Health & Environmental Research Online (HERO)


ISA-PM (2009 Final)

Show Project Details Hide Project Details
4,019 References Were Found:
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

MIND diet associated with reduced incidence of Alzheimer's disease

Authors: Morris, MC; Tangney, CC; Wang, Y; Sacks, FM; Bennett, DA; Aggarwal, NT (In Press) Alzheimer's & Dementia. HERO ID: 2825843

[Less] BACKGROUND: In a previous study, higher concordance to the MIND diet, a hybrid Mediterranean-Dietary . . . [More] BACKGROUND: In a previous study, higher concordance to the MIND diet, a hybrid Mediterranean-Dietary Approaches to Stop Hypertension diet, was associated with slower cognitive decline. In this study we related these three dietary patterns to incident Alzheimer's disease (AD).

METHODS: We investigated the diet-AD relations in a prospective study of 923 participants, ages 58 to 98 years, followed on average 4.5 years. Diet was assessed by a semiquantitative food frequency questionnaire.

RESULTS: In adjusted proportional hazards models, the second (hazards ratio or HR = 0.65, 95% confidence interval or CI 0.44, 0.98) and highest tertiles (HR = 0.47, 95% CI 0.26, 0.76) of MIND diet scores had lower rates of AD versus tertile 1, whereas only the third tertiles of the DASH (HR = 0.61, 95% CI 0.38, 0.97) and Mediterranean (HR = 0.46, 95% CI 0.26, 0.79) diets were associated with lower AD rates.

CONCLUSION: High adherence to all three diets may reduce AD risk. Moderate adherence to the MIND diet may also decrease AD risk.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Consequences of kriging and land use regression for PM2.5 predictions in epidemiologic analyses: insights into spatial variability using high-resolution satellite data

Authors: Alexeeff, SE; Schwartz, J; Kloog, I; Chudnovsky, A; Koutrakis, P; Coull, BA (2015) Journal of Exposure Science and Environmental Epidemiology 25:138-144. HERO ID: 2520054

[Less] Many epidemiological studies use predicted air pollution exposures as surrogates for true air pollution . . . [More] Many epidemiological studies use predicted air pollution exposures as surrogates for true air pollution levels. These predicted exposures contain exposure measurement error, yet simulation studies have typically found negligible bias in resulting health effect estimates. However, previous studies typically assumed a statistical spatial model for air pollution exposure, which may be oversimplified. We address this shortcoming by assuming a realistic, complex exposure surface derived from fine-scale (1 km × 1 km) remote-sensing satellite data. Using simulation, we evaluate the accuracy of epidemiological health effect estimates in linear and logistic regression when using spatial air pollution predictions from kriging and land use regression models. We examined chronic (long-term) and acute (short-term) exposure to air pollution. Results varied substantially across different scenarios. Exposure models with low out-of-sample R(2) yielded severe biases in the health effect estimates of some models, ranging from 60% upward bias to 70% downward bias. One land use regression exposure model with >0.9 out-of-sample R(2) yielded upward biases up to 13% for acute health effect estimates. Almost all models drastically underestimated the SEs. Land use regression models performed better in chronic effect simulations. These results can help researchers when interpreting health effect estimates in these types of studies.Journal of Exposure Science and Environmental Epidemiology advance online publication, 4 June 2014; doi:10.1038/jes.2014.40.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Exploration of the composition and sources of urban fine particulate matter associated with same-day cardiovascular health effects in Dearborn, Michigan

Authors: Morishita, M; Bard, RL; Kaciroti, N; Fitzner, CA; Dvonch, T; Harkema, JR; Rajagopalan, S; Brook, RD (2015) Journal of Exposure Science and Environmental Epidemiology 25:145-152. HERO ID: 2520278

