Acute effects of ambient ozone on mortality in Europe and North America: results from the APHENA study
- 533 Downloads
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.
KeywordsOzone Mortality Time-series Multi-city Cardiovascular Respiratory
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.
- Burnett RT, Cakmak S, Brook JR (1998) The effect of the urban ambient air pollution mix on daily mortality rates in 11 Canadian cities. Can J Public Health 89(3):152–156Google Scholar
- Health Effects Institute (2003) Revised analyses of time-series studies of air pollution and health. Health Effects Institute, CambridgeGoogle Scholar
- Health Effects Institute (2010) Public Health and Air Pollution in Asia (PAPA): coordinated studies of short-term exposure to air pollution and daily mortality in four cities. HEI research report 154. Health Effects Institute, BostonGoogle Scholar
- Katsouyanni K, Samet JM, Anderson HR, Atkinson R, Le Tertre A, Medina S et al (2009) Air pollution and health: a European and North American approach (APHENA). Res Rep Health Eff Inst 142:5–90Google Scholar
- Speckman P (1988) Kernel smoothing in partial linear models. J R Stat Soc Ser B 50:413–436Google Scholar
- U.S. Environmental Protection Agency. 2006. Air quality criteria for ozone and related photochemical oxidants (final). EPA/600/R-05/004aF-cF. Washington, DC:U.S. Environmental Protection AgencyGoogle Scholar
- World Health Organization (2006) Air quality guidelines: global ppdate 2005—particulate matter, ozone, nitrogen dioxide and sulfur dioxide. World Health Organization, CopenhagenGoogle Scholar