Short-term effects of nitrogen dioxide on mortality: an analysis within the APHEA project

European Respiratory Journal - Tập 27 Số 6 - Trang 1129-1138 - 2006
Evangelia Samoli1, Evangelia Aga2,3,4, Giota Touloumi5,6, K. Nisiotis5,6, Bertil Forsberg7, Agnès Lefranc8, Juha Pekkanen9,10, Bogdan Wojtyniak7, Christian Schindler2,3,4, Emilia Maria Niciu2,3,4,8, R. Brunstein11,8, M. Dodič Fikfak12, J. Schwartz2,3,4, Klea Katsouyanni13
1Dept of Hygiene and Epidemiology, University of Athens Medical School, 75 Mikras Asias Street, 115 27 Athens, Greece. [email protected]
2Harvard School of Public Health, Boston, MA, USA. " Dept of Public Health and Clinical Medicine, Umea ˚University, Umea ˚, Sweden.
3Institute of Public Health Bucharest, Bucharest, Romania.
4Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland. "" Dept of Environmental Health,
5Dept of Hygiene and Epidemiology, University of Athens, Athens, Greece.
6National Institute of Hygiene, Dept of Medical Statistics, Population Studies Laboratory, Warsaw, Poland.
7Dept of Hygiene and Epidemiology, University of Athens Medical School, 75 Mikras Asias Street, 115 27 Athens, Greece.
8Regional Observatory of Health, Ile-de-France, France.
9Dept of Public Health and Clinical Nutrition, University of Kuopio, and
10National Public Health Institute, Unit of Environmental Epidemiology, Kuopio, Finland
11Center for Quality & Safety, Hadassah University Hospital, Jerusalem, Israel.
12Institute of Public Health, Ljubljana, Slovenia
13Primary Care & Public Health Sciences

Tóm tắt

The short-term effects of nitrogen dioxide (NO2) on total, cardiovascular and respiratory mortality in 30 European cities participating in the Air Pollution on Health: a European Approach (APHEA)-2 project were investigated.The association was examined using hierarchical models implemented in two stages. In the first stage, data from each city were analysed separately, whereas in the second stage, the city-specific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity.A significant association of NO2with total, cardiovascular and respiratory mortality was found, with stronger effects on cause-specific mortality. There was evidence of confounding in respiratory mortality with black smoke and sulphur dioxide. The effect of NO2on total and cardiovascular mortality was observed mainly in western and southern European cities, and was larger when smoking prevalence was lower and household gas consumption was higher. The effect of NO2on respiratory mortality was higher in cities with a larger proportion of elderly persons in the population and higher levels of particulate matter with a 50% cut-off aerodynamic diameter of 10 μm.The results of this large study are consistent with an independent effect of nitrogen dioxide on mortality, but the role of nitrogen dioxide as a surrogate of other unmeasured pollutants cannot be completely ruled out.

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Thông tin xuất bản

European Respiratory Journal

Tập 27 Số 6

1129-1138

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