Current Levels Of Air Pollution Research Articles

Air Pollution and Lung Cancer

The health effects of air pollution have been subject to intense study in recent years. These effects have been found in short-term studies, which relate day-to-day variations in air pollution and health, and long-term studies, which have followed cohorts of exposed individuals over time. Epidemiological evidence has concurred with clinical and experimental evidence to correlate current levels of ambient air pollution, both indoors and outdoors, with respiratory effects. The association between ambient air pollution exposure and lung cancer risk indicates that long-term exposure to air pollution may cause lung cancer. In the 1950s evidence of an ongoing epidemic of lung cancer in the United States and Europe led researchers to examine the role of outdoor air pollution, which was considered by some to be a likely cause. This concern is based on the fact that known carcinogens continue to be released into outdoor air from industrial sources, power plants, and motor vehicles. The present article reviews the epidemiologic evidence for this association and discusses the limitations of current studies for estimating the lung cancer risk in the general population. It also identifies research needs and suggests possible approaches to addressing outstanding questions like the causality assessment, which can benefit from biomarker research.

Ambient air pollution and term birth weight in Texas from 1998 to 2004

Previous studies have explored the association between air pollution levels and adverse birth outcomes such as lower birth weight. Existing literature suggests an association, although results across studies are not consistent. Additional research is needed to confirm the effect, investigate the exposure window of importance, and distinguish which pollutants cause harm. We assessed the association between ambient pollutant concentrations and term birth weight for 1,548,904 births in TX from 1998 to 2004. Assignment of prenatal exposure to air pollutants was based on maternal county of residence at the time of delivery. Pollutants examined included particulate matter with aerodynamic diameter ≤10 and ≤2.5 µm (PM10 and PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). We applied a linear model with birth weight as a continuous variable. The model was adjusted for known risk factors and region. We assessed pollutant effects by trimester to identify biological exposure window of concern, and explored interaction due to race/ethnicity. An interquartile increase in ambient pollutant concentrations of SO2 and O3 was associated with a 4.99-g (95% confidence interval [CI], 1.87–8.11) and 2.72-g (95% CI, 1.11–4.33) decrease in birth weight, respectively. Lower birth weight was associated with exposure to O3 in the first and second trimester, whereas results were not significant for other pollutants by trimester. A positive association was exhibited for PM2.5 in the first trimester. Effects estimates for PM10 and PM2.5 were inconsistent across race/ethnic groups. Current ambient air pollution levels may be increasing the risk of lower birth weight for some pollutants. These risks may be increased for certain racial/ethnic groups. Additional research including consideration of improved methodology is needed to investigate these findings. Future studies should examine the influence of residual confounding. Implications: This is one of the most comprehensive studies examining criteria air pollutants and lower birth weight in Texas. Our findings confirm results found previously for adverse effects of the air pollutant SO2 on lower birth weight. Results from our study suggest that adverse pregnancy outcomes such as lower birth weight can occur even while maintaining air pollution levels below regulatory standards. Future studies should incorporate the assessment of differential pollutant exposure as well as effect estimates by race/ethnicity with individual and community-level social factors in order to enhance our understanding of how physical, social, and host factors influence birth outcomes. Supplemental Materials: Supplementary information relating to characteristics of excluded births, distribution of air pollutant monitors by pollutant, and correlation coefficients of the air pollutants is available in the publisher's online edition of the Journal of the Air & Waste Management Association.