[Less] The objective was to explore associations of chemical components and source factors of ambient fine . . . [More] The objective was to explore associations of chemical components and source factors of ambient fine particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) with cardiovascular (CV) changes following same-day exposure to ambient PM2.5. Twenty-five healthy adults living in rural Michigan were exposed to ambient air in an urban/industrial community for 4 to 5 h daily for five consecutive days. CV health outcomes were measured 1-2 h post exposure. Contributing emission sources were identified via positive matrix factorization. We examined associations between PM2.5 mass, composition and source factors, and same-day changes in CV outcomes using mixed-model analyses. PM2.5 mass (10.8±6.8 μg/m(3)), even at low ambient levels, was significantly associated with increased heart rate (HR). Trace elements as well as secondary aerosol, diesel/urban dust and iron/steel manufacturing factors potentially explained the HR changes. However, trace element analysis demonstrated additional associations with other CV responses including changes in blood pressure (BP), arterial compliance, autonomic balance and trends toward reductions in endothelial function. Two factors were related to BP changes (diesel/urban dust, motor vehicle) and trends toward impaired endothelial function (diesel/urban dust). This study indicates composition of PM2.5 and its sources may contribute to CV health effects independently of PM2.5 mass.Journal of Exposure Science and Environmental Epidemiology advance online publication, 28 May 2014; doi:10.1038/jes.2014.35.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Chronic disease prevalence in women and air pollution - A 30-year longitudinal cohort study

Authors: To, T; Zhu, J; Villeneuve, PJ; Simatovic, J; Feldman, L; Gao, C; Williams, D; Chen, H; Weichenthal, S; Wall, C; Miller, AB (2015) Environment International 80:26-32. HERO ID: 2828328

[Less] BACKGROUND: Air pollution, such as fine particulate matter (PM2.5), can increase risk . . . [More] BACKGROUND: Air pollution, such as fine particulate matter (PM2.5), can increase risk of adverse health events among people with heart disease, diabetes, asthma and chronic obstructive pulmonary disease (COPD) by aggravating these conditions. Identifying the influence of PM2.5 on prevalence of these conditions may help target interventions to reduce disease morbidity among high-risk populations.

OBJECTIVES: The objective of this study is to measure the association of exposure of PM2.5 with prevalence risk of various chronic diseases among a longitudinal cohort of women.

METHODS: Women from Ontario who enrolled in the Canadian National Breast Screening Study (CNBSS) from 1980 to 1985 (n=29,549) were linked to provincial health administrative data from April 1, 1992 to March 31, 2013 to determine the prevalence of major chronic disease and conditions (heart disease, diabetes, asthma, COPD, acute myocardial infarction, angina, stroke and cancers). Exposure to PM2.5 was measured using satellite data collected from January 1, 1998 to December 31, 2006 and assigned to resident postal-code at time of entry into study. Poisson regression models were used to describe the relationship between exposure to ambient PM2.5 and chronic disease prevalence. Prevalence rate ratios (PRs) were estimated while adjusting for potential confounders: baseline age, smoking, BMI, marital status, education and occupation. Separate models were run for each chronic disease and condition.

RESULTS: Congestive heart failure (PR=1.31, 95% CI: 1.13, 1.51), diabetes (PR=1.28, 95% CI: 1.16, 1.41), ischemic heart disease (PR=1.22, 95% CI: 1.14, 1.30), and stroke (PR=1.21, 95% CI: 1.09, 1.35) showed over a 20% increase in PRs per 10μg/m(3) increase in PM2.5 after adjusting for risk factors. Risks were elevated in smokers and those with BMI greater than 30.

CONCLUSIONS: This study estimated significant elevated prevalent rate ratios per unit increase in PM2.5 in nine of the ten chronic diseases studied.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Associations between size-fractionated particulate air pollution and blood pressure in a panel of type II diabetes mellitus patients

Authors: Zhao, A; Chen, R; Wang, C; Zhao, Z; Yang, C; Lu, J; Chen, X; Kan, H (2015) Environment International 80:19-25. HERO ID: 2828329

[Less] Little is known regarding how the size distribution of particulate matter (PM) air pollution influences . . . [More] Little is known regarding how the size distribution of particulate matter (PM) air pollution influences its effect on blood pressure (BP), especially among patients with diabetes. The objective of this study was to explore the short-term associations between size-fractionated PM and BP among diabetes patients. We scheduled 6 repeated BP examinations every 2weeks from 13 April 2013 to 30 June 2013 in a panel of 35 type 2 diabetes mellitus patients recruited from an urban community in Shanghai, China. We measured real-time PM concentrations in the size range of 0.25 to 10μm. We used linear mixed-effect models to examine the short-term association of size-fractionated PM and BP after controlling for individual characteristics, mean temperature, relative humidity, day of the week, years with diabetes and use of antihypertensive medication. The association with systolic BP and pulse pressure strengthened with decreasing diameter. The size fractions with the strongest associations were 0.25 to 0.40μm for number concentrations and ≤2.5μm for mass concentrations. Furthermore, these effects occurred immediately even after 0-2h and lasted for up to 48h following exposure. An interquartile range increase in 24-h average number concentrations of PM0.25-0.40 was associated with increases of 3.61mmHg in systolic BP and 2.96mmHg in pulse pressure. Females, patients younger than 65years of age and patients without antihypertensive treatment were more susceptible to these effects. Our results revealed important size and temporal patterns of PM in elevating BP among diabetes patients in China.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Associations between long-term exposure to chemical constituents of fine particulate matter (PM2.5) and mortality in medicare enrollees in the Eastern United States

