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Air Quality, Atmosphere & Health

, Volume 6, Issue 2, pp 445–453 | Cite as

Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study

  • Roger D. PengEmail author
  • Evangelia Samoli
  • Luu Pham
  • Francesca Dominici
  • Giota Touloumi
  • Tim Ramsay
  • Richard T. Burnett
  • Daniel Krewski
  • Alain Le Tertre
  • Aaron Cohen
  • Richard W. Atkinson
  • H. Ross Anderson
  • Klea Katsouyanni
  • Jonathan M. Samet
Article

Abstract

The “Air Pollution and Health: A Combined European and North American Approach” (APHENA) project is a collaborative analysis of multi-city time-series data on the association between air pollution and adverse health outcomes. The main objective of APHENA was to examine the coherence of findings of time-series studies relating short-term fluctuations in air pollution levels to mortality and morbidity in 125 cities in Europe, the US, and Canada. Multi-city time-series analysis was conducted using a two-stage approach. We used Poisson regression models controlling for overdispersion with either penalized or natural splines to adjust for seasonality. Hierarchical models were used to obtain an overall estimate of excess mortality associated with ozone and to assess potential effect modification. Potential effect modifiers were city-level characteristics related to exposure to other ambient air pollutants, weather, socioeconomic status, and the vulnerability of the population. Regionally pooled risk estimates from Europe and the US were similar; those from Canada were substantially higher. The pooled estimated excess relative risk associated with a 10 μg/m3 increase in 1 h daily maximum O3 was 0.26 % (95 % CI, 0.15 %, 0.37 %). Across regions, there was little consistent indication of effect modification by age or other effect modifiers considered in the analysis. The findings from APHENA on the effects of O3 on mortality in the general population were comparable with previously reported results and relatively robust to the method of data analysis. Overall, there was no indication of strong effect modification by age or ecologic variables considered in the analysis.

Keywords

Ozone Mortality Time-series Multi-city Cardiovascular Respiratory 

Notes

Acknowledgments

Funding was provided through a contract with the Health Effects Institute. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the Health Effects Institute (HEI) or its sponsors. The authors state that they have no conflicts of interest.

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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Roger D. Peng
    • 1
    Email author
  • Evangelia Samoli
    • 2
  • Luu Pham
    • 1
  • Francesca Dominici
    • 3
  • Giota Touloumi
    • 2
  • Tim Ramsay
    • 4
  • Richard T. Burnett
    • 4
    • 5
  • Daniel Krewski
    • 4
  • Alain Le Tertre
    • 6
  • Aaron Cohen
    • 7
  • Richard W. Atkinson
    • 8
  • H. Ross Anderson
    • 8
    • 9
  • Klea Katsouyanni
    • 2
  • Jonathan M. Samet
    • 10
  1. 1.Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Department of Hygiene, Epidemiology, and Medical StatisticsUniversity of Athens Medical SchoolAthensGreece
  3. 3.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  4. 4.McLaughlin Center for Population Health Risk AssessmentUniversity of OttawaOttawaCanada
  5. 5.Environmental Health and Consumer Products BranchHealth CanadaOttawaCanada
  6. 6.Environmental Health DepartmentNational Institute of Public Health Surveillance (InVS)Saint-Maurice CedexFrance
  7. 7.Health Effects InstituteBostonUSA
  8. 8.Division of Population Health Sciences and Education, MRC-HPA Centre for Environment and Health, St George’sUniversity of LondonLondonUK
  9. 9.Environmental Research Group, MRC-HPA Centre for Environment and HealthKing’s CollegeLondonUK
  10. 10.Department of Preventive Medicine, Keck School of Medicine, and USC Institute for Global HealthUniversity of Southern CaliforniaLos AngelesUSA

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