Ambient Air Pollution and Low Birth Weight in Texas, 1998–2004

O-29C4-2 Background/Aims: Existing literature supports a causal link between maternal air pollution exposure and adverse birth outcomes such as infant low birth weight, although results across studies are not consistent. Additional research is needed to confirm the effect, investigate the exposure window of importance, and distinguish which pollutants cause harm. We investigated relationships between birth weight and maternal exposure during pregnancy to particulate matter with aerodynamic diameter <10, <2.5 μm (PM10, PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) for 1,548,904 births in Texas from 1998 to 2004. Methods: Analysis included linear models with birth weight as a continuous variable, and logistic models for low birth weight (<2500 g). Exposure was assigned as the average county-level concentration over gestation and each trimester based on mother's residence. We adjusted for gestational length, prenatal care, type of delivery, child's sex, birth order, weather, year, and mother's race, education, marital status, age, and tobacco use. Results: An interquartile increase in gestational exposure to SO2 and O3 was associated with a 4.99 g (95% confidence interval [CI]: 1.87–8.11) and 2.72 g (95% CI: 1.11–4.33) lower birth weight, respectively. A positive association was found for exposure to PM2.5. Effect estimates for SO2 were higher for infants of Hispanic mothers compared to those of black and white mothers, whereas effects estimates for O3 were higher for black mothers compared with Hispanic and white mothers. Conclusion: Current ambient air pollution levels may be increasing the risk of infant low birth weight, and these risks may also increase for certain portions of the population. Additional research is needed to investigate these findings.

Ambient air pollution and hospital admission in Shanghai, China

No prior studies exist in Mainland China examining the association of outdoor air pollution with hospital admissions. In this study, we conducted a time-series analysis to examine the association of outdoor air pollutants (PM 10, SO 2, and NO 2) with both total and cause-specific hospital admission in Shanghai, using three years of daily data (2005–2007). Hospital admission and air pollution data were collected from the Shanghai Health Insurance Bureau and Shanghai Environmental Monitoring Center. Natural spline model was used to analyze the data. We found outdoor air pollution was associated with increased risk of total and cardiovascular hospital admission in Shanghai. The effect estimates of air pollutants varied by lag (L) structures of pollutants’ concentrations. For lag 5, a 10 μg/m 3 increase in concentration of PM 10, SO 2 and NO 2 corresponded to 0.18% (95% CI: −0.15%, 0.52%), 0.63% (95% CI: 0.03%, 1.23%), and 0.99% (95% CI: 0.10%, 1.88%) increase of total hospital admission; and 0.23% (95% CI: −0.03%, 0.48%), 0.65% (95% CI: 0.19%, 1.12%), and 0.80% (95% CI: 0.10%, 1.49%) increase of cardiovascular hospital admission. The associations appeared to be more evident in the cool season (from November to April) than in the warm season (from May to October). We found significant effects of gaseous pollutants (SO 2 and NO 2) after adjustment for PM 10. Our analyses provide the first evidence in China that the current air pollution level has an effect on hospital admission and strengthen the rationale for further limiting air pollution levels in Shanghai.

Association of ambient air pollution with hospital outpatient and emergency room visits in Shanghai, China

Few studies exist in China examining the association of ambient air pollution with morbidity outcomes. We conducted a time-series analysis to examine the association of outdoor air pollutants (PM 10, SO 2, and NO 2) with hospital outpatient and emergency room visits in Shanghai, China, using 3 years of daily data (2005–2007). Hospital and air pollution data were collected from the Shanghai Health Insurance Bureau and Shanghai Environmental Monitoring Center. Using a natural spline model, we examined effect of air pollutants with different lag structures including both single-day lag and multi-day lag. We examined effects of air pollution for the warm season (from April to September) and cool season (from October to March) separately. We found outdoor air pollution (SO 2 and NO 2) was associated with increased risk of hospital outpatient and emergency room visits in Shanghai. The effect estimates varied for different lag structures of pollutants’ concentrations. For lag 3, a 10 μg/m 3 increase in concentration of PM 10, SO 2 and NO 2 corresponded to 0.11% (95%CI: −0.03%, 0.26%), 0.34% (95%CI: 0.06%, 0.61%) and 0.55% (95%CI: 0.14%, 0.97%) increase of outpatient visit; and 0.01% (95%CI: −0.09%, 0.10%), 0.17% (95%CI: 0.00%, 0.35%) and 0.08% (95%CI: −0.18%, 0.33%) increase of emergency room visit. The associations appeared to be more evident in the cool season than in the warm season. In conclusion, short-term exposure to outdoor air pollution was associated with increased risk of hospital outpatient and emergency room visits in Shanghai. Our analyses provide evidence that the current air pollution level has an adverse health effect and strengthen the rationale for further limiting air pollution levels in the city.

