Κατεύθυνση ΒιοστατιστικήLibrary of the School of Health Sciences
Σαμόλη Ευαγγελία, Επίκουρη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Κατσουγιάννη Κλέα, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Δημακοπούλου Κωνσταντίνα, Διδάκτορας-Βιοστατιστικός, Ιατρική, ΕΚΠΑ
Αποτίμηση των επιδράσεων της μακροχρόνιας έκθεσης σε ατμοσφαιρική ρύπανση στη θνησιμότητα και διερεύνηση της τροποποιητικής επίδρασης γεωχωρικών χαρακτηριστικών, ανά δήμο στην ευρύτερη περιοχή της Αθήνας
Evaluation of the effects of long-term exposure to air pollution on mortality and exploration of the modifying effect of geo-spatial characteristics, per municipality in the wider area of Athens
The objective of this dissertation was to study the effects of long-term exposure to particulate matter with aerodynamic diameter 10μm (PM10) and nitrogen dioxide (NO2) in total and cause-specific mortality, per municipality in the wider area of Athens. The aim was also to explore how these effects are modified due to the economic crisis. For this purpose we collected data for the years 2001 and 2011, for 40 municipalities, including PM10 and NO2 concentrations (in μg/m3), the percentages of people over 75 years of age, of people between 25 and 64 years of age of lower education, of the unemployed, of green areas and the number of inhabitants per square kilometer (km2). To investigate the relationship between mortality (outcomes) and the air pollutants (NO2 and PM10), GLM models were initially applied to investigate the spatial autocorrelation via the Moran's I index of the residuals. In the main analysis we applied GEE models for a Poisson distribution family, which included each pollutant separately but also after mutual adjustment. Finally, the modifying effect of the crisis was investigated by introducing an interaction term in the respective model, hypothesizing that 2011 differs from 2001 due to economic crisis that started in 2008.
The results showed aggravating relationships of the long-term exposure to PM10 and NO2 in mortality due to cardiovascular disease but also due to lung cancer in the case of particulate matter as a 10 μg/m3 increase in PM10 was associated with 2.1% (95% CI: -4.3 to 9.0) and 4.8% (95% ΔΕ: -6.2 to 17.1) increase in mortality indices respectively. Further higher unemployment rates were associated with increased mortality as a 5% increase in unemployment was associated with a total mortality increase by about 15%. In addition, green spaces were associated with decreased mortality. Finally there was no indication for a modifying effect of the economic crisis on the mortality effects following air pollution exposure.
Although the results are consistent with previous findings on the effects of pollutants, the small sample size of the study prevents estimates from reaching the nominal level of statistical significance and further investigation is proposed.
Main subject category:
Air pollution, Athens, Long-term exposure, Air pollutants