Authors: Chung, Y; Dominici, F; Wang, Y; Coull, BA; Bell, ML (2015) Environmental Health Perspectives 123:467-474. HERO ID: 2772943

[Less] BACKGROUND: Several epidemiological studies have reported that long-term exposure to . . . [More] BACKGROUND: Several epidemiological studies have reported that long-term exposure to fine particulate matter (PM2.5) is associated with higher mortality. Evidence regarding contributions of PM2.5 constituents is inconclusive.

OBJECTIVES: We assembled a dataset of 12.5 million Medicare enrollees (≥65 yrs) to determine which PM2.5 constituents are: 1) associated with mortality controlling for previous-year PM2.5 total mass (main effect); and 2) elevated in locations exhibiting stronger associations between previous-year PM2.5 and mortality (effect modification).

METHODS: For 518 PM2.5 monitoring locations (Eastern US, 2000-2006), we calculated monthly mortality rates, monthly long-term (previous 1-year average) PM2.5, and 7-year averages (2000-2006) of major PM2.5 constituents [elemental carbon (EC), organic carbon matter (OCM), sulfate (SO4(=)), silicon (Si), nitrate (NO3(-)), and sodium (Na)] and community-level variables. We applied a Bayesian hierarchical model to estimate location-specific mortality rates associated with previous-year PM2.5 (model level 1) and identify constituents that contributed to the spatial variability of mortality, and constituents that modified associations between previous-year PM2.5 and mortality (model level 2), controlling for community-level confounders.

RESULTS: One standard deviation (SD) increases in 7-year average EC, Si, and NO3(-) concentrations were associated with 1.3% [95% posterior interval (PI): 0.3, 2.2], 1.4% (95% PI: 0.6, 2.4), and 1.2% (95% PI: 0.4, 2.1) increases in monthly mortality, controlling for previous-year PM2.5. Associations between previous-year PM2.5 and mortality were stronger in combination with 1-SD increases in SO4(=) and Na.

CONCLUSIONS: Long-term exposures to PM2.5 and several constituents were associated with mortality in the elderly population of the Eastern US. Moreover, some constituents increased the association between long-term exposure to PM2.5 and mortality. These results provide new evidence that chemical composition can partly explain the differential toxicity of PM2.5.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Exposure to fine particle matter, nitrogen dioxide and benzene during pregnancy and cognitive and psychomotor developments in children at 15months of age

Authors: Lertxundi, A; Baccini, M; Lertxundi, N; Fano, E; Aranbarri, A; Martínez, MD; Ayerdi, M; Álvarez, J; Santa-Marina, L; Dorronsoro, M; Ibarluzea, J (2015) Environment International 80:33-40. HERO ID: 2828330

[Less] BACKGROUND: Prenatal exposure to air pollutants has recently been identified as a potential . . . [More] BACKGROUND: Prenatal exposure to air pollutants has recently been identified as a potential risk factor for neuropsychological impairment.

OBJECTIVES: To assess whether prenatal exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and benzene were associated with impaired development in infants during their second year of life.

METHODS: Regression analyses, based on 438 mother-child pairs, were performed to estimate the association between mother exposure to air pollutants during pregnancy and neurodevelopment of the child. The average exposure to PM2.5, NO2 and benzene over the whole pregnancy was calculated for each woman. During the second year of life, infant neuropsychological development was assessed using the Bayley Scales of Infant Development. Regression analyses were performed to estimate the association between exposure and outcomes, accounting for potential confounders.

