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. 2004 Oct;58(10):831–836. doi: 10.1136/jech.2003.016386

Apheis: public health impact of PM10 in 19 European cities

S Medina 1, A Plasencia 1, F Ballester 1, H Mucke 1, J Schwartz 1
PMCID: PMC1763334  PMID: 15365108

Abstract

Study objective: Apheis is a public health surveillance system that aims to provide European, national, regional, and local decision makers, environmental health professionals, and the general public with up to date and easy to use information on air pollution and public health. This study presents the health impact assessment done in 19 cities of Western and Eastern European countries.

Design: Apheis developed guidelines for gathering and analysing data on air pollution and the impact on public health. Apheis has analysed the acute and chronic effects of fine particles on premature mortality using the estimates developed by Aphea2 study and two American cohort studies. This health impact assessment was performed for different scenarios on the health benefits of reducing levels of particles less than 10 µm in size (PM10).

Main results: PM10 concentrations were measured in 19 cities (range: 14–73 µg/m3). The population covered in this health impact assessment includes nearly 32 million inhabitants. The age standardised mortality rates (per 100 000 people) range from 456 in Toulouse to 1127 in Bucharest. Reducing long term exposure to PM10 concentrations by 5 µg/m3 would have "prevented" between 3300 and 7700 early deaths annually, 500 to 1000 of which are associated with short term exposure.

