consensus as to how PM 10 causes these effects, if indeed it does, 6 or clinical evidence of the damage it causes at these low concentrations.Concentrations of SO 2 , NO, NO 2 , CO and PM 10 were monitored daily over the study period. The high concentrations of all pollutants recorded on some winter nights are a consequence of weather conditions, so variations in the concentrations of all these pollutants were highly correlated.…”

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confidence: 99%

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Particulate air pollution and hospital admissions: consequent or subsequent?

Palmer¹

2002

Australian and New Zealand Journal of Public Health

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Retired agronomist, New Zealand"It is incident to physicians, I am afraid, above all other men, to mistake subsequence for consequence. " 1 McGowan et al. 2 examined the coincidence of daily variations in the concentrations of fine particles (PM 10 ) in the air and the numbers of people admitted to New Zealand's Christchurch Hospital for treatment of cardiac or respiratory complaints from 1988 to 1998. They found that cardiac admissions were higher on high pollution days. Respiratory admissions were also higher on high pollution days. The admissions peaked two days after high pollution days, and this higher rate persisted with only slight diminution for the ensuing four days, and perhaps for longer. From the results, they concluded that particulate pollution caused significant morbidity and that measures to reduce particulate pollution could reduce hospital admissions for cardio-respiratory illness in the city.Mean concentration of PM 10 in Christchurch is 25 µg/m 3 (not 25 mg/m 3 as given in their Table 1). This is similar to the mean concentrations now being recorded in London or Birmingham, 3 and about half that recorded in Los Angeles. 4 People smoking 30 cigarettes a day inhale as much PM 10 as they would if they were continually breathing air containing 24,000 µg/m 3 of PM 10 . 5 There is no consensus as to how PM 10 causes these effects, if indeed it does, 6 or clinical evidence of the damage it causes at these low concentrations.Concentrations of SO 2 , NO, NO 2 , CO and PM 10 were monitored daily over the study period. The high concentrations of all pollutants recorded on some winter nights are a consequence of weather conditions, so variations in the concentrations of all these pollutants were highly correlated. For days for which there were no records of PM 10 concentrations, a missing value was calculated using the regression relationship between concentrations of PM 10 and CO.Because of the high correlations between concentrations of the several pollutants, there is difficulty in separating the effects of one from the others. 7 Although the data were available, the associations between other pollutants and hospital admissions were not examined, but they were discussed. Without question or qualification, all the observed effects were attributed to variations in concentrations of PM 10 .There were considerable differences between years in the number of admissions and in the concentrations of PM 10 . Concentrations of PM 10 were generally higher in the earlier years. There may have been twice as many admissions in the later years than in the earlier years. Aside from these secular trends, the number of admissions did not appear to be positively correlated with the mean yearly PM 10 concentrations. In this the results are similar to those of

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“…Critics of the positive epidemiologic findings consider the disconnect between ambient monitors and actual exposure to be a potential source of error (10,11). However, although some studies have found poor correlations between personal exposure and ambient concentrations (12)(13)(14), the correlations have been stronger when evaluated within individuals across time (15,16).…”

mentioning

confidence: 99%