Do current levels of air pollution kill? The impact of air pollution on population mortality in England

The current air quality limit values for airborne pollutants in the UK are low by historical standards and are at levels that are believed not to harm health. We assess whether this view is correct. We examine the relationship between common sources of airborne pollution and population mortality for England. We use data at local authority level for 1998-2005 to examine whether current levels of airborne pollution, as measured by annual mean concentrations of carbon monoxide, nitrogen dioxide, particulate matter less than 10 microm in diameter (PM(10)) and ozone, are associated with excess deaths. We examine all-cause mortality and deaths from specific cardiovascular and respiratory causes that are known to be exacerbated by air pollution. The panel nature of our data allows us to control for any unobserved time-invariant associations at local authority level between high levels of air pollution and poor population health and for common time trends. We estimate multi-pollutant models to allow for the fact that three of the pollutants are closely correlated. We find that higher levels of PM(10) and ozone are associated with higher mortality rates, and the effect sizes are considerably larger than previously estimated from the primarily time series studies for England.

Air pollution and childhood asthma: recent advances and future directions

Current levels of air pollution are consistently associated with asthma development and morbidity among children, suggesting that current regulatory policies may be insufficient. This review will describe recent studies that have examined specific emission sources or components of pollutants that may be associated with pediatric asthma and identify subpopulations that may be particularly susceptible to the effects of air pollution exposure. Important advances include new characterizations of the effects of traffic-related air pollution in urban areas. They also include the application of novel exposure and outcome measures such as pollution estimates derived from land use regression modeling and biological markers of airway inflammation. Additionally, studies have identified host susceptibility characteristics that may modify responses to air pollution exposure, including polymorphisms in oxidative stress genes and epigenetic alterations. Identifying specific sources and toxic constituents of air pollution and accurately assessing air pollutant-related asthma outcomes are needed to better direct control strategies. Further research is needed to identify additional host factors that confer increased susceptibility to air pollution exposure. Future therapy to reduce the adverse effects of air pollution on respiratory disease will likely depend on targeting susceptible populations for intervention.

PM10과 오존이 연령군별 천식 입원에 미치는 영향

This study investigated the age dependencies in ambient air pollution-associated asthma hospitalization from 2003 to 2005 in Seoul. For all ages and the age groups of 0-14, 15-64, and 65+years, the Generalized Additive Model (GAM) was used to estimate the relative risks of daily asthma hospitalization associated with changes in particulate matter and ozone. The time-trends, seasonal variances, day effects, temperature, humidity, and pressure at sea level were controlled in the models. Significant associations were observed between asthma hospitalization and the levels of <TEX>$PM_{10}$</TEX> and <TEX>$O_3$</TEX>. The relative risks (RRs) of asthma hospitalization for every 10 unit increases in <TEX>$PM_{10}({\mu}g/m^3)$</TEX> and <TEX>$O_3$</TEX>(ppb) were 1.008 (95% CI 1.005-1.012), and 1.012 (95% CI 1.003-1.020), respectively. Evaluated over <TEX>$10\;{\mu}g/m^3$</TEX> increase in <TEX>$PM_{10}$</TEX>, we found the relative risks of asthma hospitalization to be 1.009 (95% CI 1.004-1.014) in 0-14 age group, and 1.015 (95% CI 1.008-1.022) in 65+ age group. Considering 10 ppb increase in <TEX>$O_3$</TEX>, those were 1.014 (95% CI 1.003-1.024) in 0-14 age group, and 1.025 (95% CI 1.009-1.041) in 65+ age group. It was concluded that current levels of ambient air pollution in Seoul make a significant contribution to the variation in daily asthma hospitalization. Further reduction in air pollution is necessary to protect the health of the community, especially that of the higher risky groups including children and elderly population.

