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. 1995 May;103(5):472–480. doi: 10.1289/ehp.95103472

Health effects of particulate air pollution: time for reassessment?

C A Pope 3rd 1, D V Bates 1, M E Raizenne 1
PMCID: PMC1523269  PMID: 7656877

Abstract

Numerous studies have observed health effects of particulate air pollution. Compared to early studies that focused on severe air pollution episodes, recent studies are more relevant to understanding health effects of pollution at levels common to contemporary cities in the developed world. We review recent epidemiologic studies that evaluated health effects of particulate air pollution and conclude that respirable particulate air pollution is likely an important contributing factor to respiratory disease. Observed health effects include increased respiratory symptoms, decreased lung function, increased hospitalizations and other health care visits for respiratory and cardiovascular disease, increased respiratory morbidity as measured by absenteeism from work or school or other restrictions in activity, and increased cardiopulmonary disease mortality. These health effects are observed at levels common to many U.S. cities including levels below current U.S. National Ambient Air Quality Standards for particulate air pollution.

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Selected References

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  1. Archer V. E. Air pollution and fatal lung disease in three Utah counties. Arch Environ Health. 1990 Nov-Dec;45(6):325–334. doi: 10.1080/00039896.1990.10118751. [DOI] [PubMed] [Google Scholar]
  2. Bates D. V., Baker-Anderson M., Sizto R. Asthma attack periodicity: a study of hospital emergency visits in Vancouver. Environ Res. 1990 Feb;51(1):51–70. doi: 10.1016/s0013-9351(05)80182-3. [DOI] [PubMed] [Google Scholar]
  3. Bates D. V. Health indices of the adverse effects of air pollution: the question of coherence. Environ Res. 1992 Dec;59(2):336–349. doi: 10.1016/s0013-9351(05)80040-4. [DOI] [PubMed] [Google Scholar]
  4. Bates D. V., Sizto R. Air pollution and hospital admissions in Southern Ontario: the acid summer haze effect. Environ Res. 1987 Aug;43(2):317–331. doi: 10.1016/s0013-9351(87)80032-4. [DOI] [PubMed] [Google Scholar]
  5. Bates D. V., Sizto R. The Ontario Air Pollution Study: identification of the causative agent. Environ Health Perspect. 1989 Feb;79:69–72. doi: 10.1289/ehp.897969. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Bobak M., Leon D. A. Air pollution and infant mortality in the Czech Republic, 1986-88. Lancet. 1992 Oct 24;340(8826):1010–1014. doi: 10.1016/0140-6736(92)93017-h. [DOI] [PubMed] [Google Scholar]
  7. Braun-Fahrländer C., Ackermann-Liebrich U., Schwartz J., Gnehm H. P., Rutishauser M., Wanner H. U. Air pollution and respiratory symptoms in preschool children. Am Rev Respir Dis. 1992 Jan;145(1):42–47. doi: 10.1164/ajrccm/145.1.42. [DOI] [PubMed] [Google Scholar]
  8. Brunekreef B., Kinney P. L., Ware J. H., Dockery D., Speizer F. E., Spengler J. D., Ferris B. G., Jr Sensitive subgroups and normal variation in pulmonary function response to air pollution episodes. Environ Health Perspect. 1991 Jan;90:189–193. doi: 10.1289/ehp.90-1519500. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. CIOCCO A., THOMPSON D. J. A follow-up of Donora ten years after: methodology and findings. Am J Public Health Nations Health. 1961 Feb;51:155–164. doi: 10.2105/ajph.51.2.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Chappie M., Lave L. The health effects of air pollution: a reanalysis. J Urban Econ. 1982 Nov;12:346–376. doi: 10.1016/0094-1190(82)90022-5. [DOI] [PubMed] [Google Scholar]