RESULTS: We estimated that a 1μg/m(3) increase during pregnancy in the average levels of PM2.5 was associated with a -1.14 point decrease in motor score (90% CI: -1.75; -0.53) and that a 1μg/m(3) increase of NO2 exposure was associated with a -0.29 point decrease in mental score (90% CI: -0.47; -0.11). Benzene did not show any significant association with development. Considering women living closer (≤100m) to metal processing activities, we found that motor scores decreased by -3.20 (90% CI: -5.18; -1.21) for PM2.5 and -0.51 (-0.89; -0.13) for NO2, while mental score decreased by -2.71 (90% CI: -4.69; -0.74) for PM2.5, and -0.41 (9% CI: -0.76; -0.06) for NO2.

CONCLUSIONS: Our findings suggest that prenatal residential exposure to PM2.5 and NO2 adversely affects infant motor and cognitive developments. This negative effect could be higher in the proximity of metal processing plants.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

The characteristics of coarse particulate matter air pollution associated with alterations in blood pressure and heart rate during controlled exposures

Authors: Morishita, M; Bard, RL; Wang, L; Das, R; Dvonch, JT; Spino, C; Mukherjee, B; Sun, Q; Harkema, JR; Rajagopalan, S; Brook, RD (2015) Journal of Exposure Science and Environmental Epidemiology 25:153-159. HERO ID: 2535127

[Less] Although fine particulate matter (PM) air pollution <2.5 μm in aerodynamic diameter (PM2.5) is a leading . . . [More] Although fine particulate matter (PM) air pollution <2.5 μm in aerodynamic diameter (PM2.5) is a leading cause of global morbidity and mortality, the potential health effects of coarse PM (2.5-10 μm in aerodynamic diameter; PM10-2.5) remain less clearly understood. We aimed to elucidate the components within coarse PM most likely responsible for mediating these hemodynamic alterations. Thirty-two healthy adults (25.9±6.6 years) were exposed to concentrated ambient coarse PM (CAP) (76.2±51.5 μg/m(3)) and filtered air (FA) for 2 h in a rural location in a randomized double-blind crossover study. The particle constituents (24 individual elements, organic and elemental carbon) were analyzed from filter samples and associated with the blood pressure (BP) and heart rate (HR) changes occurring throughout CAP and FA exposures in mixed model analyses. Total coarse PM mass along with most of the measured elements were positively associated with similar degrees of elevations in both systolic BP and HR. Conversely, total PM mass was unrelated, whereas only two elements (Cu and Mo) were positively associated with and Zn was inversely related to diastolic BP changes during exposures. Inhalation of coarse PM from a rural location rapidly elevates systolic BP and HR in a concentration-responsive manner, whereas the particulate composition does not appear to be an important determinant of these responses. Conversely, exposure to certain PM elements may be necessary to trigger a concomitant increase in diastolic BP. These findings suggest that particulate mass may be an adequate metric of exposure to predict some, but not all, hemodynamic alterations induced by coarse PM mass.Journal of Exposure Science and Environmental Epidemiology advance online publication, 17 September 2014; doi:10.1038/jes.2014.62.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Prenatal air pollution exposure and newborn blood pressure

Authors: van Rossem, L; Rifas-Shiman, SL; Melly, SJ; Kloog, I; Luttmann-Gibson, H; Zanobetti, A; Coull, BA; Schwartz, JD; Mittleman, MA; Oken, E; Gillman, MW; Koutrakis, P; Gold, DR (2015) Environmental Health Perspectives 123:353-359. HERO ID: 2823542

[Less] BACKGROUND: Air pollution exposure has been associated with increased blood pressure . . . [More] BACKGROUND: Air pollution exposure has been associated with increased blood pressure in adults.

OBJECTIVE: We examined associations of antenatal exposure to ambient air pollution with newborn systolic blood pressure (SBP).

METHODS: We studied 1,131 mother-infant pairs in a Boston, Massachusetts, area pre-birth cohort. We calculated average exposures by trimester and during the 2 to 90 days before birth for temporally resolved fine particulate matter (≤ 2.5 μm; PM2.5), black carbon (BC), nitrogen oxides, nitrogen dioxide, ozone (O3), and carbon monoxide measured at stationary monitoring sites, and for spatiotemporally resolved estimates of PM2.5 and BC at the residence level. We measured SBP at a mean age of 30 ± 18 hr with an automated device. We used mixed-effects models to examine associations between air pollutant exposures and SBP, taking into account measurement circumstances; child's birth weight; mother's age, race/ethnicity, socioeconomic position, and third-trimester BP; and time trend. Estimates represent differences in SBP associated with an interquartile range (IQR) increase in each pollutant.

