The effect of short-term changes in air pollution on respiratory and cardiovascular morbidity in Nicosia, Cyprus.

Presented at the 6th International Conference on Urban Air Quality, Limassol, March, 2007. Short-paper was submitted for peer-review and appears in proceedings of the conference.This study investigates the effect of daily changes in levels of PM10 on the daily volume of respiratory and cardiovascular admissions in Nicosia, Cyprus during 1995-2004. After controlling for long- (year and month) and short-term (day of the week) patterns as well as the effect of weather in Generalized Additive Poisson models, some positive associations were observed with all-cause and cause-specific admissions. Risk of hospitalization increased stepwise across quartiles of days with increasing levels of PM10 by 1.3% (-0.3, 2.8), 4.9% (3.3, 6.6), 5.6% (3.9, 7.3) as compared to days with the lowest concentrations. For every 10μg/m3 increase in daily average PM10 concentration, there was a 1.2% (-0.1%, 2.4%) increase in cardiovascular admissions. With respects to respiratory admissions, an effect was observed only in the warm season with a 1.8% (-0.22, 3.85) increase in admissions per 10μg/m3 increase in PM10. The effect on respiratory admissions seemed to be much stronger in women and, surprisingly, restricted to people of adult age

A 10-year time-series analysis of respiratory and cardiovascular morbidity in Nicosia, Cyprus: the effect of short-term changes in air pollution and dust storms

<p>Abstract</p> <p>Background </p> <p>To date, a substantial body of research has shown adverse health effects of short-term changes in levels of air pollution. Such associations have not been investigated in smaller size cities in the Eastern Mediterranean. A particular feature in the region is dust blown from the Sahara a few times a year resulting in extreme PM₁₀concentrations. It is not entirely clear whether such natural phenomena pose the same risks.</p> <p>Methods </p> <p>The effect of changes in daily levels of particulate matter (PM₁₀) and ozone (O₃) on hospitalization for all, cardiovascular and respiratory causes in the two hospitals in Nicosia during 1 January 1995 and 30 December 2004 was investigated using generalized additive Poisson models after controlling for long- and short-term patterns as well as for the effect of weather. Meteorological records were reviewed to identify dust-storm days and analyses were repeated to quantify their effect on cardio-respiratory morbidity.</p> <p>Results </p> <p>For every 10 μg/m³increase in daily average PM₁₀concentrations, there was a 0.9% (95%CI: 0.6%, 1.2%) increase in all-cause and 1.2% (95%CI: -0.0%, 2.4%) increase in cardiovascular admissions. With respect to respiratory causes, an effect was observed only in the warm months. No lagged effects with levels of PM₁₀were observed. In contrast, positive associations with levels of ozone were only observed the two days prior to admission. These appeared stronger for cardiovascular causes and independent of the effect of PM. All-cause and cardiovascular admissions were 4.8% (95%CI: 0.7%, 9.0%) and 10.4% (95%CI: -4.7%, 27.9%) higher on dust storm days respectively. In both cases the magnitude of effect was comparable to that seen on the quartile of non-storm days with the highest levels of PM₁₀.</p> <p>Conclusion </p> <p>We observed an increased risk of hospitalization at elevated levels of particulate matter and ozone generally consistent with the magnitude seen across several European cities. We also observed an increased risk of hospitalization on dust storm days, particularly for cardiovascular causes. While inference from these associations is limited due to the small number of dust storm days in the study period, it would appear imperative to issue health warnings for these natural events, particularly directed towards vulnerable population groups.</p

Residential exposure to motor vehicle emissions and the risk of wheezing among 7-8 year-old schoolchildren: a city-wide cross-sectional study in Nicosia, Cyprus

