Short-term Associations between Fine and Coarse Particulate Matter and Hospitalizations in Southern Europe: Results from the MED-PARTICLES Project

Abstract

Background: Evidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent.Objectives: We aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project.Methods: City-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5–10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration–response curves were estimated using a meta-smoothing approach.Results: We found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m3 in PM2.5, 6.3 μg/m3 in PM2.5–10, and 14.4 μg/m3 in PM10 (lag 0–1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM10 to 1.36% (95% CI: 0.23, 2.49) for PM2.5 (lag 0–5 days).Conclusions: PM2.5 and PM2.5–10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards.Citation: Stafoggia M, Samoli E, Alessandrini E, Cadum E, Ostro B, Berti G, Faustini A, Jacquemin B, Linares C, Pascal M, Randi G, Ranzi A, Stivanello E, Forastiere F, the MED-PARTICLES Study Group. 2013. Short-term associations between fine and coarse particulate matter and hospitalizations in Southern Europe: results from the MED-PARTICLES project. Environ Health Perspect 121:1026–1033; http://dx.doi.org/10.1289/ehp.1206151

A rapid assessment of the impact of hazard reduction burning around Sydney, May 2016

“…In accordance with the Answer to Question A5, multicity studies from 30 European cities (Katsouyanni et al, 2009) and 4 Asian cities (Wong et al, 2010b) found no evidence for deviation from linearity or the presence of a threshold for PM 10 associations. Results from multicity analyses that focused on PM 2.5 in 10 metropolitan areas in the European Mediterranean region (Samoli et al, 2013;Stafoggia et al, 2013) and in 6 cities in the United States (Schwartz, Laden & Zanobetti, 2002) replicated these findings, either for associations with mortality (Samoli et al, 2013;Schwartz, Laden & Zanobetti, 2002) or morbidity (Stafoggia et al, 2013), especially within the common range of PM 2.5 observed between cities included in the analyses, usually between 10 μg/m 3 and 35 μg/m 3 . Due to less information at the extremes of the PM distribution, the power to sufficiently detect the shape outside this range is limited.…”

Multifactorial airborne exposures and respiratory hospital admissions — The example of Santiago de Chile

“…Hoek et al (2013) described in their review significant heterogeneity in PM2.5 effect estimates across mortality and morbidity studies, likely related to variations in particle composition, differences of infiltration of particles indoors, population characteristics and methodological differences in exposure assessment and confounder control (Hoek et al, 2013). Recent studies often are attributing stronger effects to PM2.5 than PM10 (Chardon et al, 2007;Stafoggia et al, 2013) but sometimes similar or lower effects (Barnett et al, 2005;Chen et al, 2005). In the present study, there was a tendency to stronger effects of PM10 than PM2.5.…”

Mass Concentration and Size-Distribution of Atmospheric Particulate Matter in an Urban Environment

“…Numerous epidemiological and toxicological studies have documented strong correlations between measured particulate matter (PM) levels and adverse health outcomes (Erdinger et al, 2005;Schwarze et al, 2006;Brook et al, 2010;Stafoggia et al, 2013;Raaschou-Nielsen et al, 2016). Although current International Guidelines are focused on PM 10 and PM 2.5 (WHO, 2006), increasing toxicological and epidemiological evidences have suggested consistent associations between health endpoints and particles characterized by smaller aerodynamic diameters (Dp) (Ibald-Mulli et al, 2002;Oberdörster et al, 2005;Karakoti et al, 2006;Ostro et al, 2015).…”