RESULTS: Higher mean PM2.5 and BC exposures during the third trimester were associated with higher SBP (e.g., 1.0 mmHg; 95% CI: 0.1, 1.8 for a 0.32-μg/m3 increase in mean 90-day residential BC). In contrast, O3 was negatively associated with SBP (e.g., -2.3 mmHg; 95% CI: -4.4, -0.2 for a 13.5-ppb increase during the 90 days before birth).

CONCLUSIONS: Exposures to PM2.5 and BC in late pregnancy were positively associated with newborn SBP, whereas O3 was negatively associated with SBP. Longitudinal follow-up will enable us to assess the implications of these findings for health during later childhood and adulthood. Citation: van Rossem L, Rifas-Shiman SL, Melly SJ, Kloog I, Luttmann-Gibson H, Zanobetti A, Coull BA, Schwartz JD, Mittleman MA, Oken E, Gillman MW, Koutrakis P, Gold DR. 2015. Prenatal air pollution exposure and newborn blood pressure. Environ Health Perspect 123:353-359; http://dx.doi.org/10.1289/ehp.1307419.
The "refereed" or "peer review" status of a journal comes from the Ulrichsweb Global Serials Directory (http://ulrichsweb.serialssolutions.com/), as supplied by the publisher. The term refers to the system of critical evaluation of manuscripts/articles by professional colleagues or peers. The content of refereed publications is sanctioned, vetted, or otherwise approved by a peer-review or editorial board. The peer-review and evaluation system is utilized to protect, maintain, and raise the quality of scholarly material published in serials. Publications subject to the referee process are assumed, then, to contain higher quality content than those that are not.
Peer Reviewed Journal Article

Short-term effects of particulate matter constituents on daily hospitalizations and mortality in five South-European cities: Results from the MED-PARTICLES project

Authors: Basagaña, X; Jacquemin, B; Karanasiou, A; Ostro, B; Querol, X; Agis, D; Alessandrini, E; Alguacil, J; Artiñano, B; Catrambone, M; de La Rosa, JD; Díaz, J; Faustini, A; Ferrari, S; Forastiere, F; Katsouyanni, K; Linares, C; Perrino, C; Ranzi, A; Ricciardelli, I; Samoli, E; Zauli-Sajani, S; Sunyer, J; Stafoggia, M (2015) Environment International 75C:151-158. HERO ID: 2533224

[Less] BACKGROUND: Few recent studies examined acute effects on health of individual chemical . . . [More] BACKGROUND: Few recent studies examined acute effects on health of individual chemical species in the particulate matter (PM) mixture, and most of them have been conducted in North America. Studies in Southern Europe are scarce. The aim of this study is to examine the relationship between particulate matter constituents and daily hospital admissions and mortality in five cities in Southern Europe.

METHODS: The study included five cities in Southern Europe, three cities in Spain: Barcelona (2003-2010), Madrid (2007-2008) and Huelva (2003-2010); and two cities in Italy: Rome (2005-2007) and Bologna (2011-2013). A case-crossover design was used to link cardiovascular and respiratory hospital admissions and total, cardiovascular and respiratory mortality with a pre-defined list of 16 PM10 and PM2.5 constituents. Lags 0 to 2 were examined. City-specific results were combined by random-effects meta-analysis.

RESULTS: Most of the elements studied, namely EC, SO4(2-), SiO2, Ca, Fe, Zn, Cu, Ti, Mn, V and Ni, showed increased percent changes in cardiovascular and/or respiratory hospitalizations, mainly at lags 0 and 1. The percent increase by one interquartile range (IQR) change ranged from 0.69% to 3.29%. After adjustment for total PM levels, only associations for Mn, Zn and Ni remained significant. For mortality, although positive associations were identified (Fe and Ti for total mortality; EC and Mg for cardiovascular mortality; and NO3(-) for respiratory mortality) the patterns were less clear.

CONCLUSIONS: The associations found in this study reflect that several PM constituents, originating from different sources, may drive previously reported results between PM and hospital admissions in the Mediterranean area.