<p>Abstract</p> <p>Background</p> <p>Several studies have reported associations between respiratory outcomes in children and a range of self-reported, administrative or geographical indicators of traffic pollution. First-time investigation into the frequency of asthmatic symptoms among 7-8 year-old Cypriot children in 1999-2000 showed increased prevalence in the capital Nicosia compared to other areas. Geographical differences on an island the size of Cyprus may reflect environmental and/or lifestyle factors. This study investigates the relationship between self-reported symptoms and residential exposure to motor vehicle emissions among Nicosia schoolchildren.</p> <p>Methods</p> <p>The addresses of children in the metropolitan area of Nicosia who participated in the original survey (N = 1,735) were geo-coded and the level of exposure of each child was assessed using distance- and emission-based indicators (i.e. estimated levels of particulate matter and nitrogen oxides emissions due to motor vehicles on main roads around the residence). Odds ratios of wheezing and asthma diagnosis in relation to levels of exposure were estimated in logistic regression models adjusting for person-based factors, co-morbidity and intra-school clustering.</p> <p>Results</p> <p>We found an increased risk of wheezing at distances less than 50 m from a main road and/or only among those experiencing the highest levels of exposure. The strongest effect estimates were observed when exposure was defined in terms of the cumulative burden at all roads around the residence. Adjusted odds ratios for current wheezing were 2.33 (95% CI 1.27, 4.30) amongst the quartile of participants exposed to the highest levels of PM at all roads 50 m of their residence and 2.14 (95% CI 1.05, 4.35) for NOx, with no effect at intermediate levels of exposure. While the direction of effect was apparent at longer distances, differences were generally not statistically significant.</p> <p>Conclusions</p> <p>Children experiencing the highest burden of emissions in Nicosia seem to be at a higher risk of reporting asthmatic symptoms. Due to the small number of children residing at close proximity to main roads and lack of evidence of risk at intermediate levels of exposure or longer distances, the observed pattern alone does not explain the generally higher prevalence observed in urban Nicosia compared to other areas.</p

PM10 concentration levels at an urban and background site in Cyprus: the impact of urban sources and dust storms

Air quality in Cyprus is influenced by both local and transported pollution, including desert dust storms. We examined PM10 concentration data collected in Nicosia (urban representative) from April 1, 1993, through December 11, 2008, and in Ayia Marina (rural background representative) from January 1, 1999, through December 31, 2008. Measurements were conducted using a Tapered Element Oscillating Micro-balance (TEOM). PM10 concentrations, meteorological records, and satellite data were used to identify dust storm days. We investigated long-term trends using a Generalized Additive Model (GAM) after controlling for day of week, month, temperature, wind speed, and relative humidity. In Nicosia, annual PM10 concentrations ranged from 50.4 to 63.8 mg/m3 and exceeded the EU annual standard limit enacted in 2005 of 40 mg/m3 every year. A large, statistically significant impact of urban sources (defined as the difference between urban and background levels) was seen in Nicosia over the period 2000–2008, and was highest during traffic hours, weekdays, cold months, and low wind conditions. Our estimate of the mean (standard error) contribution of urban sources to the daily ambient PM10 was 24.0 (0.4) mg/m3 . The study of yearly trends showed that PM10 levels in Nicosia decreased from 59.4 mg/m3 in 1993 to 49.0 mg/m3 in 2008, probably in part as a result of traffic emission control policies in Cyprus. In Ayia Marina, annual concentrations ranged from 27.3 to 35.6 mg/m3 , and no obvious time trends were observed. The levels measured at the Cyprus background site are comparable to background concentrations reported in other Eastern Mediterranean countries. Average daily PM10 concentrations during desert dust storms were around 100 mg/m3 since 2000 and much higher in earlier years. Despite the large impact of dust storms and their increasing frequency over time, dust storms were responsible for a small fraction of the exceedances of the daily PM10 limit. Implications: This paper examines PM10 concentrations in Nicosia, Cyprus, from 1993 to 2008. The decrease in PM10 levels in Nicosia suggests that the implementation of traffic emission control policies in Cyprus has been effective. However, particle levels still exceeded the European Union annual standard, and dust storms were responsible for a small fraction of the daily PM10 limit exceedances. Other natural particles that are not assessed in this study, such as resuspended soil and sea salt, may be responsible in part for the high particle levels

Residential exposure to motor vehicle emissions and the risk of wheezing among 7-8 year-old schoolchildren in Nicosia, Cyprus

Presented at the International Epidemiological Association (IEA) and European Epidemiology Federation (EEF)Congress of Epidemiology, Warsaw, 2009.Background: First-time investigation into the frequency of asthmatic symptoms among Cypriot children showed increased prevalence in the capital compared to all other areas. Exposure to traffic pollutants have been repeatedly shown to be associated with a range of cardiorespiratory effects. Differences in asthma prevalence on an island the size of Cyprus may reflect such environmental factors. Objective: To investigate the association between residential exposure to traffic pollution and the risk of asthmatic symptoms within the city of Nicosia. Methods: The addresses of participating children in Nicosia were geo-coded (N = 1,735) and levels of exposure were assessed using both (a) distance-based and (b) emissions-based indicators e.g. estimated levels of traffic pollutants at all roads within a pre-defined distance around the residence. Odds ratios of self-reported symptoms in relation to exposure were estimated in logistic regression models adjusting for person-based risk factors and co-morbidity as well as intra-school clustering. Results: Up to 2-fold differences in symptoms were observed; however, increased risk seemed to concentrate at distances less than 50 m from a main road and/or only among those experiencing the highest levels of cumulative exposure. Associations persisted after adjusting for other risk factors. While the direction of effect was apparent at longer distances, differences were not statistically significant. Adjusted odds ratios for current wheezing were 2.33 (95% CI 1.27, 4.30) amongst the quartile of participants exposed to the highest levels of particulate matter (PM) at all roads 50 m of their residence and 2.14 (95% CI 1.05, 4.35) for levels of nitrogen oxides (NOx). Conclusions: Children with the highest vehicular emissions burden around their residence seem to be at higher risk of reporting symptoms. However, due to the small number of children residing at close proximity to main roads and with no evidence of effect at longer distances, this alone would not explain the generally higher prevalence observed in the urban areas in Nicosia

