Acute Effects of Particulate Air Pollution on Respiratory Admissions

TLDR

The APHEA 2 study examined short‑term associations between PM10 and black smoke concentrations and daily emergency admissions for asthma, COPD, and all‑respiratory disease across eight European cities, adjusting for environmental and temporal factors and exploring city‑specific variability. The analysis found that a 10 μg/m³ increase in PM10 was associated with a 1.0–1.2 % rise in daily emergency admissions for asthma and COPD, with black smoke effects smaller, and that higher ozone levels and smoking prevalence in some cities partly explained the observed variability, confirming a positive link between particulate pollution and respiratory admissions.

Abstract

The APHEA 2 project investigated short-term health effects of particles in eight European cities. In each city associations between particles with an aerodynamic diameter of less than 10 μ m (PM10) and black smoke and daily counts of emergency hospital admissions for asthma (0–14 and 15–64 yr), chronic obstructive pulmonary disease (COPD), and all-respiratory disease (65 + yr) controlling for environmental factors and temporal patterns were investigated. Summary PM10 effect estimates (percentage change in mean number of daily admissions per 10 μ g/m3 increase) were asthma (0–14 yr) 1.2% (95% CI: 0.2, 2.3), asthma (15–64 yr) 1.1% (0.3, 1.8), and COPD plus asthma and all-respiratory (65 + yr) 1.0% (0.4, 1.5) and 0.9% (0.6, 1.3). The combined estimates for Black Smoke tended to be smaller and less precisely estimated than for PM10. Variability in the sizes of the PM10 effect estimates between cities was also investigated. In the 65 + groups PM10 estimates were positively associated with annual mean concentrations of ozone in the cities. For asthma admissions (0–14 yr) a number of city-specific factors, including smoking prevalence, explained some of their variability. This study confirms that particle concentrations in European cities are positively associated with increased numbers of admissions for respiratory diseases and that some of the variation in PM10 effect estimates between cities can be explained by city characteristics.