title: Exposure to ultrafine particles and respiratory hospitalisations in five European cities.
abstract: Epidemiological evidence on the associations between exposure to ultrafine particles (UFP), with aerodynamic electrical mobility diameters <100 nm, and health is limited. We gathered data on UFP from five European cities within 2001-2011 to investigate associations between short-term changes in concentrations and respiratory hospitalisations.We applied city-specific Poisson regression models and combined city-specific estimates to obtain pooled estimates. We evaluated the sensitivity of our findings to co-pollutant adjustment and investigated effect modification patterns by period of the year, age at admission and specific diagnoses.Our results for the whole time period do not support an association between UFP and respiratory hospitalisations, although we found suggestive associations among those 0-14 years old. We nevertheless report consistent adverse effect estimates during the warm period of the year, statistically significant after lag 2 when an increase by 10 000 particles per cm(3) was associated with a 4.27% (95% CI 1.68-6.92%) increase in hospitalisations. These effect estimates were robust to particles' mass or gaseous pollutants adjustment.Considering that our findings during the warm period may reflect better exposure assessment and that the main source of non-soluble UFP in urban areas is traffic, our results call for improved regulation of traffic emissions.
authors.affiliation: Dept of Hygiene, Epidemiology and Medical Statistics, Medical school, National and Kapodistrian University of Athens, Athens, Greece esamoli@med.uoa.gr.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Samoli
authors.affiliation: Dept of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Zorana Jovanovic
authors.initials: ZJ
authors.lastname: Andersen
authors.affiliation: Dept of Hygiene, Epidemiology and Medical Statistics, Medical school, National and Kapodistrian University of Athens, Athens, Greece Dept of Primary Care and Public Health Sciences and Environmental Research Group, King's College London, London, UK.
authors.forename: Klea
authors.initials: K
authors.lastname: Katsouyanni
authors.affiliation: Leibniz Research Institute for Environmental Medicine, Dusselfdorf, Germany.
authors.forename: Frauke
authors.initials: F
authors.lastname: Hennig
authors.affiliation: IUTA e.V., Air Quality & Sustainable Nanotechnology Unit, Duisburg and CENIDE, University Duisburg-Essen, Duisburg, Germany.
authors.forename: Thomas A J
authors.initials: TA
authors.lastname: Kuhlbusch
authors.affiliation: Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Tom
authors.initials: T
authors.lastname: Bellander
authors.affiliation: Italian National Institute for Environmental Protection and Research, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cattani
authors.affiliation: Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany Environmental Science Center, University of Augsburg, Augsburg, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Cyrys
authors.affiliation: Dept of Epidemiology Lazio Region, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
authors.affiliation: INSERM, Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France CREAL-Centre for Research in Environmental Epidemiology, Barcelona, Spain.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Jacquemin
authors.affiliation: Division of Atmospheric Sciences, Dept of Physics, University of Helsinki, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Kulmala
authors.affiliation: National Institute for Health and Welfare (THL), Kuopio, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Lanki
authors.affiliation: Dept of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Loft
authors.affiliation: Dept of Environmental Science, Aarhus University, Roskilde, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Massling
authors.affiliation: Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Tobias
authors.affiliation: Dept of Epidemiology Lazio Region, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Stafoggia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000397:Air Pollution / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D005060:Europe; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects*; D016012:Poisson Distribution; D015272:Pulmonary Medicine; D012044:Regression Analysis; D013696:Temperature; D055815:Young Adult
chemical_list: D052638:Particulate Matter