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Investigating regional differences in short-term effects of air pollution on daily mortality in the APHEA project: A sensitivity analysis for controlling long-term trends and seasonality

Samoli, E; Schwartz, J; Wojtyniak, B; Touloumi, G; Spix, C; Balducci, F; Medina, S; Rossi, G; Sunyer, J; Bacharova, L; et al. Samoli, E; Schwartz, J; Wojtyniak, B; Touloumi, G; Spix, C; Balducci, F; Medina, S; Rossi, G; Sunyer, J; Bacharova, L; Anderson, HR; Katsouyanni, K (2001) Investigating regional differences in short-term effects of air pollution on daily mortality in the APHEA project: A sensitivity analysis for controlling long-term trends and seasonality. ENVIRONMENTAL HEALTH PERSPECTIVES, 109 (4). 349 - 353. ISSN 0091-6765
SGUL Authors: Anderson, Hugh Ross

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Abstract

Short-term effects of air pollution on daily mortality in eight western and five central-eastern European countries have been reported previously, as part of the APHEA project. One intriguing finding was that the effects were lower in central-eastern European cities. The analysis used sinusoidal terms for seasonal control and polynomial terms for meteorologic variables, but this is a more rigid approach than the currently accepted method, which uses generalized additive models (GAM). We therefore reanalyzed the original data to examine the sensitivity of the results to the statistical model. The data were identical to those used in the earlier analyses. The outcome was the daily total number of deaths, and the pollutants analyzed were black smoke (BS) and sulfur dioxide (SO(2)). The analyses were restricted to days with pollutant concentration < 200 microg/m(3) and < 150 microg/m(3) alternately. We used Poisson regression in a GAM model, and combined individual city regression coefficients using fixed and random-effect models. An increase in BS by 50 microg/m(3) was associated with a 2.2% and 3.1% increase in mortality when analysis was restricted to days < 200 microg/m(3) and < 150 microg/m(3), respectively. The corresponding figures were 5.0% and 5.6% for a similar increase in SO(2). These estimates are larger than the ones published previously: by 69% for BS and 55% for SO(2). The increase occurred only in central-eastern European cities. The ratio of western to central-eastern cities for estimates was reduced to 1.3 for BS (previously 4.8) and 2.6 for SO(2) (previously 4.4). We conclude that part of the heterogeneity in the estimates of air pollution effects between western and central-eastern cities reported in previous publications was caused by the statistical approach used and the inclusion of days with pollutant levels above 150 microg/m(3). However, these results must be investigated further.

Item Type: Article
Additional Information: Reproduced with permission from Environmental Health Perspectives, 2001; 109(4):349–353.
Keywords: Adolescent, Adult, Aged, Air Pollutants, Child, Child, Preschool, Environmental Exposure, Europe, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Models, Statistical, Mortality, Regression Analysis, Reproducibility of Results, Seasons, Sensitivity and Specificity, Sulfur Dioxide, Weather, Science & Technology, Life Sciences & Biomedicine, Environmental Sciences, Public, Environmental & Occupational Health, Toxicology, Environmental Sciences & Ecology, ENVIRONMENTAL SCIENCES, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI, 11 Medical And Health Sciences, 05 Environmental Sciences, generalized additive models, air pollution, black smoke, Poisson regression, sensitivity analysis, sulfur dioxide, TIME-SERIES ANALYSIS, RESPIRATORY ILLNESS, PARTICULATE MATTER, HOSPITAL ADMISSIONS, META-ANALYSIS, DISEASE
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: ENVIRONMENTAL HEALTH PERSPECTIVES
ISSN: 0091-6765
Related URLs:
Dates:
DateEvent
1 April 2001Published
Web of Science ID: WOS:000168413600024
URI: https://openaccess.sgul.ac.uk/id/eprint/107179

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