Health effects of ultrafine and fine particles in Central Europe : Results from the UFIREG study.

Background: Evidence on health effects of ultrafine particles (UFP) is still limited. The UFIREG project aimed at investigating the short-term effects of ultrafine and fine particles on daily (cause‑specific) mortality and morbidity in five European Cities. Methods: UFP (20-100nm) and fine particles <2.5µm (PM2.5) were measured in Dresden and Augsburg (Germany), Prague (Czech Republic), Ljubljana (Slovenia) and Chernivtsi (Ukraine). Meteorological data were obtained from country-specific network stations. Data on cause‑specific mortality and hospital admissions were collected for all cities. Depending on data availability the following periods were chosen: Augsburg and Dresden 2011-2012, Ljubljana and Prague 2012-2013, Chernivtsi 2013-March 2014. The effects of UFP and PM2.5 on health outcomes were assessed using confounder-adjusted Poisson regression models examining single (lag0-lag5) and cumulative lags (lag0-1, lag2-5, lag0-5). City-specific estimates were pooled using meta-analyses methods. Results: Results indicate delayed and prolonged increases in the pooled relative risk (RR) of respiratory mortality (lag5: 5.5%[95%-confidence interval:‑1.6;13.2]) and hospital admissions (lag0-5: 2.9%[‑2.8;8.9]) in association with a 2,750 particles/cm3 increase (average interquartile range across all cities) in UFP. Our findings point to delayed increases in the RR of cardiovascular mortality (lag3: 1.7%[-1.0;4.4]) and hospital admissions (lag5: 1.6%[0.1;3.1] with a 12.4 µg/m3 increase in PM2.5. We observed a 7.4%[4.7;10.2] increase in the RR of respiratory hospital admissions with an increase in the 6‑day average of PM2.5. Conclusions: Our results indicate delayed and prolonged effects of UFP on respiratory health outcomes. PM2.5 was associated with delayed effects on cardiovascular and respiratory health outcomes. Further multi-centre studies are needed investigating several years in order to produce powerful results and to draw definite conclusions on health effects of UFP

Health effects of ambient ultrafine particles - the project UFIREG background.

The project "Ultrafine particles - An evidence based contribution to the development of regional and European environmental and health policy" (UFIREG) started in July 2011 and ended in December 2014. It was implemented through the Central Europe Programme and co-financed by the European Regional Development Fund. Five cities in four Central European countries participated in the study: Augsburg (Germany), Chernivtsi (Ukraine), Dresden (Germany), Ljubljana (Slovenia) and Prague (Czech Republic). The aim of the UFIREG project was to improve the knowledge base on possible health effects of ambient ultrafine particles (UFP) and to raise overall awareness of environmental and health care authorities and the population. Methods. Epidemiological studies in the frame of the UFIREG project have assessed the short-term effects of UFP on human mortality and morbidity, especially in relation to cardiovascular and respiratory diseases. Official statistics were used to determine the association between air pollution concentration and daily (cause- -specific: respiratory and cardiovascular) hospital admissions and mortality. Associations of UFP levels and health effects were analysed for each city by use of Poisson regression models adjusting for a number of confounding factors. Results. Results on morbidity and mortality effects of UFP were heterogeneous across the five European cities investigated. Overall, an increase in respiratory hospital admissions and mortality could be detected for increases in UFP concentrations. Results on cardiovascular health were less conclusive. Conclusion. Further multi-centre studies such as UFIREG are needed preferably investigating several years in order to produce powerful results

Associations between ultrafine and fine particles and mortality in five central European cities - results from the UFIREG study.

BACKGROUND: Evidence on health effects of ultrafine particles (UFP) is still limited as they are usually not monitored routinely. The few epidemiological studies on UFP and (cause-specific) mortality so far have reported inconsistent results. OBJECTIVES: The main objective of the UFIREG project was to investigate the short-term associations between UFP and fine particulate matter (PM)<2.5μm (PM2.5) and daily (cause-specific) mortality in five European Cities. We also examined the effects of PM<10μm (PM10) and coarse particles (PM2.5-10). METHODS: UFP (20-100nm), PM and meteorological data were measured in Dresden and Augsburg (Germany), Prague (Czech Republic), Ljubljana (Slovenia) and Chernivtsi (Ukraine). Daily counts of natural and cardio-respiratory mortality were collected for all five cities. Depending on data availability, the following study periods were chosen: Augsburg and Dresden 2011-2012, Ljubljana and Prague 2012-2013, Chernivtsi 2013-March 2014. The associations between air pollutants and health outcomes were assessed using confounder-adjusted Poisson regression models examining single (lag 0-lag 5) and cumulative lags (lag 0-1, lag 2-5, and lag 0-5). City-specific estimates were pooled using meta-analyses methods. RESULTS: Results indicated a delayed and prolonged association between UFP and respiratory mortality (9.9% [95%-confidence interval: -6.3%; 28.8%] increase in association with a 6-day average increase of 2750particles/cm(3) (average interquartile range across all cities)). Cardiovascular mortality increased by 3.0% [-2.7%; 9.1%] and 4.1% [0.4%; 8.0%] in association with a 12.4μg/m(3) and 4.7μg/m(3) increase in the PM2.5- and PM2.5-10-averages of lag 2-5. CONCLUSIONS: We observed positive but not statistically significant associations between prolonged exposures to UFP and respiratory mortality, which were independent of particle mass exposures. Further multi-centre studies are needed investigating several years to produce more precise estimates on health effects of UFP

Ultrafine and fine particles and hospital admissions in Central Europe: Results from the UFIREG study.

RATIONALE: Evidence on short-term effects of ultrafine particles (UFP) on health is still inconsistent and few multi-center studies have been conducted so far especially in Europe. OBJECTIVES: Within the UFIREG project, we investigated the short-term effects of UFP and fine particulate matter <2.5 µm (PM2.5) on daily cause-specific hospital admissions in five Central and Eastern European cities using harmonized protocols for measurements and analyses. METHODS: Daily counts of cause-specific hospital admissions were obtained for Augsburg and Dresden (Germany) 2011-2012, Chernivtsi (Ukraine) 2013-March 2014, Ljubljana (Slovenia) and Prague (Czech Republic) 2012-2013 focusing on cardiovascular and respiratory diseases. Air pollution and meteorological data were measured at fixed monitoring sites in all cities. We analyzed city-specific associations using confounder-adjusted Poisson regression models and pooled the city-specific effect estimates using meta-analyses methods. MAIN RESULTS: A 2,750 particles/cm3 increase (average interquartile range (IQR) across all cities) in the 6-day average of UFP indicated a delayed and prolonged increase in the pooled relative risk of respiratory hospital admissions (3.4% [95%-confidence interval:-1.7%;8.8%]). We also found increases in the pooled relative risk of cardiovascular (exposure average of lag 2-5: 1.8% [0.1%;3.4%]) and respiratory (6-day average exposure: 7.5% [4.9%;10.2%]) admissions per 12.4 µg/m3 increase (average IQR) in PM2.5. CONCLUSIONS: Our findings indicated delayed and prolonged effects of UFP exposure on respiratory hospital admissions in Central and Eastern Europe. Cardiovascular and respiratory hospital admissions increased in association with an increase in PM2.5. Further multi-center studies are needed using harmonized UFP measurements to draw definite conclusions on health effects of UFP