PM 3-‘Particulate matter monitoring’ LIFE+ Project: integration of satellite remotely sensed data and ground measurements

PM3 is the result of a joint effort of the Department of Labour Inspection in Cyprus , Aristotle University of Thessaloniki, ESS Austria, Cyprus University of Technology and the Atlantis Consulting Cyprus Ltd and aims to improve the air quality and on a long term basis the quality of life and health of all Cyprus’s citizens. Through the project, the Department aspires to reduce level of dust in the atmosphere through targeted measures. The project is funded by LIFE+ Environment Policy & Governance. This paper presents some of the results obtained by using ground and satellite remotely sensed data. Moreover an emphasis is given to the main local emission sources, including mines and quarries, worksites and unpaved roads with high emissions. Statistical analysis between PM10 and aerosol optical thickness as retrieved from satellite images has been made. Finally NDVI maps required for the forecasting purposes of air pollution as will be further used in the model are presente

Time-series analysis of respiratory and cardiovascular morbidity in Nicosia, Cyprus, 1995-2004: the effect of air pollution and dust storms

Background - A substantial body of research has shown adverse health effects of short-term changes in levels of air pollution. Associations have not been investigated in smaller size Mediterranean cities where re-suspended dust from desert regions can raise particle concentrations considerably above European guidelines. It is unclear whether such natural phenomena pose the same risks. Methods – The effect of daily changes in particulate matter (PM) and ozone on hospital admissions was investigated in generalized additive Poisson models controlling for the effect of weather. Meteorological records and wind trajectories were reviewed to identify dust-storm days and analyses were repeated to quantify their effect. Results – An increasing risk of hospitalisation was observed across quartiles of days with increasing levels of PM. For a 10μg/m3 increase, there was a 0.9% 95%CI (0.6, 1.2) increase in all and 1.2% (-0.0, 2.4) increase in cardiovascular admissions. With respect to respiratory causes, the effect was stronger but restricted to the warm season and may indicate a synergy with temperature. Admissions were 4.8% (0.7, 9.0), 10.4% (-4.7, 27.9) and 3.1% (-10.2, 18.3) higher on dust storm days for all, cardiovascular and respiratory causes respectively. Conclusions – Estimates of the effect of daily changes in air pollution were generally consistent with those seen elsewhere. There was also some evidence of increased admissions on dust-storm days. While inference is limited, the magnitude was at least comparable to that seen on days with the highest levels of PM from traffic sources and may, thus, merit special warnings to vulnerable groups

Particulate matter concentrations during desert dust outbreaks and daily mortality in Nicosia, Cyprus

Ambient particulate matter (PM) has been shown to have short- and long-term effects on cardiorespiratory mortality and morbidity. Most of the risk is associated with fine PM (PM 2.5); however, recent evidence suggests that desert dust outbreaks are major contributors to coarse PM (PM 10-2.5) and may be associated with adverse health effects. The objective of this study was to investigate the risk of total, cardiovascular and respiratory mortality associated with PM concentrations during desert dust outbreaks. We used a time-series design to investigate the effects of PM 10 on total non-trauma, cardiovascular and respiratory daily mortality in Cyprus, between 1 January 2004 and 31 December 2007. Separate PM 10 effects for non-dust and dust days were fit in generalized additive Poisson models. We found a 2.43% (95% CI: 0.53, 4.37) increase in daily cardiovascular mortality associated with each 10-μg/m 3 increase in PM 10 concentrations on dust days. Associations for total (0.13% increase, 95% CI: -1.03, 1.30) and respiratory mortality (0.79% decrease, 95% CI: -4.69, 3.28) on dust days and all PM 10 and mortality associations on non-dust days were not significant. Although further study of the exact nature of effects across different affected regions during these events is needed, this study suggests adverse cardiovascular effects associated with desert dust events