The temporal pattern of mortality responses to ambient ozone in the APHEA project
- E Samoli1,
- A Zanobetti2,
- J Schwartz2,
- R Atkinson3,
- A LeTertre4,
- C Schindler5,
- L Pérez6,
- E Cadum7,
- J Pekkanen8,9,
- A Paldy10,
- G Touloumi1,
- K Katsouyanni1
- 1Departement of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece
- 2Harvard School of Public Health, Boston, USA
- 3St George’s, University of London, UK
- 4Environmental Health Unit, National Institute of Public Health Surveillance, Paris, France
- 5Institute of Social and Preventive Medicine, University of Basel, Switzerland
- 6CREAL-Barcelona, Spain
- 7Center for Epidemiology and Environmental Health, Regional Agency for Environmental Protection, Turin, Italy
- 8Department of Environmental Health, National Public Health Institute (KTL), Finland
- 9School of Public Health and Clinical Nutrition, University of Kuopio, Finland
- 10National Institute of Environmental Health, Budapest, Hungary
- Correspondence to Dr E Samoli, Department of Hygiene and Epidemiology, University of Athens Medical School, 75 Mikras Asias Street, 115 27 Athens, Greece;
- Accepted 27 April 2009
- Published Online First 30 July 2009
Background: The temporal pattern of effects of summertime ozone (O3) in total, cardiovascular and respiratory mortality were investigated in 21 European cities participating in the APHEA-2 (Air Pollution and Health: a European Approach) project, which is fundamental in determining the importance of the effect in terms of life loss.
Methods: Data from each city were analysed separately using distributed lag models with up to 21 lags. City-specific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity.
Results: Stronger effects on respiratory mortality that extend to a period of 2 weeks were found. A 10 μg/m3 increase in O3 was associated with a 0.36% (95% CI −0.21% to 0.94%) increase in respiratory deaths for lag 0 and with 3.35% (95% CI 1.90% to 4.83%) for lags 0–20. Significant adverse health effects were found of summer O3 (June–August) on total and cardiovascular mortality that persist up to a week, but are counterbalanced by negative effects thereafter.
Conclusions: The results indicate that studies on acute health effects of O3 using single-day exposures may have overestimated the effects on total and cardiovascular mortality, but underestimated the effects on respiratory mortality.
▸ Supplemental file published online only at http://jech.bmj.com/content/vol63/issue12
Funding This work was funded through two grants from the European Commission (EC) Environment and Climate Programme (contract numbers ENV4-CT97-0534 and QLK4-CT-2001-30055).
Competing interests None.
Provenance and Peer review Not commissioned; externally peer reviewed.