title: Ultrafine and Fine Particles and Hospital Admissions in Central Europe. Results from the UFIREG Study.
abstract: Evidence of short-term effects of ultrafine particles (UFP) on health is still inconsistent and few multicenter studies have been conducted so far especially in Europe.
  
  
  
  Within the UFIREG project, we investigated the short-term effects of UFP and fine particulate matter (particulate matter with an aerodynamic diameter less than 2.5 μm [PM2.5]) on daily cause-specific hospital admissions in five Central and Eastern European cities using harmonized protocols for measurements and analyses.
  
  
  
  Daily counts of cause-specific hospital admissions focusing on cardiovascular and respiratory diseases were obtained for Augsburg and Dresden (Germany), 2011-2012; Chernivtsi (Ukraine), 2013 to March 2014; and Ljubljana (Slovenia) and Prague (Czech Republic), 2012-2013. Air pollution and meteorologic data were measured at fixed monitoring sites in all cities. We analyzed city-specific associations using confounder-adjusted Poisson regression models and pooled the city-specific effect estimates using metaanalysis methods.
  
  
  
  A 2,750 particles/cm3increase (average interquartile range across all cities) in the 6-day average of UFP indicated a delayed and prolonged increase in the pooled relative risk of respiratory hospital admissions (3.4% [95% confidence interval, -1.7 to 8.8%]). We also found increases in the pooled relative risk of cardiovascular (exposure average of lag 2-5, 1.8% [0.1-3.4%]) and respiratory (6-d average exposure, 7.5% [4.9-10.2%]) admissions per 12.4 μg/m3increase (average interquartile range) in PM2.5.
  
  
  
  Our findings indicated delayed and prolonged effects of UFP exposure on respiratory hospital admissions in Central and Eastern Europe. Cardiovascular and respiratory hospital admissions increased in association with an increase in PM2.5. Further multicenter studies are needed using harmonized UFP measurements to draw definite conclusions on health effects of UFP.
authors.affiliation: 1 Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lanzinger
authors.affiliation: 1 Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schneider
authors.affiliation: 1 Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Breitner
authors.affiliation: 2 Department of Epidemiology, Lazio Region Health Service, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Stafoggia
authors.affiliation: 3 National Institute of Public Health Slovenia, Ljubljana, Slovenia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Erzen
authors.affiliation: 4 Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Dostal
authors.affiliation: 4 Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
authors.forename: Anna
authors.initials: A
authors.lastname: Pastorkova
authors.affiliation: 5 Saxon State Office for Environment, Agriculture and Geology, Dresden, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Bastian
authors.affiliation: 1 Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.|6 Environmental Science Center, University of Augsburg, Augsburg, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Cyrys
authors.affiliation: 7 Research Association Public Health Saxony and Saxony-Anhalt, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; and.
authors.forename: Anja
authors.initials: A
authors.lastname: Zscheppang
authors.affiliation: 8 L. I. Medved's Research Center of Preventive Toxicology, Food and Chemical Safety, Ministry of Health, Chernivtsi, Ukraine.
authors.forename: Tetiana
authors.initials: T
authors.lastname: Kolodnitska
authors.affiliation: 1 Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002947:Cities; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D052638:Particulate Matter; D012120:Respiration Disorders / Q000453:epidemiology*; D017524:Slovenia / Q000453:epidemiology; D014455:Ukraine / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: cardiovascular; hospital admissions; particulate matter; respiratory; ultrafine particles