Air pollution and population health: a global challenge

"Air pollution and population health" is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still at relatively high levels, though the levels have been gradually decreasing or have remained stable during rapid economic development. In recent years, several hundred epidemiological studies have emerged showing adverse health effects associated with short-term and long-term exposure to air pollutants. Time-series studies conducted in Asian cities also showed similar health effects on mortality associated with exposure to particulate matter (PM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)) and ozone (O(3)) to those explored in Europe and North America. The World Health Organization (WHO) published the "WHO Air Quality Guidelines (AQGs), Global Update" in 2006. These updated AQGs provide much stricter guidelines for PM, NO(2), SO(2) and O(3). Considering that current air pollution levels are much higher than the WHO-recommended AQGs, interim targets for these four air pollutants are also recommended for member states, especially for developing countries in setting their country-specific air quality standards. In conclusion, ambient air pollution is a health hazard. It is more important in Asian developing countries within the context of pollution level and population density. Improving air quality has substantial, measurable and important public health benefits.

Hospitalizações por causas respiratórias e cardiovasculares associadas à contaminação atmosférica no Município de São Paulo, Brasil

The recognition that current air pollution levels cause harmful health effects makes the definition of the air quality regulatory process imperative. This study examines the association between exposure to air pollution and hospital admissions in the city of São Paulo, aiming to support the development of measures to reduce such health risks. The authors conducted an ecological time series study of hospital admissions for respiratory and cardiovascular diseases in children and the elderly in relation to daily air pollution levels, using generalized additive Poisson regression models. All air pollutants except ozone showed a statistically significant association with admissions for respiratory and cardiovascular diseases. An increase of 10 microg/m3 in fine particulate matter was associated with a 4.6% increase in asthma admissions in children and a 4.3% increase in admissions for chronic obstructive pulmonary disease and 1.5% for ischemic heart disease in the elderly. These associations are consistent with a large body of literature in this area and indicate that the current air pollution levels in São Paulo have an important negative impact on the population's health.

Air pollution: A threat to the health of our children

Current air pollution levels pose a threat to the health of children starting from conception. The scientific evidence is presented for mortality, morbidity, and sub-clinical effects. The first section deals with exposure data, the following sections with the evidence of health effects from epidemiology and toxicology leading to recommendations. Improved air quality reduces the number of infants' deaths as well as disease and pain. Medical doctors have a responsibility to know the facts and to advise their patients. Doctors when visiting their patients' homes should be aware of the possibly grave impact of the indoor environment for the respiratory health of their patients. They should recognize and advise the parents on problems associated with environmental tobacco smoke, poor ventilation, mould growth, and maintenance of heating installations. With regard to outdoor air pollution, doctors could serve as role models and also advise their patients and parents on environmentally friendly behaviour. Such behaviour not only calls for personal commitment but also for the right infrastructure to be provided (e.g. public transport, district heating). Doctors should be proactive in the community and in their country as advocates for a healthier environment for our children.

Gaseous Air Pollutants and Hospitalization for Respiratory Disease in the Neonatal Period

ObjectiveCurrent levels of ambient air pollution are associated with morbidity and mortality in the general population. To determine the influence of gaseous air pollutants on neonatal respiratory morbidity, we tested the association between daily respiratory hospitalizations and daily concentrations of ambient air pollution gases: ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide, in 11 large Canadian cities.Study DesignDaily time-series analyses were employed and results were adjusted for day of the week, temperature, barometric pressure, and relative humidity.ResultsThe percent increases in hospitalization associated with an increase in air pollution equivalent to its interquartile range were 3.35 [95% confidence interval (CI), 1.73–4.77] for O3, 2.85 (95% CI, 1.68–4.02) for NO2, 1.66 (95% CI, 0.63–2.69) for SO2, and 1.75 (95% CI, 0.48–3.02) for CO. The independent effect of all pollutants combined was 9.61% (95% CI, 4.52–14.7%).ConclusionOur results suggest that neonates are experiencing adverse effects of air pollution at current levels in Canada, and that accounts for a significant proportion of hospitalizations in this subgroup.

