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| [[heande:ERF of air pollution]] | | #REDIRECT [[Concentration-response to PM2.5]] |
| [[Category:Health effects]]
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| [[Category:Classical air pollutants]]
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| [[Category: CLAIH]]
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| [[Category:Urgenche]]
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| {{variable|moderator = Virpi Kollanus
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| |respect = 3}}
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| ==Scope==
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| '''[[ERF]] of PM<sub>2.5</sub> on mortality in general population''' describes the relationship between PM<sub>2.5</sub> exposure and specific causes of mortality in general adult population. The variable focuses but is not limited to long-term (chronic) exposure.
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| ==Definition==
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| ===Data===
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| '''PM<sub>2.5</sub>''' are fine particles less than 2.5 μm in diameter. Exposure-response function can be derived from exposure modelling, animal toxicology, small clinical or panel studies, and epidemiological studies. Exposed population can be divided into subpopulations (e.g. adults, children, infants, the elderly), and exposure is assessed per certain time period (e.g. daily or annual exposure).
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| *Health effects related to '''short-term exposure'''
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| **respiratory symptoms
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| **adverse cardiovascular effects
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| **increased medication usage
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| **increased number of hospital admissions
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| **increased mortality
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| *Health effects related to '''long-term exposure''' (more relevance to public health)
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| **increased incidence of respiratory symptoms
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| **reduction in lung function
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| **increased incidence of chronic obstructive pulmonary disease (COPD)
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| **reduction in life expectancy
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| ***increased cardiopulmonary mortality
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| ***increased lung cancer mortality
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| Sensitive subgroups: children, the elderly, individuals with heart and lung disease, individuals who are active outdoors.
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| '''Mortality effects of long-term (chronic) exposure to ambient air
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| In principle the ERFs for long-term exposure (produced by cohort studies) should also capture the mortality effects of short-term exposure (ERFs produced by time-series studies). In practice it is likely that they do not do so fully. This is due to the so-called "harvesting" phenomenon, i.e. it is possible that acute exposure, at least to some extent, only brings forward deaths that would have happened shortly in any case. However, adding effects of acute exposure to effects of long-term exposure is problematic because the risk of double-counting. <ref>[http://ec.europa.eu/environment/archives/air/cafe/pdf/cba_methodology_vol2.pdf Service Contract for Carrying out Cost-Benefit Analysis of Air Quality Related Issues, in particular in the Clean Air for Europe (CAFE) Programme. Volume 2: Health Impact Assessment. AEA Technology Environment, 2005.]</ref>
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| '''''Pope et al. (2002) <ref>*Pope CA III, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K & Thurston KD (2002). Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 287(9), 1132-1141.</ref>
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| *6% increase in the risk of deaths from all causes (excluding violent death) (95% CI 2-11%) per 10 µg/m3 PM2.5 in age group 30+
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| *12% increase in the risk of death from cardiovascular diseases and diabetes (95% CI 8-15%) per 10 µg/m3 PM2.5 in age group 30+
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| *14% increase in the risk of death from lung cancer (95% CI 4-23%) per 10 µg/m3 PM<sub>2.5</sub> in age group 30+
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| '''''Woodruff et al (1997) <ref>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1470072 Woodruff TJ, Grillo J & Schoendorf KC (1997). The relationship between selected causes of postneonatal infant mortality and particulate air pollution in the United States. Environmental Health Perspectives, 105: 608-612.]</ref>
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| *4% (95% Cl 2%-7%) increase in all-cause infant mortality per 10 µg/m3 PM<sub>10</sub> (age 1 month to 1 year)
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| '''''Tuomisto et al. 2008:<ref>Tuomisto et al. 2008. Uncertainty in mortality response to airborne fine particulate matter: Combining European air pollution experts. Reliability Engineering and System Safety 93, 732-744.</ref>
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| *A structured expert judgement study of the population mortality effects of PM<sub>2.5</sub> air pollution.
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| *Opinions of six European air pollution experts were elicited.
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| *Percent increase per 1 µg/m<sup>3</sup> increase in PM<sub>2.5</sub>:
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| **Equal-weight decision-maker
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| ***Best estimate 0.97
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| ***95% quantile 4.54
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| ***5% quantile 0.02
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| **Performance-based decision-maker
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| ***Best estimate 0.60
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| ***95% quantile 3.80
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| ***5% quantile 0.06
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| ''''Mortality effects of short-term (acute) exposure to ambient air PM
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| '''''Anderson et al. 2004 <ref>[http://www.euro.who.int/document/E82792.pdf Anderson HR, Atkinson RW, Peacock JL, Marston L & Konstantinou K (2004). Meta-analysis of time-series studies and panel studies of paticulate matter (PM) and ozone (O3). Report of a WHO task group. World Health Organization.]</ref>
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| *0.6% (95% Cl 0.4%-0.8%) increase in all-cause mortality (excluding accidents) per 10 µg/m3 PM<sub>10</sub> in all ages
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| *1.3% (95% Cl 0.5%-2%) increase in respiratory mortality per 10 µg/m3 PM<sub>10</sub> in all ages
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| *0.9% (95% Cl 0.5%-1.3%) increase in cardiovascular mortality per 10 µg/m3 PM<sub>10</sub> in all ages
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| === Unit ===
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| Relative risk (RR) per 10 µg/m<sup>3</sup> increase in exposure
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| == Result ==
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| '''ERF for chronic PM<sub>2.5</sub> exposure '''
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| {|{{prettytable}}
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| ! Cause of death
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| ! RR
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| ! 95% Cl
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| |-----
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| | All-cause
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| | 1.06
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| | 1.02-1.11
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| |-----
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| | Cardiopulmonary
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| | 1.09
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| | 1.03-1.16
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| |-----
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| | Lung cancer
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| | 1.14
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| | 1.04-1.23
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| |}
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| These coefficients are defined as distributions around estimates of central tendency for each cause of death.