  11. Chestnut L. G., Schwartz J., Savitz D. A., Burchfiel C. M. Pulmonary function and ambient particulate matter: epidemiological evidence from NHANES I. Arch Environ Health. 1991 May-Jun;46(3):135–144. doi: 10.1080/00039896.1991.9937440. [DOI] [PubMed] [Google Scholar]
  12. Dassen W., Brunekreef B., Hoek G., Hofschreuder P., Staatsen B., de Groot H., Schouten E., Biersteker K. Decline in children's pulmonary function during an air pollution episode. J Air Pollut Control Assoc. 1986 Nov;36(11):1223–1227. doi: 10.1080/00022470.1986.10466168. [DOI] [PubMed] [Google Scholar]
  13. Delfino R. J., Becklake M. R., Hanley J. A. Reliability of hospital data for population-based studies of air pollution. Arch Environ Health. 1993 May-Jun;48(3):140–146. doi: 10.1080/00039896.1993.9940812. [DOI] [PubMed] [Google Scholar]
  14. Dockery D. W., Pope C. A., 3rd Acute respiratory effects of particulate air pollution. Annu Rev Public Health. 1994;15:107–132. doi: 10.1146/annurev.pu.15.050194.000543. [DOI] [PubMed] [Google Scholar]
  15. Dockery D. W., Pope C. A., 3rd, Xu X., Spengler J. D., Ware J. H., Fay M. E., Ferris B. G., Jr, Speizer F. E. An association between air pollution and mortality in six U.S. cities. N Engl J Med. 1993 Dec 9;329(24):1753–1759. doi: 10.1056/NEJM199312093292401. [DOI] [PubMed] [Google Scholar]
  16. Dockery D. W., Schwartz J., Spengler J. D. Air pollution and daily mortality: associations with particulates and acid aerosols. Environ Res. 1992 Dec;59(2):362–373. doi: 10.1016/s0013-9351(05)80042-8. [DOI] [PubMed] [Google Scholar]
  17. Dockery D. W., Speizer F. E., Stram D. O., Ware J. H., Spengler J. D., Ferris B. G., Jr Effects of inhalable particles on respiratory health of children. Am Rev Respir Dis. 1989 Mar;139(3):587–594. doi: 10.1164/ajrccm/139.3.587. [DOI] [PubMed] [Google Scholar]
  18. Dockery D. W., Ware J. H., Ferris B. G., Jr, Speizer F. E., Cook N. R., Herman S. M. Change in pulmonary function in children associated with air pollution episodes. J Air Pollut Control Assoc. 1982 Sep;32(9):937–942. doi: 10.1080/00022470.1982.10465494. [DOI] [PubMed] [Google Scholar]
  19. Ellison J. M., Waller R. E. A review of sulphur oxides and particulate matter as air pollutants with particular reference to effects on health in the United Kingdom. Environ Res. 1978 Jul;16(1-3):302–325. doi: 10.1016/0013-9351(78)90164-0. [DOI] [PubMed] [Google Scholar]
  20. Euler G. L., Abbey D. E., Magie A. R., Hodgkin J. E. Chronic obstructive pulmonary disease symptom effects of long-term cumulative exposure to ambient levels of total suspended particulates and sulfur dioxide in California Seventh-Day Adventist residents. Arch Environ Health. 1987 Jul-Aug;42(4):213–222. [PubMed] [Google Scholar]
  21. Fairley D. The relationship of daily mortality to suspended particulates in Santa Clara County, 1980-1986. Environ Health Perspect. 1990 Nov;89:159–168. doi: 10.1289/ehp.9089159. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. HILL A. B. THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION? Proc R Soc Med. 1965 May;58:295–300. [PMC free article] [PubMed] [Google Scholar]
  23. HOLLAND W. W., REID D. D. THE URBAN FACTOR IN CHRONIC BRONCHITIS. Lancet. 1965 Feb 27;1(7383):445–448. doi: 10.1016/s0140-6736(65)91584-9. [DOI] [PubMed] [Google Scholar]
