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Confounding and effect modification in the short-term effects of ambient particles on total mortality: results from 29 european cities within the APHEA2 Project / Katsouyanni K in Epidemiology, Vol. 12, N° 5 (09/2001)

[article]  inEpidemiology > Vol. 12, N° 5 (09/2001) . - 512-31 Titre : Confounding and effect modification in the short-term effects of ambient particles on total mortality: results from 29 european cities within the APHEA2 Project Type de document : Article scientifique Auteur(s) : Katsouyanni K ; Touloumi G ; Samoli E ; Gryparis A ; Le Tertre A ; Monopolis Y ; Rossi G ; Zmirou D ; Ballester F ; Boumghar A ; Anderson HR ; Wojtyniak B ; Paldy A ; Braunstein R ; Pekkanen J ; Schindler C ; Schwartz J Appartenance auteur(s) InVS DSE Année de publication : 2001 Article en page(s) : 512-31 Langues : Anglais (eng) Mots-clés : Pollution atmosphérique ; Europe ; Particule atmosphérique ; Fumée noire ; Ville ; Mortalité ; Réseau surveillance ; Surveillance épidémiologique Résumé : We present the results of the Air Pollution and Health: A European Approach 2 (APHEA2) project on short-term effects of ambient particles on mortality with emphasis on effect modification. We used daily measurements for particulate matter less than 10 um in aerodynamic diameter (PM10) and/or black smoke from 29 European cities. We considered confounding from other pollutants as well as meteorologic and chronologic variables. We investigated several variables describing the cities' pollution, climate, population, and geography as potential effect modifiers. For the individual city analysis, generalized additive models extending Poisson regression, using a smoother to control for seasonal patterns, were applied. To provide quantitative summaries of the results and explain remaining heterogeneity, we applied second-stage regression models. The estimated increase in the daily number of deaths for all ages for a 10 ug/m3 increase in daily PM10 or black smoke concentrations was 0.6% [95% confidence interval (CI) = 0.4-0.8%], whereas for the elderly it was slightly higher. We found important effect modification for several of the variables studied. Thus, in a city with low average NO2, the estimated increase in daily mortality for an increase of 10 ug/m3 in PM10 was 0.19 (95% CI = 0.00-0.41), whereas in a city with high average NO2 it was 0.80% (95% CI = 0.67-0.93%); in a relatively cold climate the corresponding effect was 0.29% (95% CI = 0.16-0.42), whereas in a warm climate it was 0.82% (95% CI = 0.69-0.96); in a city with low standardized mortality rate it was 0.80% (95% CI = 0.65-0.95%), and in one with a high rate it was 0.43% (95% CI = 0.24-0.62). Our results confirm those previously reported on the effects of ambient particles on mortality. Furthermore, they show that the heterogeneity found in the effect parameters among cities reflects real effect modification, which is explained by specific city characteristics. PMID Pubmed : Pubmed : 11505171 Corpus : Production scientifique InVS Permalink : http://opac.invs.sante.fr/index.php?lvl=notice_display&id=4169 [article]

Short-term effects of ambient particles on mortality in the elderly: results from 28 cities in the APHEA2 project / Aga E in The European respiratory journal [Eur Respir J], Vol. 21, N° Suppl 40 (05/2003)

[article]  inThe European respiratory journal [Eur Respir J] > Vol. 21, N° Suppl 40 (05/2003) . - 28s-33s Titre : Short-term effects of ambient particles on mortality in the elderly: results from 28 cities in the APHEA2 project Type de document : Article scientifique Auteur(s) : Aga E ; Samoli E ; Touloumi G ; Anderson HR ; Cadum E ; Forsberg B ; Goodman P ; Goren A ; Kotesovec F ; Kriz B ; Macarol Hiti M ; Medina S ; Paldy A ; Schindler C ; Sunyer J ; Tittanen P ; Wojtyniak B ; Zmirou D ; Schwartz J ; Katsouyanni K Appartenance auteur(s) InVS DSE Année de publication : 2003 Article en page(s) : 28s-33s Langues : Anglais (eng) Mots-clés : Pollution atmosphérique ; Europe ; Réseau surveillance ; Mortalité ; Particule atmosphérique ; Fumée noire ; Dioxyde azote ; Personne âgée ; Court terme ; Dioxyde soufre ; Ozone ; Milieu urbain ; Ville ; Synthèse connaissance Mots-clés : IMPACT  APPAREIL RESPIRATOIRE [PATHOLOGIE] Résumé : Within the framework of the APHEA2 (Air Pollution on Health: a European Approach) project, the effects of ambient particles on mortality among persons > or = 65 yrs were investigated. Daily measurements for particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10) and black smoke (BS), as well as the daily number of deaths among persons > or = 65 yrs of age, from 29 European cities, have been collected. Data on other pollutants and meteorological variables, to adjust for confounding effects and data on city characteristics, to investigate potential effect modification, were also recorded. For individual city analysis, generalised additive models extending Poisson regression, using a locally weighted regression (LOESS) smoother to control for seasonal effects, were applied. To combine individual city results and explore effect modification, second stage regression models were applied. The per cent increase (95% confidence intervals), associated with a 10 microg x m(-3) increase in PM10, in the elderly daily number of deaths was 0.8%, (0.7-0.9%) and the corresponding number for BS was 0.6%, (0.5-0.8%). The effect size was modified by the long-term average levels of nitrogen dioxide (higher levels were associated with larger effects), temperature (larger effects were observed in warmer countries), and by the proportion of the elderly in each city (a larger proportion was associated with higher effects). These results indicate that ambient particles have effects on mortality among the elderly, with relative risks comparable or slightly higher than those observed for total mortality and similar effect modification patterns. The effects among the older persons are of particular importance, since the attributable number of events will be much larger, compared to the number of deaths among the younger population. Corpus : Production scientifique InVS Permalink : http://opac.invs.sante.fr/index.php?lvl=notice_display&id=5493 [article]