Τίτλος:
Confounding and effect modification in the short-term effects of ambient
particles on total mortality: Results from 29 European cities within the
APHEA2 project
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
We present the results of the Air Pollution and Health: A European
Approach (APHEA-2,) project on short-term effects of ambient particles
on mortality with emphasis on effect modification. We used daily
measurements for particulate matter less than 10 mum in aerodynamic
diameter (PM10) and/or black smoke from 29 European cities. We
considered confounding from other pollutants as well as meteorologic and
chronologic variables. We investigated several variables describing the
cities’ pollution, climate, population, and geography as potential
effect modifiers. For the individual city analysis, generalized additive
models extending Poisson regression, using a smoother to control for
seasonal patterns, were applied. To provide quantitative summaries of
the results and explain remaining heterogeneity, we applied second-stage
regression models. The estimated increase in the daily number of deaths
for all ages for a 10 mug/m(3) increase in daily PM10 or black smoke
concentrations was 0.6% [95% confidence interval (CI) = 0.4-0.8%],
whereas for the elderly it was slightly higher. We found important
effect modification for several of the variables studied. Thus, in a
city with low average NO2, the estimated increase in daily mortality for
an increase of 10 mug/m(3) in PM10 was 0.19 (95% CI = 0.00-0.41),
whereas in a city with high average NO2 it was 0.80% (95% CI =
0.67-0.93%); in a relatively cold climate the corresponding effect was
0.29% (95% CI = 0.16-0.42), whereas in a warm climate it was 0.82%
(95% CI = 0.69-0.96); in a city with low standardized mortality rate it
was 0.80% (95% CI = 0.65-0.95%), and in one with a high rate it was
0.43% (95% CI = 0.24-0.62). Our results confirm those previously
reported on the effects of ambient particles on mortality. Furthermore,
they show that the heterogeneity found in the effect parameters among
cities reflects real effect modification, which is explained by specific
city characteristics.
Συγγραφείς:
Katsouyanni, K
Touloumi, G
Samoli, E
Gryparis, A
Le
Tertre, A
Monopolis, Y
Rossi, G
Zmirou, D
Ballester, F
and Boumghar, A
Anderson, HR
Wojtyniak, B
Paldy, A and
Braunstein, R
Pekkanen, J
Schindler, C
Schwartz, J
Περιοδικό:
Epidemiology Monitor
Εκδότης:
Lippincott, Williams & Wilkins
Λέξεις-κλειδιά:
air pollution; ambient particles; mortality; time-series; Poisson
regression; geographic comparisons
DOI:
10.1097/00001648-200109000-00011
