Short term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities: results from time series data from the APHEA project
Open accessAbstract
Abstract Objectives: To carry out a prospective combined quantitative analysis of the associations between all cause mortality and ambient particulate matter and sulphur dioxide. Design: Analysis of time series data on daily number of deaths from all causes and concentrations of sulphur dioxide and particulate matter (measured as black smoke or particles smaller than 10 μm in diameter (PM10)) and potential confounders. Setting: 12 European cities in the APHEA project (Air Pollution and Health: a European Approach). Main outcome measure: Relative risk of death. Results: In western European cities it was found that an increase of 50 μg/m3 in sulphur dioxide or black smoke was associated with a 3% (95% confidence interval 2% to 4%) increase in daily mortality and the corresponding figure for PM10 was 2% (1% to 3%). In central eastern European cities the increase in mortality associated with a 50 μg/m3 change in sulphur dioxide was 0.8% (-0.1% to 2.4%) and in black smoke 0.6% (0.1% to 1.1%). Cumulative effects of prolonged (two to four days) exposure to air pollutants resulted in estimates comparable with the one day effects. The effects of both pollutants were stronger during the summer and were mutually independent. Conclusions: The internal consistency of the results in western European cities with wide differences in climate and environmental conditions suggest that these associations may be causal. The long term health impact of these effects is uncertain, but today9s relatively low levels of sulphur dioxide and particles still have detectable short term effects on health and further reductions in air pollution are advisable. Key messages Evidence is accumulating that air pollution below the levels of national and international standards has adverse short term health effects In this study data from 12 European cities showed that increases in sulphur dioxide and particulate matter are associated with increased total mortality The effects of the two pollutants seem to be independent Associations were stronger and more consistent in western European cities Current low levelsof sulphur dioxide and particles stillaffect health and further reductions in pollution are needed
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PM is associated with increased risk of mortality for short-term exposure.
“PM is also associated with increased risk of mortality for short-term exposure (Katsouyanni et al. 1997; Samet et al. 2000a) and could co-vary with ozone levels due to parallel sources of particles and ozone precursors (e.g., transportation).”
From Potential confounding of particulate matter on the short-term association between ozone and mortality in multisite time-series studies (2007) · cites this paper as Katsouyanni et al. 1997
The exposure-response curve of air pollution tends to become flat at higher concentrations.
“It is well-known that the exposure-response curve of air pollution tends to become flat at higher concentration (Katsouyanni et al. 1997).”
From Differentiating the effects of fine and coarse particles on daily mortality in Shanghai, China (2007) · cites this paper as Katsouyanni et al. 1997
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- Authors
- Katsouyanni, K., Touloumi, G., Spix, C., Schwartz, J., Balducci, F., Medina, S., Rossi, G., Wojtyniak, B., Sunyer, J., Bacharova, L., Schouten, J. P., Ponka, A., & Anderson, H. R.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Helmholtz Munich (DE)
- Harvard University (US)
- Pôle de recherche et d'enseignement supérieur Université de Grenoble (FR)
- Istituto di Fisiologia Clinica (IT)
- Narodowy Instytut Zdrowia Publicznego PZH – Państwowy Instytut Badawczy (PL)
- University of Groningen (NL)
- St George's, University of London (GB)
- Corresponding author
- Katsouyanni, K
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1997-06-07
- Volume
- 314
- Issue
- 7095
- Pages
- 1658-1658
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2126873
- OpenAlex
- W1785546977
- Cited by
- 875
- References
- 27
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 13 · 2023: 16 · 2022: 18 · 2021: 22 · 2020: 23 · 2019: 35 · 2018: 32 · 2017: 28 · 2016: 30 · 2015: 43 · 2014: 31 · 2013: 39 · 2012: 25
- FWCI
- 30.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- European Commission
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Keywords
- sulfur dioxide, particulate matter, PM10, black smoke, air pollution, all-cause mortality, short-term health effects, cumulative exposure, seasonal variation, European cities, relative risk of death
- MeSH terms
- Air Pollutants, Air Pollution, Europe, Humans, Mortality, Particle Size, Seasons, Smoke, Sulfur Dioxide, Urban Health, Risk Assessment
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