Short-term effects of nitrogen dioxide on mortality : an analysis within the APHEA project

• The short-term effects of nitrogen dioxide (NO2) on total, cardiovascular and respiratory mortality in 30 European cities participating in the Air Pollution on Health: a European Approach (APHEA)-2 project were investigated. The association was examined using hierarchical models implemented in two stages. In the first stage, data from each city were analysed separately, whereas in the second stage, the city-specific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity. A significant association of NO2 with total, cardiovascular and respiratory mortality was found, with stronger effects on cause-specific mortality. There was evidence of confounding in respiratory mortality with black smoke and sulphur dioxide. The effect of NO2 on total and cardiovascular mortality was observed mainly in western and southern European cities, and was larger when smoking prevalence was lower and household gas consumption was higher. The effect of NO2 on respiratory mortality was higher in cities with a larger proportion of elderly persons in the population and higher levels of particulate matter with a 50% cut-off aerodynamic diameter of 10 μm. The results of this large study are consistent with an independent effect of nitrogen dioxide on mortality, but the role of nitrogen dioxide as a surrogate of other unmeasured pollutants cannot be completely ruled out.

Keyword

Air Pollutants/*toxicity

Cardiovascular Diseases/*mortality

Cause of Death

Cross-Cultural Comparison

Dust

Europe/epidemiology

Humans

Models; Statistical

Nitrogen Dioxide/*toxicity

Respiratory Tract Diseases/*mortality

Smoke

Smoking/adverse effects/mortality

Statistics as Topic

Sulfur Dioxide/toxicity

Urban Population/*statistics & numerical data

Publication and Content Type

ref (subject category)

art (subject category)