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Impact of legislative changes to reduce the sulphur content in fuels in Europe on daily mortality in 20 European cities: an analysis of data from the Aphekom project

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Abstract

Following the implementation of three successive European Directives during the 1990s to reduce the sulphur content of fuels, background SO2 concentrations in European cities have fallen substantially. We investigated the magnitude of the short-term associations between daily SO2 concentrations and mortality during the various phases of legislation. Daily counts of all-cause and cause-specific mortality, SO2 concentration, temperature and humidity were obtained for 20 European cities participating in the Aphekom project during 1990–2008. Poisson regression was used to estimate the city-specific risks of death associated with changes in SO2 concentrations for the time periods before legislation and subsequent periods following the implementation of the three European Directives. City-specific risk estimates were pooled using meta-regression. We also estimated the health impact associated with changes in SO2 concentrations during these pre-and post-implementation periods. During the study period, 10 μg/m3 increases in SO2 levels were associated with increases in all-cause (0.53 %), respiratory (0.49 %) and cardiovascular (0.72 %) mortality. We found no evidence of changes in the SO2 concentration–response function across the implementation periods. We estimated, annually, a total of 639, 1,093 and 1,616 premature deaths across the 14 EU cities as result of respective reductions in SO2 concentrations in each of the three implementation periods. Our study suggests that the linear relationship between daily SO2 concentrations and mortality has remained unaltered despite substantial reductions in ambient concentrations in recent years arising from EU directives to limit sulphur content in fuel. This linearity suggests that new legislation to reduce SO2 concentrations further will bring about additional public health benefits.

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Acknowledgments

The large amount of work behind the Aphekom project is the fruit of generous and constructive input from all the members of the Aphekom network. We wish to record our thanks and appreciation of all their contributions. The Aphekom project has been co-funded by the European Commission’s Programme on Community Action in the Field of Public Health (2003–2008) under grant agreement no. 2007105 and by the many national and local institutions that have dedicated resources to the fulfilment of this project.

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Authors and Affiliations

  1. French Institute for Public Health Surveillance, InVS, Paris, France

    Alain Le Tertre & Sylvia Medina

  2. Dublin Institute of Technology, Dublin, Ireland

    Susann Henschel & Pat Goodman

  3. Division of Population Health Sciences and Education and MRC-PHE Centre for Environment and Health, St George’s, University of London, London, UK

    Richard W. Atkinson

  4. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece

    Antonis Analitis & Klea Katsouyanni

  5. Institute for the Environment, Brunel University, London, UK

    Ariana Zeka

  6. InVS ,12 rue du Val d’Osne, 94410, Saint-Maurice, France

    Alain Le Tertre

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  1. Alain Le Tertre
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  2. Susann Henschel
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  4. Antonis Analitis
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  8. Sylvia Medina
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Correspondence to Alain Le Tertre.

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Le Tertre, A., Henschel, S., Atkinson, R.W. et al. Impact of legislative changes to reduce the sulphur content in fuels in Europe on daily mortality in 20 European cities: an analysis of data from the Aphekom project. Air Qual Atmos Health 7, 83–91 (2014). https://doi.org/10.1007/s11869-013-0215-x

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