  24. Hoek G., Brunekreef B. Acute effects of a winter air pollution episode on pulmonary function and respiratory symptoms of children. Arch Environ Health. 1993 Sep-Oct;48(5):328–335. doi: 10.1080/00039896.1993.9936721. [DOI] [PubMed] [Google Scholar]
  25. Holland W. W., Bennett A. E., Cameron I. R., Florey C. V., Leeder S. R., Schilling R. S., Swan A. V., Waller R. E. Health effects of particulate pollution: reappraising the evidence. Am J Epidemiol. 1979 Nov;110(5):527–659. doi: 10.1093/oxfordjournals.aje.a112836. [DOI] [PubMed] [Google Scholar]
  26. Ito K., Thurston G. D., Hayes C., Lippmann M. Associations of London, England, daily mortality with particulate matter, sulfur dioxide, and acidic aerosol pollution. Arch Environ Health. 1993 Jul-Aug;48(4):213–220. doi: 10.1080/00039896.1993.9940362. [DOI] [PubMed] [Google Scholar]
  27. Johnson K. G., Loftsgaarden D. O., Gideon R. A. The effects of Mount St. Helens volcanic ash on the pulmonary function of 120 elementary school children. Am Rev Respir Dis. 1982 Dec;126(6):1066–1069. doi: 10.1164/arrd.1982.126.6.1066. [DOI] [PubMed] [Google Scholar]
  28. Kinney P. L., Ozkaynak H. Associations of daily mortality and air pollution in Los Angeles County. Environ Res. 1991 Apr;54(2):99–120. doi: 10.1016/s0013-9351(05)80094-5. [DOI] [PubMed] [Google Scholar]
  29. Kinney P. L., Ware J. H., Spengler J. D., Dockery D. W., Speizer F. E., Ferris B. G., Jr Short-term pulmonary function change in association with ozone levels. Am Rev Respir Dis. 1989 Jan;139(1):56–61. doi: 10.1164/ajrccm/139.1.56. [DOI] [PubMed] [Google Scholar]
  30. Koenig J. Q., Larson T. V., Hanley Q. S., Rebolledo V., Dumler K., Checkoway H., Wang S. Z., Lin D., Pierson W. E. Pulmonary function changes in children associated with fine particulate matter. Environ Res. 1993 Oct;63(1):26–38. doi: 10.1006/enrs.1993.1123. [DOI] [PubMed] [Google Scholar]
  31. LOGAN W. P. D. Mortality in the London fog incident, 1952. Lancet. 1953 Feb 14;1(6755):336–338. doi: 10.1016/s0140-6736(53)91012-5. [DOI] [PubMed] [Google Scholar]
  32. Lave L. B., Seskin E. P. Air pollution and human health. Science. 1970 Aug 21;169(3947):723–733. doi: 10.1126/science.169.3947.723. [DOI] [PubMed] [Google Scholar]
  33. Lebowitz M. D., Holberg C. J., Boyer B., Hayes C. Respiratory symptoms and peak flow associated with indoor and outdoor air pollutants in the southwest. J Air Pollut Control Assoc. 1985 Nov;35(11):1154–1158. doi: 10.1080/00022470.1985.10466016. [DOI] [PubMed] [Google Scholar]
  34. Lipfert F. W. Air pollution and mortality: specification searches using SMSA-based data. J Environ Econ Manage. 1984 Sep;11(3):208–243. doi: 10.1016/0095-0696(84)90019-6. [DOI] [PubMed] [Google Scholar]
  35. Lipfert F. W., Hammerstrom T. Temporal patterns in air pollution and hospital admissions. Environ Res. 1992 Dec;59(2):374–399. doi: 10.1016/s0013-9351(05)80043-x. [DOI] [PubMed] [Google Scholar]
  36. Lutz L. J. Health effects of air pollution measured by outpatient visits. J Fam Pract. 1983 Feb;16(2):307–313. [PubMed] [Google Scholar]
  37. MARTIN A. E. MORTALITY AND MORBIDITY STATISTICS AND AIR POLLUTION. Proc R Soc Med. 1964 Oct;57:SUPPL–SUPPL:975. [PMC free article] [PubMed] [Google Scholar]
  38. Mazumdar S., Sussman N. Relationships of air pollution to health: results from the Pittsburgh study. Arch Environ Health. 1983 Jan-Feb;38(1):17–24. doi: 10.1080/00039896.1983.10543974. [DOI] [PubMed] [Google Scholar]
  39. Ostro B. D. Associations between morbidity and alternative measures of particulate matter. Risk Anal. 1990 Sep;10(3):421–427. doi: 10.1111/j.1539-6924.1990.tb00525.x. [DOI] [PubMed] [Google Scholar]
