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      Saharan Dust and Associations between Particulate Matter and Daily Mortality in Rome, Italy

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          Abstract

          Background: Outbreaks of Saharan-Sahel dust over Euro-Mediterranean areas frequently induce exceedances of the Europen Union's 24-hr standard of 50 μg/m 3 for particulate matter (PM) with aerodynamic diameter ≤ than 10 μm (PM 10).

          Objectives: We evaluated the effect of Saharan dust on the association between different PM fractions and daily mortality in Rome, Italy.

          Methods: In a study of 80,423 adult residents who died in Rome between 2001 and 2004, we performed a time-series analysis to explore the effects of PM 2.5, PM 2.5–10, and PM 10 on natural, cardiac, cerebrovascular, and respiratory mortality. We defined Saharan dust days by combining light detection and ranging (LIDAR) observations and analyses from operational models. We tested a Saharan dust–PM interaction term to evaluate the hypothesis that the effects of PM, especially coarse PM (PM 2.5–10), on mortality would be enhanced on dust days.

          Results: Interquartile range increases in PM 2.5–10 (10.8 μg/m 3) and PM 10 (19.8 μg/m 3) were associated with increased mortality due to natural, cardiac, cerebrovascular, and respiratory causes, with estimated effects ranging from 2.64% to 12.65% [95% confidence interval (CI), 1.18–25.42%] for the association between PM 2.5–10 and respiratory mortality (0- to 5-day lag). Associations of PM 2.5–10 with cardiac mortality were stronger on Saharan dust days (9.73%; 95% CI, 4.25–15.49%) than on dust-free days (0.86%; 95% CI, –2.47% to 4.31%; p = 0.005). Saharan dust days also modified associations between PM 10 and cardiac mortality (9.55% increase; 95% CI, 3.81–15.61%; vs. dust-free days: 2.09%; 95% CI, –0.76% to 5.02%; p = 0.02).

          Conclusions: We found evidence of effects of PM 2.5–10 and PM 10 on natural and cause-specific mortality, with stronger estimated effects on cardiac mortality during Saharan dust outbreaks. Toxicological and biological effects of particles from desert sources need to be further investigated and taken into account in air quality standards.

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          Saharan dust storms: nature and consequences

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            The Effect of Fine and Coarse Particulate Air Pollution on Mortality: A National Analysis

            Background Although many studies have examined the effects of air pollution on mortality, data limitations have resulted in fewer studies of both particulate matter with an aerodynamic diameter of ≤ 2.5 μm (PM2.5; fine particles) and of coarse particles (particles with an aerodynamic diameter > 2.5 and < 10 μm; PM coarse). We conducted a national, multicity time-series study of the acute effect of PM2.5 and PM coarse on the increased risk of death for all causes, cardiovascular disease (CVD), myocardial infarction (MI), stroke, and respiratory mortality for the years 1999–2005. Method We applied a city- and season-specific Poisson regression in 112 U.S. cities to examine the association of mean (day of death and previous day) PM2.5 and PM coarse with daily deaths. We combined the city-specific estimates using a random effects approach, in total, by season and by region. Results We found a 0.98% increase [95% confidence interval (CI), 0.75–1.22] in total mortality, a 0.85% increase (95% CI, 0.46–1.24) in CVD, a 1.18% increase (95% CI, 0.48–1.89) in MI, a 1.78% increase (95% CI, 0.96–2.62) in stroke, and a 1.68% increase (95% CI, 1.04–2.33) in respiratory deaths for a 10-μg/m3 increase in 2-day averaged PM2.5. The effects were higher in spring. For PM coarse, we found significant but smaller increases for all causes analyzed. Conclusions We conclude that our analysis showed an increased risk of mortality for all and specific causes associated with PM2.5, and the risks are higher than what was previously observed for PM10. In addition, coarse particles are also associated with more deaths.
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              Referent selection in case-crossover analyses of acute health effects of air pollution.

              The case-crossover design was proposed for the study of a transient effect of an intermittent exposure on the subsequent occurrence of a rare acute-onset disease. This design can be an alternative to Poisson time series regression for studying the health effects of fine particulate matter air pollution. Characteristics of time-series of particulate matter, including long-term time trends, seasonal trends, and short-term autocorrelations, require that referent selection in the case-crossover design be considered carefully and adapted to minimize bias. We performed simulations to evaluate the bias associated with various referent selection strategies for a proposed case-crossover study of associations between particulate matter and primary cardiac arrest. Some a priori reasonable strategies were associated with a relative bias as large as 10%, but for most strategies the relative bias was less than 2% with confidence interval coverage within 1% of the nominal level. We show that referent selection for case-crossover designs raises the same issues as selection of smoothing method for time series analyses. In addition, conditional logistic regression analysis is not strictly valid for some case-crossover designs, introducing further bias.
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                Author and article information

                Journal
                Environ Health Perspect
                EHP
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                1552-9924
                17 June 2011
                October 2011
                : 119
                : 10
                : 1409-1414
                Affiliations
                [1 ]Institute for Cancer Prevention, Florence, Italy
                [2 ]Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
                [3 ]Institute of Atmospheric Sciences and Climate, National Research Council, Rome, Italy
                [4 ]Department of Environment and Primary Prevention, National Institute of Health, Rome, Italy
                Author notes
                Address correspondence to M. Stafoggia, Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy. Telephone: 390683060474. Fax: 390683060374. E-mail: stafoggia@ 123456asplazio.it
                Article
                ehp.1003026
                10.12989/ehp.1003026
                3230430
                21970945
                83b94c82-c094-4da9-b2d1-62481ba279da
                Copyright @ 2011

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 September 2010
                : 17 June 2011
                Categories
                Research

                Public health
                particulate matter,saharan dust,epidemiology,air pollution,mortality
                Public health
                particulate matter, saharan dust, epidemiology, air pollution, mortality

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