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| Relative increase of mortality per 1 μgm-3 increase of outdoor PM2.5 concentration. Values were drawn with equal probability from the two distributions reported in <ref>Dockery, D. W., Pope, C. A., III, Xu, X., Spengler, J. D., Ware, J. H., Fay, M. E., Ferris, B. G., Jr., &amp; Speizer F. E. (1993). An association between air pollution and mortality in six U.S. cities. The New England Journal of Medicine, 329(24), 1753-1759</ref>, <ref>Pope, C. A. III, Burnett, R. T., Thun, M. J., Calle, E. E., Krewski, D., Ito, K., &amp; Thurston, G. D. (2002). Lung Cancer, Cardiopulmory Mortality, and Long-term Exposure to Fine Particulate Air Pollution. The Journal of the American Medical Association, 287(9), 1132-1141</ref>
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| Crude mortality rate statistics from gas bus model (the dose response sub model). See [[Media:Gasbus_model_01.ANA|the model here]].
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| {| {{prettytable}}
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| |-
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| | Cause of death
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| | Min
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| | Median
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| | Mean
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| | Max
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| | Std.Dev.
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| |-
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| | Cardiopulmonary
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| | -0.0036
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| | 0.0115
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| | 0.0128
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| | 0.0375
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| | -0.0060
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| |-
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| | Lung cancer
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| | -0.0350
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| | 0.0140
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| | 0.0150
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| | 0.0728
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| | 0.0109
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| |-
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| | Other causes
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| | -0.0232
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| | 0.0008
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| | 0.0008
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| | 0.0252
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| | 0.0050
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| |-
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| | All causes
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| | -0.0019
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| | 0.0080
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| | 0.0091
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| | 0.0289
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| | 0.0047
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| |}
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| '''Uncertainties:'''
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| * Mortality estimate from Hoek et al. (2002)<ref> Hoek, G, Brunekreef, B, Goldbohm, S, Fischer, P, &amp; van den Brandt, P. A. (2002). Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study.
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| Lancet, 360 (9341), 1203-1209. </ref> was not included due to many confounding factors related to mortality, e.g. road noise.
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| * Probability for PM2.5 assumed to be the true cause of the effects in 70 %, 90 %, and 10 % for cardiopulmonary, lung cancer and all other mortality, respectively (author judgement).
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| * Toxicity differences between ambient air particles and the particles generated by different bus types were not taken into account due to lack of comprehensive data. <ref>Laden, F., Neas, L. M., Dockery, D. W., &amp; Schwartz, J. (2000). Association of fine particulate matter from different sources with daily mortality in six U.S. cities. Environmental Health Perspectives, 108, 941-947. </ref> <ref>Mar, T. F., Norris, G. A., Koenig, J. Q., &amp; Larson, T. V. (2000). Associations between air pollution and mortality in Phoenix, 1995-1997. Environmental Health Perspectives, 108(4), 347-353.</ref>
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| * No threshold was assumed in the dose-response relationship. <ref>WHO Regional Office for Europe (2003). Health Aspects of Air Pollution with Particulate Matter, Ozone and Nitrogen Dioxide, Report on a WHO Working Group. Report on a WHO working group,
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| Bonn, Germany, January 13-15 2003. Copenhagen. 98 pages. Available at http://www.euro.who.int/eprise/main/who/progs/aiq/newsevents/20030115_2 </ref> <ref>Schwartz, J., Laden, F., &amp; Zanobetti, A. (2002). The concentration-response relation between PM2.5 and daily deaths. Environmental Health Perspectives, 110(10), 1025-1029. </ref>
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| ==See also==
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| *[http://heande.opasnet.org/wiki/Piltti:Relative_risks_of_mortality Relative risks of mortality -page in Heande]
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| *[http://www.euro.who.int/document/E83080.pdf Health aspects of air pollution. Results from the WHO project "Systematic review of health aspects of air pollution in Europe". World Health Organization, 2004.]
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| *Pope et al. 2004. Cardiovascular mortality and long-term exposure to particulate air pollution. Circulation (109), 71-77.
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| *[http://aje.oxfordjournals.org/cgi/content/full/kwn232v1Robin C. Puett, Joel Schwartz, Jaime E. Hart, Jeff D. Yanosky, Frank E. Speizer, Helen Suh, Christopher J. Paciorek, Lucas M. Neas and Francine Laden: Chronic Particulate Exposure, Mortality, and Coronary Heart Disease in the Nurses’ Health Study. American Journal of Epidemiology, doi:10.1093/aje/kwn232]
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| *[http://www.needs-project.org/docs/results/RS1b/NEEDS_Rs1b_D3.7.pdf NEEDS - New Energy Externalities Developments for Sustainability, Deliverable 3.7 "A set of concentration-response function", Integrated Project, Sixth Framework Programme, Project no. 502687.]
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| ==References==
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| <references/>
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| {{mfiles}}
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| [[Category:Exposure-response functions]]
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