Pollution atmosphérique et poumon : approche épidémiologique

Epidemiological evidence has concurred with clinical and experimental evidence to correlate current levels of ambient air pollution, both indoors and outdoors, with respiratory effects. In this respect, the use of specific epidemiological methods has been crucial. Common outdoor pollutants are particulate matter, nitrogen dioxide, carbon monoxide, volatile organic compounds and ozone. Short-term effects of outdoor air pollution include changes in lung function, respiratory symptoms and mortality due to respiratory causes. Increase in the use of health care resources has also been associated with short-term effects of air pollution. Long-term effects of cumulated exposure to urban air pollution include lung growth impairment, chronic obstructive pulmonary disease (COPD), lung cancer, and probably the development of asthma and allergies. Lung cancer and COPD have been related to a shorter life expectancy. Common indoor pollutants are environmental tobacco smoke, particulate matter, nitrogen dioxide, carbon monoxide, volatile organic compounds and biological allergens. Concentrations of these pollutants can be many times higher indoors than outdoors. Indoor air pollution may increase the risk of irritation phenomena, allergic sensitisation, acute and chronic respiratory disorders and lung function impairment. Recent conservative estimates have shown that 1.5-2 million deaths per year worldwide could be attributed to indoor air pollution. Further epidemiological research is necessary to better evaluate the respiratory health effects of air pollution and to implement protective programmes for public health.

Literature review: The best new articles in the specialty of allergy, asthma, and immunology, 2004–2005

A series of eight articles from the published literature for the period 2004-2005 was selected for review in this article. Small-airway obstruction in chronic obstructive pulmonary disease (COPD) and its management were the subjects of the first two articles reviewed in this commentary. Progression of COPD from the Global Initiative for Chronic Obstructive Lung Disease stages 0-4 was found to be most strongly associated with thickening of the airway wall and each of its compartments by a repair or remodeling process. Management of COPD, including the addition of pulmonary rehabilitation to treatment regimens, may reduce symptoms and improve exercise performance. The addition of theophylline or an inhaled corticosteroid (or both) to optimal inhaled bronchodilator therapy together with aggressive treatment of hypoxemia were suggested to provide additional benefits and lung-volume-reduction surgery and transplantation were recommended as other treatment options for a subgroup of patients with very severe disease. The next three articles addressed the impact of outdoor and indoor air pollution and the effects of childhood asthma as antecedents of asthma in the adult in later life. Current levels of air pollution are known to have chronic, adverse effects on lung development in children from age 10 to 18 years, leading to clinically significant deficits in attained forced expiratory volume in one second as children reach adulthood. Among inner-city children with atopic asthma, an individualized, home-based, comprehensive environmental intervention resulted in reduced asthma-associated morbidity and supported that a multifaceted, home-based, environmental intervention approach may be beneficial. The prognosis of childhood allergic asthma in adulthood was found to be determined largely early in life and the degree of atopy appeared to be a critical determinant of asthma persistence. The next article reviewed the controversial area of the treatment of chronic rhinosinusitis caused by fungi. Intranasal Amphotericin B was shown to reduce inflammatory mucosal thickening on both CT scan and nasal endoscopy and decreased the levels of intranasal markers for eosinophilic inflammation in patients with chronic rhinosinusitis. The last two articles reviewed two papers dealing with the role that gastrointestinal immune responses play in maintaining protective immunity in health and a critical role in the pathogenesis of a wide variety of clinical disorders associated with food allergy as well as the suspected pivotal role of oral tolerance to dietary proteins for the prevention of food allergy. The mode of antigen uptake in the gut and different regulatory immune cells appear to play critical roles in maintenance of oral tolerance as shown in many animal model systems.

A protocol for investigation of the effects of outdoor air pollution on stroke incidence, phenotypes and survival using the South London Stroke Register

