Cause-specific mortality and the extended effects of particulate pollution and temperature exposure.

Air pollution exposure studies in the past decade have focused on acute (days) or long-term (years) effects. We present an analysis of medium-term (weeks to months) exposure effects of particulate pollution and temperature. We assessed the associations of particulate pollution (black smoke) and temperature with age-standardized daily mortality rates over 17 years in Dublin, Ireland, using a polynomial distributed lag model of both temperature and particulate air pollution simultaneously through 40 days after exposure. When only acute effects (3-day mean) were considered, we found total mortality increased by 0.4% for each 10-microg/m3 increase in black smoke concentration. When deaths in the 40 days after exposure were considered, we found a 1.1% increase. For respiratory mortality, the estimated effect was 0.9% for acute exposures, but 3.6% for the extended follow-up. We found each increase in current-day temperature by 1 degree C was associated with a 0.4% increase in total mortality, whereas each decrease of 1 degree C was associated with a 2.6% increase in mortality in the following 40 days. For both temperature and pollution, the largest effects on cardiovascular mortality were observed immediately, whereas respiratory mortality was delayed and distributed over several weeks. These effects were two to three times greater than the acute effects reported in other studies, and approach the effects reported in longer-term survival studies. This analysis suggests that studies on the acute effects of air pollution have underestimated the total effects of temperature and particulate air pollution on mortality.

[1]  J Schwartz,et al.  Do respiratory epidemics confound the association between air pollution and daily deaths? , 2000, The European respiratory journal.

[2]  G. Donaldson Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe , 1997, The Lancet.

[3]  Andrew R. McFarland,et al.  Wind tunnel evaluation of the British Smoke Shade Sampler , 1982 .

[4]  W. Keatinge,et al.  Mortality related to cold and air pollution in London after allowance for effects of associated weather patterns. , 2001, Environmental research.

[5]  J. Schwartz,et al.  Assessing confounding, effect modification, and thresholds in the association between ambient particles and daily deaths. , 2000, Environmental health perspectives.

[6]  T P Speed,et al.  A score test for the linkage analysis of qualitative and quantitative traits based on identity by descent data from sib-pairs. , 2000, Biostatistics.

[7]  E G Luebeck,et al.  Particulate air pollution and mortality. , 1996, Epidemiology.

[8]  D L Davis,et al.  Reassessment of the lethal London fog of 1952: novel indicators of acute and chronic consequences of acute exposure to air pollution. , 2001, Environmental health perspectives.

[9]  S. Hajat,et al.  Associations of cold temperatures with GP consultations for respiratory and cardiovascular disease amongst the elderly in London. , 2002, International journal of epidemiology.

[10]  D. M. Fleming,et al.  The duration and magnitude of influenza epidemics: A study of surveillance data from sentinel general practices in England, Wales and the Netherlands , 1999, European Journal of Epidemiology.

[11]  J. Schwartz,et al.  Air pollution and cause-specific mortality in Milan, Italy, 1980-1989. , 1999, Archives of environmental health.

[12]  S L Zeger,et al.  Harvesting-resistant estimates of air pollution effects on mortality. , 1999, Epidemiology.

[13]  J Schwartz,et al.  The distributed lag between air pollution and daily deaths. , 2000, Epidemiology.

[14]  Brigitte Reusens,et al.  Influences of pre- and postnatal nutritional exposures on vascular/endocrine systems in animals. , 2000 .

[15]  J. Schwartz,et al.  Short term effects of air pollution on health: a European approach using epidemiologic time series data: the APHEA protocol. , 1996, Journal of epidemiology and community health.

[16]  Shirley Almon The Distributed Lag Between Capital Appropriations and Expenditures , 1965 .

[17]  M P Wand,et al.  Generalized additive distributed lag models: quantifying mortality displacement. , 2000, Biostatistics.

[18]  J. Schwartz,et al.  Race, gender, and social status as modifiers of the effects of PM10 on mortality. , 2000, Journal of occupational and environmental medicine.

[19]  J. Schwartz,et al.  Methodological issues in studies of air pollution and daily counts of deaths or hospital admissions. , 1996, Journal of epidemiology and community health.

[20]  D. Dockery,et al.  Acute respiratory effects of particulate air pollution. , 1994, Annual review of public health.

[21]  M. Weijenberg,et al.  The impact of heat waves and cold spells on mortality rates in the Dutch population. , 2001, Environmental health perspectives.

[22]  Antonella Zanobetti,et al.  The Temporal Pattern of Mortality Responses to Air Pollution: A Multicity Assessment of Mortality Displacement , 2002, Epidemiology.

[23]  Antonella Zanobetti,et al.  The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. , 2002, Environmental health perspectives.

[24]  F A Boddy,et al.  Seasonal variation in mortality in Scotland. , 2000, International journal of epidemiology.

[25]  W. Keatinge Winter mortality and its causes , 2002, International journal of circumpolar health.

[26]  F. Dominici,et al.  On the use of generalized additive models in time-series studies of air pollution and health. , 2002, American journal of epidemiology.

[27]  J. Schwartz,et al.  Harvesting and long term exposure effects in the relation between air pollution and mortality. , 2000, American journal of epidemiology.

[28]  Scott L Zeger,et al.  Temperature and mortality in 11 cities of the eastern United States. , 2002, American journal of epidemiology.

[29]  W. Keatinge,et al.  Early increases in ischaemic heart disease mortality dissociated from and later changes associated with respiratory mortality after cold weather in south east England. , 1997, Journal of epidemiology and community health.

[30]  D. Dockery,et al.  Effect of air-pollution control on death rates in Dublin, Ireland: an intervention study , 2002, The Lancet.

[31]  J Schwartz,et al.  Short-term effects of particulate air pollution on cardiovascular diseases in eight European cities , 2002, Journal of epidemiology and community health.

[32]  J. Schwartz,et al.  The Lag Structure Between Particulate Air Pollution and Respiratory and Cardiovascular Deaths in 10 US Cities , 2001, Journal of occupational and environmental medicine.

[33]  W. Cleveland Robust Locally Weighted Regression and Smoothing Scatterplots , 1979 .

[34]  E. Hennessy Air pollution and short term mortality , 2002, BMJ : British Medical Journal.