  40. Ostro B. D., Lipsett M. J., Wiener M. B., Selner J. C. Asthmatic responses to airborne acid aerosols. Am J Public Health. 1991 Jun;81(6):694–702. doi: 10.2105/ajph.81.6.694. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Ostro B. D., Rothschild S. Air pollution and acute respiratory morbidity: an observational study of multiple pollutants. Environ Res. 1989 Dec;50(2):238–247. doi: 10.1016/s0013-9351(89)80004-0. [DOI] [PubMed] [Google Scholar]
  42. Ostro B. A search for a threshold in the relationship of air pollution to mortality: a reanalysis of data on London winters. Environ Health Perspect. 1984 Dec;58:397–399. doi: 10.1289/ehp.8458397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Ostro B. The association of air pollution and mortality: examining the case for inference. Arch Environ Health. 1993 Sep-Oct;48(5):336–342. doi: 10.1080/00039896.1993.9936722. [DOI] [PubMed] [Google Scholar]
  44. Ozkaynak H., Spengler J. D. Analysis of health effects resulting from population exposures to acid precipitation precursors. Environ Health Perspect. 1985 Nov;63:45–55. doi: 10.1289/ehp.856345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Ozkaynak H., Thurston G. D. Associations between 1980 U.S. mortality rates and alternative measures of airborne particle concentration. Risk Anal. 1987 Dec;7(4):449–461. doi: 10.1111/j.1539-6924.1987.tb00482.x. [DOI] [PubMed] [Google Scholar]
  46. Pope C. A., 3rd, Dockery D. W. Acute health effects of PM10 pollution on symptomatic and asymptomatic children. Am Rev Respir Dis. 1992 May;145(5):1123–1128. doi: 10.1164/ajrccm/145.5.1123. [DOI] [PubMed] [Google Scholar]
  47. Pope C. A., 3rd, Dockery D. W., Spengler J. D., Raizenne M. E. Respiratory health and PM10 pollution. A daily time series analysis. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):668–674. doi: 10.1164/ajrccm/144.3_Pt_1.668. [DOI] [PubMed] [Google Scholar]
  48. Pope C. A., 3rd, Kanner R. E. Acute effects of PM10 pollution on pulmonary function of smokers with mild to moderate chronic obstructive pulmonary disease. Am Rev Respir Dis. 1993 Jun;147(6 Pt 1):1336–1340. doi: 10.1164/ajrccm/147.6_Pt_1.1336. [DOI] [PubMed] [Google Scholar]
  49. Pope C. A., 3rd Respiratory disease associated with community air pollution and a steel mill, Utah Valley. Am J Public Health. 1989 May;79(5):623–628. doi: 10.2105/ajph.79.5.623. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Pope C. A., 3rd Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys. Arch Environ Health. 1991 Mar-Apr;46(2):90–97. doi: 10.1080/00039896.1991.9937434. [DOI] [PubMed] [Google Scholar]
  51. Pope C. A., 3rd, Schwartz J., Ransom M. R. Daily mortality and PM10 pollution in Utah Valley. Arch Environ Health. 1992 May-Jun;47(3):211–217. doi: 10.1080/00039896.1992.9938351. [DOI] [PubMed] [Google Scholar]
  52. Pope C. A., 3rd, Thun M. J., Namboodiri M. M., Dockery D. W., Evans J. S., Speizer F. E., Heath C. W., Jr Particulate air pollution as a predictor of mortality in a prospective study of U.S. adults. Am J Respir Crit Care Med. 1995 Mar;151(3 Pt 1):669–674. doi: 10.1164/ajrccm/151.3_Pt_1.669. [DOI] [PubMed] [Google Scholar]
  53. Pönkä A. Asthma and low level air pollution in Helsinki. Arch Environ Health. 1991 Sep-Oct;46(5):262–270. doi: 10.1080/00039896.1991.9934386. [DOI] [PubMed] [Google Scholar]
