Long-term particulate matter exposure and mortality: a review of European epidemiological studies.
BACKGROUND
Several studies considered the relation between long-term exposure to particulate matter (PM) and total mortality, as well as mortality from cardiovascular and respiratory diseases. Our aim was to provide a comprehensive review of European epidemiological studies on the issue.


METHODS
We searched the Medline database for epidemiological studies on air pollution and health outcomes published between January 2002 and December 2007. We also examined the reference lists of individual papers and reviews. Two independent reviewers classified the studies according to type of air pollutant, duration of exposure and health outcome considered. Among European investigations that examined long-term PM exposure we found 4 cohort studies (considering total and cardiopulmonary mortality), 1 case-control study (considering mortality from myocardial infarction), and 4 ecologic studies (2 studies considering total and cardiopulmonary mortality and 2 studies focused on cardiovascular mortality).


RESULTS
Measurement indicators of PM exposure used in European studies, including PM10, PM2.5, total suspended particulate and black smoke, were heterogeneous. This notwithstanding, in all analytic studies total mortality was directly associated with long-term exposure to PM. The excesses in mortality were mainly due to cardiovascular and respiratory causes. Three out of 4 ecologic studies found significant direct associations between PM indexes and mortality.


CONCLUSIONS
European studies on long-term exposure to PM indicate a direct association with mortality, particularly from cardiovascular and respiratory diseases.
Pelucchi
Claudio
C
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. pelucchi@marionegri.it
Negri
Eva
E
Gallus
Silvano
S
Boffetta
Paolo
P
Tramacere
Irene
I
La Vecchia
Carlo
C
D002318:Cardiovascular Diseases / Q000401:mortality; D004781:Environmental Exposure / Q000009:adverse effects*; D016021:Epidemiologic Studies; D005060:Europe / Q000453:epidemiology; D006801:Humans; D009026:Mortality; D052638:Particulate Matter / Q000009:adverse effects*; D012140:Respiratory Tract Diseases / Q000401:mortality
D052638:Particulate Matter