Acute effects of particulate matter on respiratory diseases, symptoms and functions:: epidemiological results of the Austrian Project on Health Effects of Particulate Matter (AUPHEP)
Introduction
At the study areas described (Hauck et al., 2004) outdoor air pollution and meteorology has been monitored together with mortality and morbidity of the general population, with respiratory symptoms of school children living around the monitoring stations in all study areas, and with respiratory functions of pre-school children attending kindergartens close to the monitoring station in Vienna (capital of Austria) and of children attending a primary school close to the monitoring station in Linz (capital of Upper Austria).
A temporal correlation between high concentrations of SO2 with acute increases of respiratory and cardiopulmonary mortality had been established in 1972–83 in Vienna for men and women aged 70 years or older (Neuberger et al., 1987). Since then no such correlations had been found anymore which may be explained by the fact that SO2 in Austrian cities is no longer a key indicator of air pollution and a surrogate for fine particulates, because desulphurisation of fuels and industrial emission sources were successful. During the 1980s Austria achieved the highest SO2 reduction among the signatory states of the Helsinki Protocol (Neuberger et al., 1999), however, other sources of fine particulate matter like diesel traffic increased.
During the last decade numerous epidemiological studies on health effects of particulate matter in large cities in North America (Samet et al., 2000), Europe (Katsouyanni et al., 1997) and Australia (Morgan et al., 1998) showed excess morbidity and/or mortality in elderly populations for increases in PM10 concentrations when certain cardiovascular or pulmonary diseases were studied.
The Austrian time series study monitored PM10 together with the smaller fractions PM2.5 and PM1, gaseous pollutants and weather parameters over the period of a full year and aimed to assess PM-dependent hazards in age groups at risk. In this first synopsis on epidemiological results only respiratory outcomes are reported.
Section snippets
General population study on elderly people
Data on daily mortality and morbidity were obtained from the Ministry of Health and from Statistics Austria. Diagnoses at hospital discharge and at death are encoded according to the International Classification of Diseases (ICD). The following respiratory diseases coded 490–496 (ICD-9) were analysed for the city of Vienna and the rural control area (northern part of Lower Austria): Bronchitis (chronic and not specified), emphysema, asthma, bronchiectasis, extrinsic allergic alveolitis, and
General population study on elderly people
For Viennese males and females the association between PM and respiratory admissions is empirically linear and the association between NO2 and respiratory admissions is empirically non-linear but can be approximated in a linear fashion for the log link. These observations motivate identifying PM respectively, NO2 as the parametric component in a semiparametric Poisson-GAM All the models we fitted showed neither underdispersion nor relevant overdispersion (dispersion parameters between 1 and
Discussion
Numerous studies on respiratory mortality found no evidence for a threshold of PM effects which does not imply that no threshold exists (WHO, 2000). The reason why we did not find a significant increase of respiratory mortality related to daily changes of PM could be the relatively low exposures of limited variability, compared to other European cities of comparable size (Künzli et al., 2000). These exposures were insufficient to detect an increase in daily deaths from COPD and asthma, because
Acknowledgements
The project has been funded by the Ministry for the Environment, Youth and Family Affairs and the Ministry for Science and Traffic (contract No 14 4440/45-I/4/98), and the Austrian Academy of Sciences. Additional contributions have been made by the ambient air monitoring networks of the Austrian Provinces, the Federal Environmental Agency and several companies. We appreciate the substantial input from the project advisory board. The cooperation of the municipalities, schools, parents and
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