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. Air Pollution and Health: a European Approach.
OBJECTIVE
To carry out a prospective combined quantitative analysis of the associations between all cause mortality and ambient particulate matter and sulphur dioxide.


METHODS
Analysis of time series data on daily number of deaths from all causes and concentrations of sulphur dioxide and particulate matter (measured as black smoke or particles smaller than 10 microns in diameter (PM10)) and potential confounders.


METHODS
12 European cities in the APHEA project (Air Pollution and Health: a European Approach).


METHODS
Relative risk of death.


RESULTS
In western European cities it was found that an increase of 50 micrograms/m3 in sulphur dioxide or black smoke was associated with a 3% (95% confidence interval 2% to 4%) increase in daily mortality and the corresponding figure for PM10 was 2% (1% to 3%). In central eastern European cities the increase in mortality associated with a 50 micrograms/m3 change in sulphur dioxide was 0.8% (-0.1% to 2.4%) and in black smoke 0.6% (0.1% to 1.1%). Cumulative effects of prolonged (two to four days) exposure to air pollutants resulted in estimates comparable with the one day effects. The effects of both pollutants were stronger during the summer and were mutually independent.


CONCLUSIONS
The internal consistency of the results in western European cities with wide differences in climate and environmental conditions suggest that these associations may be causal. The long term health impact of these effects is uncertain, but today's relatively low levels of sulphur dioxide and particles still have detectable short term effects on health and further reductions in air pollution are advisable.
Katsouyanni
K
K
Department of Hygiene and Epidemiology, University of Athens Medical School, Greece.
Touloumi
G
G
Spix
C
C
Schwartz
J
J
Balducci
F
F
Medina
S
S
Rossi
G
G
Wojtyniak
B
B
Sunyer
J
J
Bacharova
L
L
Schouten
J P
JP
Ponka
A
A
Anderson
H R
HR
D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D005060:Europe; D006801:Humans; D009026:Mortality; D010316:Particle Size; D018570:Risk Assessment; D012621:Seasons; D012906:Smoke / Q000009:adverse effects / Q000032:analysis; D013458:Sulfur Dioxide / Q000009:adverse effects* / Q000032:analysis; D014504:Urban Health
D000393:Air Pollutants; D012906:Smoke; D013458:Sulfur Dioxide