Stroke is a major cause of death and disability. About 5.3 million people die every year from stroke worldwide with over 9 million people surviving at any one time after suffering a stroke. About 1 in 4 men and 1 in 5 women aged 45 years will suffer a stroke if they live to their 85th year. It is estimated that by 2023 there will be an absolute increase in the number of people experiencing a first ever stroke of about 30% compared with 1983.In the UK, stroke is the third commonest cause of death and the most common cause of adult physical disability and consumes 5% of the health and social services budget. Stroke is assuming strategic public health importance because of increased awareness in society, an ageing population and emerging new treatments. It is an NHS health service and research priority, being identified as a target in Our Healthier Nation and the NSF for Older People for prevention and risk factor control and in the NHS Plan as a disease requiring intermediate care planning and reduction in inequalities of care.Whilst a number of risk factors for stroke are well known (e.g. increasing age, ethnicity, socioeconomic deprivation, hypertension), the potential importance of outdoor air pollution as a modifiable risk factor is much less well recognised. This is because studies to date are inconclusive or have methodological limitations. In Sheffield, we estimated that 11% of stroke deaths may be linked to current levels of outdoor air pollution and this high figure is explained by the fact that so many people are exposed to air pollution.We plan to study the effects of outdoor air pollution on stroke using a series of epidemiological (i.e. population based) studies. The purpose of this project is:• to examine if short term increases in pollution can trigger a stroke in susceptible individuals;• to investigate if the occurrence of stroke is higher amongst people living in more polluted areas (which would be explained by a combination of exposure to short term increases and longer term exposure to higher pollution levels); and• to see if people living in more polluted areas have reduced survival following their stroke.We will use geographical information systems, robust statistical methods and powerful grid computing facilities to link and analyse the data. The datasets we will use are the South London Stroke Register database, daily monitored pollution data from national monitoring networks and modelled pollution data for London from the Greater London Authority. The South London Stroke Register records information on all patients who suffer a stroke ("incident" cases) living within a defined area. This stroke incidence dataset offers major advantages over previous studies examining the effects of pollution on hospital admissions and mortality, as not all patients with stroke are admitted or die and there may be a delay between the onset of stroke and admission or death. In addition, it contains other useful information, particularly the type of stroke people have suffered.Air pollution is a potentially modifiable risk factor for stroke. This study will provide robust population level evidence regarding the effects of outdoor air pollution on stroke. If it confirms the link, it will suggest to policy-makers at national and international levels that targeting policy interventions at high pollution areas may be a feasible option for stroke prevention.

Air pollution: from lung to heart.

Epidemiological, clinical, and experimental evidence correlates current levels of ambient air pollution with both respiratory and cardiovascular effects. Oxidative stress, inflammation, induction of a pro-coagulatory state and dysfunction of the autonomic nervous system appear to play a major role. Acute effects include changes in lung function, heart rate, blood pressure and inflammatory state, and clinical measures such as respiratory symptoms, thrombosis, myocardial infarction, arrhythmia, stroke, and death. In addition, there is an increase in the use of health care resources due to these effects. Long-term consequences of cumulated exposure include adverse effects on lung growth, chronic bronchitis, lung cancer, and probably the development of asthma and atherosclerosis. These morbidities ultimately lead to shorter life expectancy. Host factors including genotype are important modifiers of the effects of air pollution. Further research will help identify susceptible subgroups and disentangle specific effects and mechanisms associated with various constituents and sources of air pollution.

Air pollution: from lung to heart.

Epidemiological, clinical, and experimental evidence correlates current levels of ambient air pollution with both respiratory and cardiovascular effects. Oxidative stress, inflammation, induction of a pro-coagulatory state and dysfunction of the autonomic nervous system appear to play a major role. Acute effects include changes in lung function, heart rate, blood pressure and inflammatory state, and clinical measures such as respiratory symptoms, thrombosis, myocardial infarction, arrhythmia, stroke, and death. In addition, there is an increase in the use of health care resources due to these effects. Long-term consequences of cumulated exposure include adverse effects on lung growth, chronic bronchitis, lung cancer, and probably the development of asthma and atherosclerosis. These morbidities ultimately lead to shorter life expectancy. Host factors including genotype are important modifiers of the effects of air pollution. Further research will help identify susceptible subgroups and disentangle specific effects and mechanisms associated with various constituents and sources of air pollution.

Decline of Ambient Air Pollution Levels and Improved Respiratory Health in Swiss Children