  54. Raizenne M. E., Burnett R. T., Stern B., Franklin C. A., Spengler J. D. Acute lung function responses to ambient acid aerosol exposures in children. Environ Health Perspect. 1989 Feb;79:179–185. doi: 10.1289/ehp.8979179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Ransom M. R., Pope C. A., 3rd Elementary school absences and PM10 pollution in Utah Valley. Environ Res. 1992 Aug;58(2):204–219. doi: 10.1016/s0013-9351(05)80216-6. [DOI] [PubMed] [Google Scholar]
  56. Samet J. M., Bishop Y., Speizer F. E., Spengler J. D., Ferris B. G., Jr The relationship between air pollution and emergency room visits in an industrial community. J Air Pollut Control Assoc. 1981 Mar;31(3):236–240. doi: 10.1080/00022470.1981.10465214. [DOI] [PubMed] [Google Scholar]
  57. Schwartz J. Air pollution and daily mortality in Birmingham, Alabama. Am J Epidemiol. 1993 May 15;137(10):1136–1147. doi: 10.1093/oxfordjournals.aje.a116617. [DOI] [PubMed] [Google Scholar]
  58. Schwartz J. Air pollution and daily mortality: a review and meta analysis. Environ Res. 1994 Jan;64(1):36–52. doi: 10.1006/enrs.1994.1005. [DOI] [PubMed] [Google Scholar]
  59. Schwartz J. Air pollution and hospital admissions for the elderly in Birmingham, Alabama. Am J Epidemiol. 1994 Mar 15;139(6):589–598. doi: 10.1093/oxfordjournals.aje.a117048. [DOI] [PubMed] [Google Scholar]
  60. Schwartz J. Air pollution and hospital admissions for the elderly in Detroit, Michigan. Am J Respir Crit Care Med. 1994 Sep;150(3):648–655. doi: 10.1164/ajrccm.150.3.8087333. [DOI] [PubMed] [Google Scholar]
  61. Schwartz J., Dockery D. W. Increased mortality in Philadelphia associated with daily air pollution concentrations. Am Rev Respir Dis. 1992 Mar;145(3):600–604. doi: 10.1164/ajrccm/145.3.600. [DOI] [PubMed] [Google Scholar]
  62. Schwartz J., Dockery D. W., Neas L. M., Wypij D., Ware J. H., Spengler J. D., Koutrakis P., Speizer F. E., Ferris B. G., Jr Acute effects of summer air pollution on respiratory symptom reporting in children. Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 1):1234–1242. doi: 10.1164/ajrccm.150.5.7952546. [DOI] [PubMed] [Google Scholar]
  63. Schwartz J., Dockery D. W. Particulate air pollution and daily mortality in Steubenville, Ohio. Am J Epidemiol. 1992 Jan 1;135(1):12–25. doi: 10.1093/oxfordjournals.aje.a116195. [DOI] [PubMed] [Google Scholar]
  64. Schwartz J. Lung function and chronic exposure to air pollution: a cross-sectional analysis of NHANES II. Environ Res. 1989 Dec;50(2):309–321. doi: 10.1016/s0013-9351(89)80012-x. [DOI] [PubMed] [Google Scholar]
  65. Schwartz J., Marcus A. Mortality and air pollution in London: a time series analysis. Am J Epidemiol. 1990 Jan;131(1):185–194. doi: 10.1093/oxfordjournals.aje.a115473. [DOI] [PubMed] [Google Scholar]
  66. Schwartz J. PM10, ozone, and hospital admissions for the elderly in Minneapolis-St. Paul, Minnesota. Arch Environ Health. 1994 Sep-Oct;49(5):366–374. doi: 10.1080/00039896.1994.9954989. [DOI] [PubMed] [Google Scholar]
  67. Schwartz J. Particulate air pollution and chronic respiratory disease. Environ Res. 1993 Jul;62(1):7–13. doi: 10.1006/enrs.1993.1083. [DOI] [PubMed] [Google Scholar]
  68. Schwartz J. Particulate air pollution and daily mortality in Detroit. Environ Res. 1991 Dec;56(2):204–213. doi: 10.1016/s0013-9351(05)80009-x. [DOI] [PubMed] [Google Scholar]
  69. Schwartz J., Slater D., Larson T. V., Pierson W. E., Koenig J. Q. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis. 1993 Apr;147(4):826–831. doi: 10.1164/ajrccm/147.4.826. [DOI] [PubMed] [Google Scholar]
