@article{3058010,
    title = "Which specific causes of death are associated with short term exposure to fine and coarse particles in Southern Europe? Results from the MED-PARTICLES project",
    author = "Samoli, E. and Stafoggia, M. and Rodopoulou, S. and Ostro, B. and Alessandrini, E. and Basagan~a, X. and Di´az, J. and Faustini, A. and Gandini, M. and Karanasiou, A. and Kelessis, A.G. and Le Tertre, A. and Linares, C. and Ranzi, A. and Scarinzi, C. and Katsouyanni, K. and Forastiere, F. and Angelini, P. and Berti, G. and Bisanti, L. and Cadum, E. and Catrambone, M. and Chiusolo, M. and Davoli, M. and de' Donato, F. and Demaria, M. and Grosa, M. and Ferrari, S. and Pandolfi, P. and Pelosini, R. and Perrino, C. and Pietrodangelo, A. and Pizzi, L. and Poluzzi, V. and Priod, G. and Randi, G. and Rowinski, M. and Stivanello, E. and Zauli-Sajani, S. and Dimakopoulou, K. and Elefteriadis, K. and Kelessis, A. and Maggos, T. and Michalopoulos, N. and Pateraki, S. and Petrakakis, M. and Sypsa, V. and Agis, D. and Artiñano, B. and Barrera-Gómez, J. and de la Rosa, J. and Diaz, J. and Fernandez, R. and Jacquemin, B. and Perez, N. and Pey, J. and Querol, X. and Sanchez, AM. and Sunyer, J. and Tobias, A. and Bidondo, M. and Declercq, C. and Lozano, P. and Medina, S. and Pascal, L. and Pascal, M. and MED-PARTICLES Study group",
    journal = "Environment International",
    year = "2014",
    volume = "67",
    pages = "54-61",
    publisher = "Elsevier Ireland Ltd",
    issn = "0160-4120",
    doi = "10.1016/j.envint.2014.02.013",
    keywords = "Digital storage;  Heart;  Medical problems;  Pollution;  Regression analysis;  Time series analysis, Cardiac;  Cerebrovascular;  Coarse particles;  COPD;  Fine particles;  Mediterranean;  Mortality;  Particulate Matter, Pulmonary diseases, cardiovascular disease;  cause of death;  diabetes;  environmental risk;  health risk;  metropolitan area;  mortality;  numerical model;  particulate matter;  Poisson ratio;  regression analysis;  respiratory disease;  seasonality;  urban society, air pollution;  airborne particle;  article;  cause of death;  cerebrovascular disease;  chronic obstructive lung disease;  controlled study;  diabetes mellitus;  environmental exposure;  heart death;  heart disease;  human;  long term exposure;  lower respiratory tract infection;  mortality;  particle size;  particulate matter;  priority journal;  seasonal variation;  Southern Europe;  urban area, Southern Europe, Cardiac;  Cerebrovascular;  Coarse particles;  COPD;  Diabetes;  Fine particles;  Mediterranean;  Mortality;  Particulate matter;  Time series analysis, Air Pollution;  Cause of Death;  Cities;  Diabetes Mellitus;  Environmental Exposure;  Europe;  Heart Diseases;  Humans;  Models, Theoretical;  Particle Size;  Particulate Matter;  Pulmonary Disease, Chronic Obstructive;  Seasons",
    abstract = "We investigated the short-term effects of particles with aerodynamic diameter less than 2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10) and less than 10μm (PM10) on deaths from diabetes, cardiac and cerebrovascular causes, lower respiratory tract infections (LRTI) and chronic obstructive pulmonary disease (COPD) in 10 European Mediterranean metropolitan areas participating in the MED-PARTICLES project during 2001-2010.In the first stage of the analysis, data from each city were analyzed separately using Poisson regression models, whereas in the second stage, the city-specific air pollution estimates were combined to obtain overall estimates. We investigated the effects following immediate (lags 0-1), delayed (lags 2-5) and prolonged exposure (lags 0-5) and effect modification patterns by season. We evaluated the sensitivity of our results to co-pollutant exposures or city-specific model choice. We applied threshold models to investigate the pattern of selected associations.For a 10μg/m3 increase in two days' PM2.5 exposure there was a 1.23% (95% confidence interval (95% CI): -1.63%, 4.17%) increase in diabetes deaths, while six days' exposure statistically significantly increased cardiac deaths by 1.33% (95% CI: 0.27, 2.40%), COPD deaths by 2.53% (95% CI: -0.01%, 5.14%) and LRTI deaths by 1.37% (95% CI: -1.94%, 4.78%). PM2.5 results were robust to co-pollutant adjustments and alternative modeling approaches. Stronger effects were observed in the warm season. Coarse particles displayed positive, even if not statistically significant, associations with mortality due to diabetes and cardiac causes that were more variable depending on exposure period, co-pollutant and seasonality adjustment.Our findings provide support for positive associations between PM2.5 and mortality due to diabetes, cardiac causes, COPD, and to a lesser degree to cerebrovascular causes, in the European Mediterranean region, which seem to drive the particles short-term health effects. © 2014 Elsevier Ltd."
}