ERF of PM2.5 on mortality in general population

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Scope

ERF of PM2.5 on mortality in general population describes the relationship between PM2.5 exposure and specific causes of mortality in general adult population. The variable focuses but is not limited to long-term (chronic) exposure.

Definition

Data

PM2.5 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).

  • Health effects related to short-term exposure
    • respiratory symptoms
    • adverse cardiovascular effects
    • increased medication usage
    • increased number of hospital admissions
    • increased mortality
  • Health effects related to long-term exposure (more relevance to public health)
    • increased incidence of respiratory symptoms
    • reduction in lung function
    • increased incidence of chronic obstructive pulmonary disease (COPD)
    • reduction in life expectancy
      • increased cardiopulmonary mortality
      • increased lung cancer mortality

Sensitive subgroups: children, the elderly, individuals with heart and lung disease, individuals who are active outdoors.


Mortality effects of long-term (chronic) exposure to ambient air

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. [1]


Pope et al. (2002) [2]

  • 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+
  • 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+
  • 14% increase in the risk of death from lung cancer (95% CI 4-23%) per 10 µg/m3 PM2.5 in age group 30+


Woodruff et al (1997) [3]

  • 4% (95% Cl 2%-7%) increase in all-cause infant mortality per 10 µg/m3 PM10 (age 1 month to 1 year)


Tuomisto et al. 2008:[4]

  • A structured expert judgement study of the population mortality effects of PM2.5 air pollution.
  • Opinions of six European air pollution experts were elicited.
  • Percent increase per 1 µg/m3 increase in PM2.5:
    • Equal-weight decision-maker
      • Best estimate 0.97
      • 95% quantile 4.54
      • 5% quantile 0.02
    • Performance-based decision-maker
      • Best estimate 0.60
      • 95% quantile 3.80
      • 5% quantile 0.06


'Mortality effects of short-term (acute) exposure to ambient air PM

Anderson et al. 2004 [5]

  • 0.6% (95% Cl 0.4%-0.8%) increase in all-cause mortality (excluding accidents) per 10 µg/m3 PM10 in all ages
  • 1.3% (95% Cl 0.5%-2%) increase in respiratory mortality per 10 µg/m3 PM10 in all ages
  • 0.9% (95% Cl 0.5%-1.3%) increase in cardiovascular mortality per 10 µg/m3 PM10 in all ages

Unit

Relative risk (RR) per 10 µg/m3 increase in exposure

Result

ERF for chronic PM2.5 exposure

Cause of death RR 95% Cl
All-cause 1.06 1.02-1.11
Cardiopulmonary 1.09 1.03-1.16
Lung cancer 1.14 1.04-1.23


These coefficients are defined as distributions around estimates of central tendency for each cause of death.

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 [6], [7]

Crude mortality rate statistics from gas bus model (the dose response sub model). See the model here.


Cause of death Min Median Mean Max Std.Dev.
Cardiopulmonary -0.0036 0.0115 0.0128 0.0375 -0.0060
Lung cancer -0.0350 0.0140 0.0150 0.0728 0.0109
Other causes -0.0232 0.0008 0.0008 0.0252 0.0050
All causes -0.0019 0.0080 0.0091 0.0289 0.0047

Uncertainties:

  • Mortality estimate from Hoek et al. (2002)[8] was not included due to many confounding factors related to mortality, e.g. road noise.
  • 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).
  • 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. [9] [10]
  • No threshold was assumed in the dose-response relationship. [11] [12]

See also

References

  1. ↑ 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.
  2. ↑ *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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ Dockery, D. W., Pope, C. A., III, Xu, X., Spengler, J. D., Ware, J. H., Fay, M. E., Ferris, B. G., Jr., & 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
  7. ↑ Pope, C. A. III, Burnett, R. T., Thun, M. J., Calle, E. E., Krewski, D., Ito, K., & 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
  8. ↑ Hoek, G, Brunekreef, B, Goldbohm, S, Fischer, P, & van den Brandt, P. A. (2002). Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study. Lancet, 360 (9341), 1203-1209.
  9. ↑ Laden, F., Neas, L. M., Dockery, D. W., & 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.
  10. ↑ Mar, T. F., Norris, G. A., Koenig, J. Q., & Larson, T. V. (2000). Associations between air pollution and mortality in Phoenix, 1995-1997. Environmental Health Perspectives, 108(4), 347-353.
  11. ↑ 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, Bonn, Germany, January 13-15 2003. Copenhagen. 98 pages. Available at http://www.euro.who.int/eprise/main/who/progs/aiq/newsevents/20030115_2
  12. ↑ Schwartz, J., Laden, F., & Zanobetti, A. (2002). The concentration-response relation between PM2.5 and daily deaths. Environmental Health Perspectives, 110(10), 1025-1029.


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