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Association between Mortality and Short-Term Exposure to Particles, Ozone and Nitrogen Dioxide in Stockholm, Sweden
Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry.
Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry. Environment and Health Administration, SLB, Stockholm, Sweden.
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 6, article id 1028Article in journal (Refereed) Published
Abstract [en]

In this study, the effects on daily mortality in Stockholm associated with short-term exposure to ultrafine particles (measured as number of particles with a diameter larger than 4 nm, PNC4), black carbon (BC) and coarse particles (PM2.5–10) have been compared with the effects from more common traffic-pollution indicators (PM10, PM2.5 and NO2) and O3 during the period 2000–2016. Air pollution exposure was estimated from measurements at a 20 m high building in central Stockholm. The associations between daily mortality lagged up to two days (lag 02) and the different air pollutants were modelled by using Poisson regression. The pollutants with the strongest indications of an independent effect on daily mortality were O3, PM2.5–10 and PM10. In the single-pollutant model, an interquartile range (IQR) increase in O3 was associated with an increase in daily mortality of 2.0% (95% CI: 1.1–3.0) for lag 01 and 1.9% (95% CI: 1.0–2.9) for lag 02. An IQR increase in PM2.5–10 was associated with an increase in daily mortality of 0.8% (95% CI: 0.1–1.5) for lag 01 and 1.1% (95% CI: 0.4–1.8) for lag 02. PM10 was associated with a significant increase only at lag 02, with 0.8% (95% CI: 0.08–1.4) increase in daily mortality associated with an IQR increase in the concentration. NO2 exhibits negative associations with mortality. The significant excess risk associated with O3 remained significant in two-pollutant models after adjustments for PM2.5–10, BC and NO2. The significant excess risk associated with PM2.5–10 remained significant in a two-pollutant model after adjustment for NO2. The significantly negative associations for NO2 remained significant in two-pollutant models after adjustments for PM2.5–10, O3 and BC. A potential reason for these findings, where statistically significant excess risks were found for O3, PM2.5–10 and PM10, but not for NO2, PM2.5, PNC4 and BC, is behavioral factors that lead to misclassification in the exposure. The concentrations of O3 and PM2.5–10 are in general highest during sunny and dry days during the spring, when exposure to outdoor air tend to increase, while the opposite applies to NO2, PNC4 and BC, with the highest concentrations during the short winter days with cold weather, when people are less exposed to outdoor air.

Place, publisher, year, edition, pages
2019. Vol. 16, no 6, article id 1028
Keywords [en]
particle number count (PNC), PM2.5–10, exposure, mortality, ozone, excess risk, linear regression
National Category
Earth and Related Environmental Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Applied Environmental Science
Identifiers
URN: urn:nbn:se:su:diva-168268DOI: 10.3390/ijerph16061028ISI: 000465159500128OAI: oai:DiVA.org:su-168268DiVA, id: diva2:1307612
Note

This article belongs to the Special Issue Ultrafine Particles Exposure and Health.

Available from: 2019-04-29 Created: 2019-04-29 Last updated: 2019-05-27Bibliographically approved
In thesis
1. Air pollution and health – Indicators, trends and impacts
Open this publication in new window or tab >>Air pollution and health – Indicators, trends and impacts
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on some of the limitations and difficulties that exist when it comes to quantifying the human health effects that arise as a result of air pollution exposure. The following four issues are particularly analysed and discussed: 1) The measurement techniques used for carbonaceous particles and their lack of consistency; 2) Do the health risks associated with exposure to PM10 depend on the content of elemental carbon in the aerosol?; 3) Trends in air pollutants and the health effects that arise as a result of changed exposure to the measured pollutants; 4) The associations between the measured concentrations of different air pollutants in Stockholm and the daily number deaths; 5) Air quality indicators and health outcomes as basis for an air quality health index (AQHI).

The method that has been used is largely based on empirical data analysis, where further statistical processing has been used in order to clarify the scientific issues. The overall conclusions are the following: 1) The health impact assessments associated with exposure to carbonaceous particles would benefit from the introduction of a more uniform measurement technique in order to get more consistent and reliable results; 2) The health risks associated with exposure to PM10 are dependent on the content of elemental carbon; 3) The life expectancy increase associated with decreasing NOx trends during 1990–2015 in Stockholm, Gothenburg and Malmo make up as much as about 20 % of the total gain in life expectancy during this period, which clearly shows the beneficial effects related to decreased exposure; 4) The associations between daily mortality and the concentrations of O3 and PM2.5-10 in Stockholm are statistically significant, which does not apply to the exhaust-related pollutants, possibly reflecting behavioural factors affecting the degree of exposure; 5) In comparison with the currently used air quality index (AQI), the air quality health index (AQHI) is a more useful tool in order to address the short-term health effects associated with multi-pollutant exposure to NOx, O3, PM10 and birch pollen.

We hope that these findings will be useful from a policy point of view. Introducing a more consistent measurement technique for soot particles would be beneficial in assessing the health effects related to exposure to these particles. The increase in life expectancy associated with decreasing NOx trends shows the benefits from a public health perspective when it comes to introducing emission-reducing measures from traffic. The AQHI would be beneficial to implement in legislation, as it is based on several pollutants, which means that the cumulative health effects associated exposure to several different air pollutants are accounted for.  

Place, publisher, year, edition, pages
Stockholm: Department of Environmental Science and Analytical Chemistry, Stockholm University, 2019. p. 50
Keywords
air pollution, health, measurements, trends, impacts, mortality, NOx, elemental carbon, AQHI
National Category
Meteorology and Atmospheric Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Applied Environmental Science
Identifiers
urn:nbn:se:su:diva-168306 (URN)978-91-7797-468-0 (ISBN)978-91-7797-469-7 (ISBN)
Public defence
2019-06-13, Nordenskiöldsalen, Geovetenskapens hus, Svante Arrhenius väg 12, Stockholm, 10:00 (English)
Opponent
Supervisors
Available from: 2019-05-21 Created: 2019-04-29 Last updated: 2019-05-07Bibliographically approved

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