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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Tài liệu tham khảo

1992, Am Rev Respir Dis, 145, 600, 10.1164/ajrccm/145.3.600

1995, Inhal Toxicol, 7, 1, 10.3109/08958379509014267

10.1093/oxfordjournals.aje.a009249

10.1056/NEJM200012143432401

10.1097/00001648-200109000-00011

Pope CA III, Dockery DW. Epidemiology of particle effects. In: Holgate ST, Samet JM, Koren HS, eds. Air pollution and Health. San Diego, Academic Press, 1999; pp. 673–705

10.1136/bmj.314.7095.1658

10.1097/00001648-199707000-00004

10.1164/rccm.200403-333OC

10.1164/rccm.200407-933OC

World Health Organization. Air Quality Guidelines for Europe. 2nd Edn. WHO Regional Publications European Series No. 91, Copenhagen, Denmark, 2000

US Environmental Protection Agency Office of Air Quality Planning and Standards. Review of the National Ambient Air Quality Standards for Particulate Matter: Policy Assessment of Scientific and Technical Information. WAWPS Staff Paper. EPA-45/R-1996:96-013. Research Triangle Park, NC, US EPA Office of Air Quality Planning and Standards, 1996

Commission of the European Communities. Council Directive 1999/30/EC relating to limit values for sulphur dioxide, oxides of nitrogen, particulate matter and lead in ambient air. Brussels, European Commission, 1999

1996, Am J Respir Crit Care Med, 154, 1700, 10.1164/ajrccm.154.6.8970358

10.1164/ajrccm.156.2.9612042

1992, Toxicol Ind Health, 8, 273, 10.1177/074823379200800505

1992, Am Rev Respir Dis, 145, 291, 10.1164/ajrccm/145.2_Pt_1.291

2005, Environ Res, 97, 58, 10.1016/j.envres.2004.02.009

10.1097/00001648-200005000-00016

10.1136/oem.60.12.977

10.1002/env.623

10.1111/1467-9868.00240

10.1111/1467-9868.00374

2000, JASA, 95, 16, 10.1080/01621459.2000.10473895

10.1034/j.1399-3003.2000.16d26.x

10.1097/01.ede.0000142152.62400.13

10.1097/00001648-200201000-00014

10.1016/0197-2456(86)90046-2

10.1002/(SICI)1097-0258(19981130)17:22<2537::AID-SIM953>3.0.CO;2-C

10.1093/ije/24.6.1147

1995, Environ Res, 69, 139

1994, Environ Res, 65, 207, 10.1006/enrs.1994.1032

1993, Eur Respir J, 6, 1109, 10.1183/09031936.93.06081109

1991, Environ Res, 54, 99, 10.1016/S0013-9351(05)80094-5

1996, Soc Prev Med, 41, 107, 10.1007/BF01323089

1996, Epidemiology, 7, 225, 10.1097/00001648-199605000-00002

1996, J Expos Anal Environ Epidemiol, 6, 97

Samet JM, Zeger SL, Dominici F, et al. The National Morbidity, Mortality and Air Pollution Study. Part II: Morbidity, Mortality, and Air Pollution in the United States. HEI Research report. Boston, HEI publications, 2000; No. 94, Part II

2004, J Aerosol Sci, 35, S1081, 10.1016/S0021-8502(19)30275-7

10.1136/thorax.58.12.1012

2004, Environ Health Perspect, 112, 369, 10.1289/ehp.6523

Thông tin
Thông tin xuất bản

European Respiratory Journal

Tập 27 Số 6

1129-1138

Thông tin tác giả