  70. Schwartz J., Spix C., Wichmann H. E., Malin E. Air pollution and acute respiratory illness in five German communities. Environ Res. 1991 Oct;56(1):1–14. doi: 10.1016/s0013-9351(05)80104-5. [DOI] [PubMed] [Google Scholar]
  71. Schwartz J. What are people dying of on high air pollution days? Environ Res. 1994 Jan;64(1):26–35. doi: 10.1006/enrs.1994.1004. [DOI] [PubMed] [Google Scholar]
  72. Seaton A., MacNee W., Donaldson K., Godden D. Particulate air pollution and acute health effects. Lancet. 1995 Jan 21;345(8943):176–178. doi: 10.1016/s0140-6736(95)90173-6. [DOI] [PubMed] [Google Scholar]
  73. Shumway R. H., Azari A. S., Pawitan Y. Modeling mortality fluctuations in Los Angeles as functions of pollution and weather effects. Environ Res. 1988 Apr;45(2):224–241. doi: 10.1016/s0013-9351(88)80049-5. [DOI] [PubMed] [Google Scholar]
  74. Shy C. M. Epidemiologic evidence and the United States air quality standards. Am J Epidemiol. 1979 Dec;110(6):661–671. doi: 10.1093/oxfordjournals.aje.a112847. [DOI] [PubMed] [Google Scholar]
  75. Speizer F. E. Studies of acid aerosols in six cities and in a new multi-city investigation: design issues. Environ Health Perspect. 1989 Feb;79:61–67. doi: 10.1289/ehp.897961. [DOI] [PMC free article] [PubMed] [Google Scholar]
  76. Sunyer J., Antó J. M., Murillo C., Saez M. Effects of urban air pollution on emergency room admissions for chronic obstructive pulmonary disease. Am J Epidemiol. 1991 Aug 1;134(3):277–289. doi: 10.1093/oxfordjournals.aje.a116081. [DOI] [PubMed] [Google Scholar]
  77. Thurston G. D., Ito K., Kinney P. L., Lippmann M. A multi-year study of air pollution and respiratory hospital admissions in three New York State metropolitan areas: results for 1988 and 1989 summers. J Expo Anal Environ Epidemiol. 1992 Oct-Dec;2(4):429–450. [PubMed] [Google Scholar]
  78. Utell M. J., Samet J. M. Particulate air pollution and health. New evidence on an old problem. Am Rev Respir Dis. 1993 Jun;147(6 Pt 1):1334–1335. doi: 10.1164/ajrccm/147.6_Pt_1.1334. [DOI] [PubMed] [Google Scholar]
  79. Ware J. H., Ferris B. G., Jr, Dockery D. W., Spengler J. D., Stram D. O., Speizer F. E. Effects of ambient sulfur oxides and suspended particles on respiratory health of preadolescent children. Am Rev Respir Dis. 1986 May;133(5):834–842. [PubMed] [Google Scholar]
  80. Ware J. H., Thibodeau L. A., Speizer F. E., Colome S., Ferris B. G., Jr Assessment of the health effects of atmospheric sulfur oxides and particulate matter: evidence from observational studies. Environ Health Perspect. 1981 Oct;41:255–276. doi: 10.1289/ehp.8141255. [DOI] [PMC free article] [PubMed] [Google Scholar]
  81. Whittemore A. S., Korn E. L. Asthma and air pollution in the Los Angeles area. Am J Public Health. 1980 Jul;70(7):687–696. doi: 10.2105/ajph.70.7.687. [DOI] [PMC free article] [PubMed] [Google Scholar]
  82. Wichmann H. E., Mueller W., Allhoff P., Beckmann M., Bocter N., Csicsaky M. J., Jung M., Molik B., Schoeneberg G. Health effects during a smog episode in West Germany in 1985. Environ Health Perspect. 1989 Feb;79:89–99. doi: 10.1289/ehp.897989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  83. Wyzga R. E. The effect of air pollution upon mortality: a consideration of distributed lag models. J Am Stat Assoc. 1978;73(363):463–472. doi: 10.1080/01621459.1978.10480035. [DOI] [PubMed] [Google Scholar]
  84. Xu X. P., Dockery D. W., Wang L. H. Effects of air pollution on adult pulmonary function. Arch Environ Health. 1991 Jul-Aug;46(4):198–206. doi: 10.1080/00039896.1991.9937448. [DOI] [PubMed] [Google Scholar]

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