Short-term effects of fine and coarse particles on mortality and morbidity in 4 Mediterranean countries

摘要

Background and Aims: Few studies have investigated the independent health effects of different size fractions of particulate matter (PM), in multiple locations, especially in Europe. We investigated the short-term effects of PM with aerodynamic diameter less than 10μm (PM10), less than 2.5μm (PM2.5) and between 2.5 and 10μm (PM2.5-10) on mortality and morbidity outcomesin 10 European Mediterranean areas within the MED-PARTICLES project. Methods: We analyzed data from each city using Poisson regression models, and combined city-specific estimates to obtain overall effects. We evaluated the sensitivity of our results to co-pollutant exposures, city-specific model choice and investigated effect modification by age, sex or season. We applied distributed lag and threshold models to investigate the associations' patterns. Results: A 10 μg/m3 increase, in two days' PM2.5 concentration was associated with 0.55% (95% confidence interval (95%CI): 0.27%, 0.84%) increase in all-cause mortality, while a corresponding weekly increase was associated with a 1.91% (95%CI: 0.71%, 3.12%) increase in respiratory mortality. Stronger effects were observed in cause specific mortality, in the warm season and among those ＞ 75 years. Coarse particles displayed consistently adverse effects which were non-significant in most mortality analyses. Regarding hospitalizations increases of 10 μg/m3 in PM2.5 and 6.3 μg/m3 in PM2.5-10 were associated with increases in cardiovascular admissions of 0.51% (95% 95% CI: 0.12%, 0.90%) and 0.46% (95% CI: 0.10%, 0.82%), respectively. Higher effects on respiratory hospitalizations were estimated at lag 0-5, ranging from 1.15% for PM10 to 1.36% for PM2.5. Conclusions: We found adverse health effects of PM2.5 on mortality and morbidity outcomes in the European Mediterranean region. Coarse particles also appear to have adverse effects, mainly on hospitalisations. The effects are more prolonged for respiratory outcomes and are modified by season and age. Acknowledgements: MED-PARTICLES EU LIFE10 ENV/IT/327.