Air pollution and mortality in Madrid, Spain: a time-series analysis.
OBJECTIVE
To assess the relationship, if any, between air pollutant (sulfur dioxide and total suspended particulate) levels and mortality in the city of Madrid during the period 1986-1992, controlling for weather, season, and influenza epidemics.


METHODS
Daily death counts were obtained from the Regional Mortality Registry. Pollution data were supplied by the Municipal Monitoring Network. Time-series analysis methodology was used to assess the link between non-accidental as well as circulatory- and respiratory-disease mortality, on the one hand, and mean daily concentrations of SO2 and total suspended particulate (TSP), on the other. Multivariate autoregressive integrated moving-average (ARIMA) models were used to adjust for season, temperature, relative humidity, and influenza. A sensitivity analysis was run to assess the robustness of the estimators.


RESULTS
Graphical analysis revealed a linear relationship between mortality and TSP. The relationship was logarithmic in the case of SO2. TSP lagged 1 day and SO2 lagged 3 days with an independent effect on mortality. This relationship was produced without the detection of a minimal threshold in emission values.


CONCLUSIONS
These results support the hypothesis of an association between pollution levels and mortality between 1986-1992 in Madrid. Additional measures designed to reduce pollution levels without compromising thermal comfort should be implemented.
Alberdi Odriozola
J C
JC
Centro Universitario de Salud Pública de Madrid, Spain.
Díaz Jiménez
J
J
Montero Rubio
J C
JC
Mirón Pérez
I J
IJ
Pajares Ortiz
M S
MS
Ribera Rodrigues
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012140:Respiratory Tract Diseases / Q000209:etiology / Q000401:mortality*; D013029:Space-Time Clustering; D013030:Spain / Q000453:epidemiology; D013458:Sulfur Dioxide / Q000009:adverse effects / Q000032:analysis
D000393:Air Pollutants; D013458:Sulfur Dioxide