title: Short-term associations between fine and coarse particulate matter and hospitalizations in Southern Europe: results from the MED-PARTICLES project.
abstract: BACKGROUND
  Evidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent.
  
  
  OBJECTIVE
  We aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project.
  
  
  METHODS
  City-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5-10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration-response curves were estimated using a meta-smoothing approach.
  
  
  RESULTS
  We found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m3 in PM2.5, 6.3 μg/m3 in PM2.5-10, and 14.4 μg/m3 in PM10 (lag 0-1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM10 to 1.36% (95% CI: 0.23, 2.49) for PM2.5 (lag 0-5 days).
  
  
  CONCLUSIONS
  PM2.5 and PM2.5-10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards.
authors.affiliation: Department of Epidemiology, Lazio Region Health Service, Rome, Italy. m.stafoggia@deplazio.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Stafoggia
authors.forename: Evangelia
authors.initials: E
authors.lastname: Samoli
authors.forename: Ester
authors.initials: E
authors.lastname: Alessandrini
authors.forename: Ennio
authors.initials: E
authors.lastname: Cadum
authors.forename: Bart
authors.initials: B
authors.lastname: Ostro
authors.forename: Giovanna
authors.initials: G
authors.lastname: Berti
authors.forename: Annunziata
authors.initials: A
authors.lastname: Faustini
authors.forename: Benedicte
authors.initials: B
authors.lastname: Jacquemin
authors.forename: Cristina
authors.initials: C
authors.lastname: Linares
authors.forename: Mathilde
authors.initials: M
authors.lastname: Pascal
authors.forename: Giorgia
authors.initials: G
authors.lastname: Randi
authors.forename: Andrea
authors.initials: A
authors.lastname: Ranzi
authors.forename: Elisa
authors.initials: E
authors.lastname: Stivanello
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002947:Cities; D005060:Europe / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008962:Models, Theoretical; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis*; D016012:Poisson Distribution; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology
chemical_list: D052638:Particulate Matter