Conclusions: Apheis shows that current levels of air pollution in urban Europe have a non-negligible impact on public health, and that preventive measures could reduce this impact, even in cities with low levels of air pollution.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atkinson R. W., Anderson H. R., Sunyer J., Ayres J., Baccini M., Vonk J. M., Boumghar A., Forastiere F., Forsberg B., Touloumi G. Acute effects of particulate air pollution on respiratory admissions: results from APHEA 2 project. Air Pollution and Health: a European Approach. Am J Respir Crit Care Med. 2001 Nov 15;164(10 Pt 1):1860–1866. doi: 10.1164/ajrccm.164.10.2010138. [DOI] [PubMed] [Google Scholar]
  2. Aunan K., Pátzay G., Asbjørn Aaheim H., Martin Seip H. Health and environmental benefits from air pollution reductions in Hungary. Sci Total Environ. 1998 Apr 8;212(2-3):245–268. doi: 10.1016/s0048-9697(98)00002-3. [DOI] [PubMed] [Google Scholar]
  3. Ballester F., Sáez M., Pérez-Hoyos S., Iñguez C., Gandarillas A., Tobías A., Bellido J., Taracido M., Arribas F., Daponte A. The EMECAM project: a multicentre study on air pollution and mortality in Spain: combined results for particulates and for sulfur dioxide. Occup Environ Med. 2002 May;59(5):300–308. doi: 10.1136/oem.59.5.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Biggeri Annibale, Baccini Michela, Accetta Gabriele, Lagazio Corrado, Gruppo MISA Stime degli effetti a breve termine degli inquinanti atmosferici in Italia. Epidemiol Prev. 2002 Jul-Aug;26(4):203–205. [PubMed] [Google Scholar]
  5. Dhalla N. S., Temsah R. M., Netticadan T. Role of oxidative stress in cardiovascular diseases. J Hypertens. 2000 Jun;18(6):655–673. doi: 10.1097/00004872-200018060-00002. [DOI] [PubMed] [Google Scholar]
  6. 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]
  7. Dominici Francesca, McDermott Aidan, Zeger Scott L., Samet Jonathan M. On the use of generalized additive models in time-series studies of air pollution and health. Am J Epidemiol. 2002 Aug 1;156(3):193–203. doi: 10.1093/aje/kwf062. [DOI] [PubMed] [Google Scholar]
  8. Gold D. R., Litonjua A., Schwartz J., Lovett E., Larson A., Nearing B., Allen G., Verrier M., Cherry R., Verrier R. Ambient pollution and heart rate variability. Circulation. 2000 Mar 21;101(11):1267–1273. doi: 10.1161/01.cir.101.11.1267. [DOI] [PubMed] [Google Scholar]
  9. Hoek Gerard, Brunekreef Bert, Goldbohm Sandra, Fischer Paul, van den Brandt Piet A. Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study. Lancet. 2002 Oct 19;360(9341):1203–1209. doi: 10.1016/S0140-6736(02)11280-3. [DOI] [PubMed] [Google Scholar]
  10. Katsouyanni K., Touloumi G., Samoli E., Gryparis A., Le Tertre A., Monopolis Y., Rossi G., Zmirou D., Ballester F., Boumghar A. Confounding and effect modification in the short-term effects of ambient particles on total mortality: results from 29 European cities within the APHEA2 project. Epidemiology. 2001 Sep;12(5):521–531. doi: 10.1097/00001648-200109000-00011. [DOI] [PubMed] [Google Scholar]
  11. Katsouyanni Klea, Touloumi Giota, Samoli Evangelia, Gryparis Alexandros, Monopolis Yannis, LeTertre Alain, Boumghar Azedine, Rossi Giuseppe, Zmirou Denis, Ballester Ferran. Different convergence parameters applied to the S-PLUS GAM function. Epidemiology. 2002 Nov;13(6):742–743. doi: 10.1097/00001648-200211000-00024. [DOI] [PubMed] [Google Scholar]
  12. Krzyzanowski M., Cohen A., Anderson R., WHO Working Group Quantification of health effects of exposure to air pollution. Occup Environ Med. 2002 Dec;59(12):791–793. doi: 10.1136/oem.59.12.791. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Künzli N., Kaiser R., Medina S., Studnicka M., Chanel O., Filliger P., Herry M., Horak F., Jr, Puybonnieux-Texier V., Quénel P. Public-health impact of outdoor and traffic-related air pollution: a European assessment. Lancet. 2000 Sep 2;356(9232):795–801. doi: 10.1016/S0140-6736(00)02653-2. [DOI] [PubMed] [Google Scholar]
  14. Le Tertre Alain, Quénel Philippe, Eilstein Daniel, Medina Sylvia, Prouvost Helene, Pascal Laurence, Boumghar Azzedine, Saviuc Philippe, Zeghnoun Abdelkrim, Filleul Laurent. Short-term effects of air pollution on mortality in nine French cities: a quantitative summary. Arch Environ Health. 2002 Jul-Aug;57(4):311–319. doi: 10.1080/00039890209601414. [DOI] [PubMed] [Google Scholar]
  15. Leksell I., Rabl A. Air pollution and mortality: quantification and valuation of years of life lost. Risk Anal. 2001 Oct;21(5):843–857. doi: 10.1111/0272-4332.215156. [DOI] [PubMed] [Google Scholar]
  16. Levy J. I., Carrothers T. J., Tuomisto J. T., Hammitt J. K., Evans J. S. Assessing the public health benefits of reduced ozone concentrations. Environ Health Perspect. 2001 Dec;109(12):1215–1226. doi: 10.1289/ehp.011091215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Levy J. I., Carrothers T. J., Tuomisto J. T., Hammitt J. K., Evans J. S. Assessing the public health benefits of reduced ozone concentrations. Environ Health Perspect. 2001 Dec;109(12):1215–1226. doi: 10.1289/ehp.011091215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Pekkanen J., Brunner E. J., Anderson H. R., Tiittanen P., Atkinson R. W. Daily concentrations of air pollution and plasma fibrinogen in London. Occup Environ Med. 2000 Dec;57(12):818–822. doi: 10.1136/oem.57.12.818. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Pope CA3rd, Dockery D. W., Kanner R. E., Villegas G. M., Schwartz J. Oxygen saturation, pulse rate, and particulate air pollution: A daily time-series panel study. Am J Respir Crit Care Med. 1999 Feb;159(2):365–372. doi: 10.1164/ajrccm.159.2.9702103. [DOI] [PubMed] [Google Scholar]
  20. 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]
  21. Pope C. Arden, 3rd, Burnett Richard T., Thun Michael J., Calle Eugenia E., Krewski Daniel, Ito Kazuhiko, Thurston George D. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA. 2002 Mar 6;287(9):1132–1141. doi: 10.1001/jama.287.9.1132. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Samet J. M., Dominici F., Curriero F. C., Coursac I., Zeger S. L. Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994. N Engl J Med. 2000 Dec 14;343(24):1742–1749. doi: 10.1056/NEJM200012143432401. [DOI] [PubMed] [Google Scholar]
  23. Schwartz J. Harvesting and long term exposure effects in the relation between air pollution and mortality. Am J Epidemiol. 2000 Mar 1;151(5):440–448. doi: 10.1093/oxfordjournals.aje.a010228. [DOI] [PubMed] [Google Scholar]
  24. Schwartz J. Is there harvesting in the association of airborne particles with daily deaths and hospital admissions? Epidemiology. 2001 Jan;12(1):55–61. doi: 10.1097/00001648-200101000-00010. [DOI] [PubMed] [Google Scholar]
  25. Schwartz Joel, Laden Francine, Zanobetti Antonella. The concentration-response relation between PM(2.5) and daily deaths. Environ Health Perspect. 2002 Oct;110(10):1025–1029. doi: 10.1289/ehp.021101025. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Smith K. R., Corvalán C. F., Kjellström T. How much global ill health is attributable to environmental factors? Epidemiology. 1999 Sep;10(5):573–584. [PubMed] [Google Scholar]
  27. Stieb David M., De Civita Paul, Johnson F. Reed, Manary Matthew P., Anis Aslam H., Beveridge Robert C., Judek Stan. Economic evaluation of the benefits of reducing acute cardiorespiratory morbidity associated with air pollution. Environ Health. 2002 Dec 18;1(1):7–7. doi: 10.1186/1476-069X-1-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Zanobetti Antonella, Schwartz Joel, Samoli Evi, Gryparis Alexandros, Touloumi Giota, Atkinson Richard, Le Tertre Alain, Bobros Janos, Celko Martin, Goren Ayana. The temporal pattern of mortality responses to air pollution: a multicity assessment of mortality displacement. Epidemiology. 2002 Jan;13(1):87–93. doi: 10.1097/00001648-200201000-00014. [DOI] [PubMed] [Google Scholar]
  29. Zemp E., Elsasser S., Schindler C., Künzli N., Perruchoud A. P., Domenighetti G., Medici T., Ackermann-Liebrich U., Leuenberger P., Monn C. Long-term ambient air pollution and respiratory symptoms in adults (SAPALDIA study). The SAPALDIA Team. Am J Respir Crit Care Med. 1999 Apr;159(4 Pt 1):1257–1266. doi: 10.1164/ajrccm.159.4.9807052. [DOI] [PubMed] [Google Scholar]

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