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

Katsouyanni, Klea; Touloumi, Giota; Spix, Claudia; Schwartz, Joel; Balducci, Franck; Médina, Sylvia; Rossi, Giuseppe; Wojtyniak, Bogdan; Sunyer, Jordi; Bachárová, Ljuba; Schouten, JP; Pönkä, Antti; Anderson, Hugh

doi:10.1136/bmj.314.7095.1658

Cited by 805 publications

(518 citation statements)

References 27 publications

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“…Using the large multicity studies as an example, significant and robust associations with mortality have been observed for PM 10 (PM with an aerodynamic mass median diameter of less than or equal to 10 mm) in the National Morbidity and Mortality Air Pollution Study (NMMAPS) of 90 US cities (Samet et al, 2000, reanalyzed by Dominici et al, 2003, O 3 in 95 US communities from NMMAPS (Bell et al, 2004), NO 2 in 12 Canadian cities (Burnett et al, 2004), and SO 2 in 12 European cities ranging from Athens to Wroclaw in the APHEA project (Air Pollution and Health: A European Approach) (Katsouyanni et al, 1997). A meta analysis of 109 time-series studies published since 1985 by Stieb et al (2003) also indicated significant associations between mortality and all pollutants examined, including PM 10 , O 3 , NO 2 , SO 2 , and CO, in single-pollutant models.…”

Section: Methods Used To Distinguish Effects Of Multipollutant Exposuresmentioning

confidence: 99%

Panel discussion review: session two — interpretation of observed associations between multiple ambient air pollutants and health effects in epidemiologic analyses

Kim

Burnett

Neas

et al. 2007

J Expo Sci Environ Epidemiol

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Air pollution epidemiologic research has often utilized ambient air concentrations measured from centrally located monitors as a surrogate measure of exposure to these pollutants. Associations between these ambient concentrations and health outcomes such as lung function, hospital admissions, and mortality have been examined in short-and long-term cohort studies as well as in time-series and case-crossover studies. The issues related to interpreting the observed associations of ambient air pollutants with health outcomes were discussed at the US EPA sponsored workshop on December 13 and 14, 2006 in Chapel Hill, North Carolina, USA. The second session of this workshop focused on the following topics: (1) statistical methodology and study designs that may improve understanding of multipollutant health effects; (2) ambient concentrations as surrogate measures of pollutant mixtures; and (3) source-focused epidemiologic research. New methodology and approaches to better distinguish the effects of individual pollutants include multicity hierarchical modeling and the use of case-crossover analysis to control for copollutants. An alternative approach is to examine the mixture as a whole using principal component analysis. Another important consideration is to what extent the observed health associations are attributable to individual pollutants, which are often from common sources and are correlated, versus the pollutant mixtures that the pollutants are representing. For example, several ambient air concentrations, such as particulate matter mass, nitrogen dioxide, and carbon monoxide, may be serving as surrogate measures of motor vehicle exhaust. Source apportionment analysis is one method that may allow further advancement in understanding the source components that contribute to multipollutant health effects.

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Section: Methods Used To Distinguish Effects Of Multipollutant Exposuresmentioning

confidence: 99%

Panel discussion review: session two — interpretation of observed associations between multiple ambient air pollutants and health effects in epidemiologic analyses

Kim

Burnett

Neas

et al. 2007

J Expo Sci Environ Epidemiol

View full text Add to dashboard Cite

show abstract

“…In general, there is evidence linking particulate matter to increased risk for each of these outcome measures. There is some overlap among the cities included in each of these different sets of analyses; by design, some of the same cities are included in the NMMAPS and APHEA (Katsouyanni et al, 1997(Katsouyanni et al, , 2001) studies. However, patterns of correlation of effects among the cities for different health outcomes have not yet been examined.…”

Section: Discussionmentioning

confidence: 99%

“…Critics of single-site studies questioned the choice of particular cities and asked if models had been selected that gave estimates of effect that were biased upwards (Lipfert and Wyzga, 1993;Li and Roth, 1995). These criticisms have been addressed by using multi-site studies (Katsouyanni et al, 1997;Samet et al, 2000a;Hwang and Chan, 2001) in which site-specific data on air pollution and health are assembled under a common framework.…”

Section: Introductionmentioning

confidence: 99%

Hierarchical bivariate time series models: a combined analysis of the effects of particulate matter on morbidity and mortality

Dominici¹

2004

Biostatistics

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In this paper we develop a hierarchical bivariate time series model to characterize the relationship between particulate matter less than 10 microns in aerodynamic diameter (P M 10 ) and both mortality and hospital admissions for cardiovascular diseases. The model is applied to time series data on mortality and morbidity for 10 metropolitan areas in the United States from 1986 to 1993. We postulate that these time series should be related through a shared relationship with P M 10 .At the first stage of the hierarchy, we fit two seemingly unrelated Poisson regression models to produce city-specific estimates of the log relative rates of mortality and morbidity associated with exposure to P M 10 within each location. The sample covariance matrix of the estimated log relative rates is obtained using a novel generalized estimating equation approach that takes into account the correlation between the mortality and morbidity time series. At the second stage, we combine information across locations to estimate overall log relative rates of mortality and morbidity and variation of the rates across cities.Using the combined information across the 10 locations we find that a 10 µg/m 3 increase in average P M 10 at the current day and previous day is associated with a 0.26% increase in mortality (95% posterior interval −0.37, 0.65), and a 0.71% increase in hospital admissions (95% posterior interval 0.35, 0.99). The log relative rates of mortality and morbidity have a similar degree of heterogeneity across cities: the posterior means of the between-city standard deviations of the mortality and morbidity air pollution effects are 0.42 (95% interval 0.05, 1.18), and 0.31 (95% interval 0.10, 0.89), respectively. The city-specific log relative rates of mortality and morbidity are estimated to have very low correlation, but the uncertainty in the correlation is very substantial (posterior mean = 0.20, 95% interval −0.89, 0.98).With the parameter estimates from the model, we can predict the hospitalization log relative rate for a new city for which hospitalization data are unavailable, using that city's estimated mortality relative rate. We illustrate this prediction using New York as an example.

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“…Several studies show a connection between sulfur dioxide exposure and increased emergency departments visits and hospital admissions for respiratory illnesses. The exposure to sulfur dioxide is extremely risky for people's health because these compounds enter the repository system directly through the airways Katsouyanni et al 1997).…”

Section: Introductionmentioning

confidence: 99%

An evaluation of hospital admission respiratory disease attributed to sulfur dioxide ambient concentration in Ahvaz from 2011 through 2013

Goudarzi

Geravandi

Idani

et al. 2016

Environ Sci Pollut Res

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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

Abstract: Objectives: To carry out a prospective combined quantitative analysis of the associations between all cause mortality and ambient particulate matter and sulphur dioxide.

Cited by 805 publications

References 27 publications

Panel discussion review: session two — interpretation of observed associations between multiple ambient air pollutants and health effects in epidemiologic analyses

Panel discussion review: session two — interpretation of observed associations between multiple ambient air pollutants and health effects in epidemiologic analyses

Hierarchical bivariate time series models: a combined analysis of the effects of particulate matter on morbidity and mortality

An evaluation of hospital admission respiratory disease attributed to sulfur dioxide ambient concentration in Ahvaz from 2011 through 2013

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