title: Long-term particulate matter exposure and mortality: a review of European epidemiological studies.
abstract: 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.
authors.affiliation: Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. pelucchi@marionegri.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Pelucchi
authors.forename: Eva
authors.initials: E
authors.lastname: Negri
authors.forename: Silvano
authors.initials: S
authors.lastname: Gallus
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Irene
authors.initials: I
authors.lastname: Tramacere
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: 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
chemical_list: D052638:Particulate Matter