The causality of observed associations between air pollution and respiratory health in children is still subject to debate. If reduced air pollution exposure resulted in improved respiratory health of children, this would argue in favor of a causal relation. We investigated whether a rather moderate decline of air pollution levels in the 1990s in Switzerland was associated with a reduction in respiratory symptoms and diseases in school children. In nine Swiss communities, 9,591 children participated in cross-sectional health assessments between 1992 and 2001. Their parents completed identical questionnaires on health status and covariates. We assigned to each child an estimate of regional particles with an aerodynamic diameter < 10 μg/m3 (PM10) and determined change in PM10 since the first survey. Adjusted for socioeconomic, health-related, and indoor factors, declining PM10 was associated in logistic regression models with declining prevalence of chronic cough [odds ratio (OR) per 10-μg/m3 decline = 0.65, 95% confidence interval (CI), 0.54–0.79], bronchitis (OR = 0.66; 95% CI, 0.55–0.80), common cold (OR = 0.78; 95% CI, 0.68–0.89), nocturnal dry cough (OR = 0.70; 95% CI, 0.60–0.83), and conjunctivitis symptoms (OR = 0.81; 95% CI, 0.70–0.95). Changes in prevalence of sneezing during pollen season, asthma, and hay fever were not associated with the PM10 reduction. Our findings show that the reduction of air pollution exposures contributes to improved respiratory health in children. No threshold of adverse effects of PM10 was apparent because we observed the beneficial effects for relatively small changes of rather moderate air pollution levels. Current air pollution levels in Switzerland still exceed limit values of the Swiss Clean Air Act; thus, children’s health can be improved further.

Evaluación en cinco ciudades españolas del impacto en salud de la contaminación atmosférica por partículas: Proyecto europeo APHEIS

The health effects of air pollution have been analyzed in numerous studies over recent years, thus having made it possible to quantify the relationship between the two. This study is aimed at analyzing the theoretical benefits which would be achieved by meeting the air quality objectives set forth under EC Directive 1999/30/EC with regard to suspended particles. The exposure measurement was taken for Black Smoke (Barcelona, Bilbao, Valencia) and suspended particles under 10 microm (PM10) (Bilbao, Madrid y Sevilla). The health indicators calculated were the mortality due to all causes and respiratory and cardiovascular causes, and emergency hospital admissions and mortality due to respiratory and cardiovascular causes. In the case of PM10 the impact has been calculated because its effects to short-term, within a period of up to 40 days following exposure, and to long-term. For Black Smoke the effects only has been calculated to short-term. The daily levels of PM10 from exceeding 50 microg/m3 in Bilbao, Madrid and Sevilla cause the earlier death of 1.4/100,000 individuals per year because its effects. The effect within a period of up to 40 days following exposure is of 2.8 deaths/100,000. The total number of deaths per year which may be later due to long-term exposure if the yearly average is lowered to 20 microg/m3 is 68/100,000. The health impact of the current air pollution levels is quantifiable and is not insignificant. APHEIS and the impact evaluations may be of aid in healthcare planning and environmental policies.

A review and critique of the EPA’s rationale for a fine particle standard

I review the rationale for the Environmental Protection Agency’s 1996 fine particle standard, which was based almost entirely on the epidemiological data with neither support from Toxicology nor understanding of mechanism. While many epidemiological papers available in 1996 reported associations between ambient particles and adverse effects on human health, many others did not and the evidence fell far short of supporting a causal association between particle mass concentration and human health. The literature appearing after 1996 further complicates the picture. The large studies that have appeared after 1996, such as National Mortality Morbidity and Air Pollution Study, and the reanalyses of the American Cancer Society II study, report risks that are substantially smaller than the risks reported in the 1996 Criteria Document and Staff Paper. Moreover, concerns about confounding by weather, temporal trends and co-pollutants remain unresolved. Other issues having to do with model choice have resurfaced as a result of reanalyses of critical data to address a glitch in a widely used software package for time-series epidemiology studies of air pollution. Finally, contemporary examples show that the results of observational epidemiology studies can be seriously biased, particularly when estimated risks are small, as is the case with studies of air pollution. The Agency has largely ignored these issues. I conclude that a particle mass standard is not defensible on the basis of a causal association between ambient particle mass and adverse effects on human health. Such a standard may be justifiable on the basis of the precautionary principle, however. The Agency could argue that the Science raises concerns about current levels of air pollution, and that reduction of ambient fine particulate matter mass, if it could be achieved without an increase in the level of the ultrafines, could have positive effects on human health. If the Agency justifies a particulate matter mass standard on these grounds then the debate over the form and level of the standard will, for all practical purposes, belong strictly in the Policy arena.