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Open AccessFeature PaperArticle

Synergistic Effects of Ambient Temperature and Air Pollution on Health in Europe: Results from the PHASE Project

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Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Department of Epidemiology, Lazio Regional Health Service, 00147 Rome, Italy
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Department of Health Security, National Institute for Health and Welfare (THL), 70210 Kuopio, Finland
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Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland
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Barcelona Institute for Global Health (ISGlobal), 08003 Barcelona, Spain
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Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
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Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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FISABIO, Epidemiology and Environmental Health Joint Research Unit, Universitat Jaume I, Universitat de València, 46010 Valencia, Spain
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Unit of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
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National Public Health Institute, Directorate of Public Health, 1097 Budapest, Hungary
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Department of Environmental Health (DSE), Santé Publique France, 94415 Saint Maurice, France
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Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
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Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
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Department of Population Health Sciences and Department of Analytical, Environmental and Forensic Sciences, School of Population Health & Environmental Sciences, King’s College London, London SE1 9NH, UK
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(9), 1856; https://doi.org/10.3390/ijerph15091856
Received: 22 June 2018 / Revised: 30 July 2018 / Accepted: 18 August 2018 / Published: 28 August 2018
(This article belongs to the Special Issue Climate Change, Extreme Temperatures, Air Pollution, and Health)
We studied the potential synergy between air pollution and meteorology and their impact on mortality in nine European cities with data from 2004 to 2010. We used daily series of Apparent Temperature (AT), measurements of particulate matter (PM10), ozone (O3), and nitrogen dioxide (NO2) and total non-accidental, cardiovascular, and respiratory deaths. We applied Poisson regression for city-specific analysis and random effects meta-analysis to combine city-specific results, separately for the warm and cold seasons. In the warm season, the percentage increase in all deaths from natural causes per °C increase in AT tended to be greater during high ozone days, although this was only significant for all ages when all causes were considered. On low ozone days, the increase in the total daily number of deaths was 1.84% (95% CI 0.87, 2.82), whilst it was 2.20% (95% CI 1.28, 3.13) in the high ozone days per 1 °C increase in AT. Interaction with PM10 was significant for cardiovascular (CVD) causes of death for all ages (2.24% on low PM10 days (95% CI 1.01, 3.47) whilst it is 2.63% (95% CI 1.57, 3.71) on high PM10 days) and for ages 75+. In days with heat waves, no consistent pattern of interaction was observed. For the cold period, no evidence for synergy was found. In conclusion, some evidence of interactive effects between hot temperature and the levels of ozone and PM10 was found, but no consistent synergy could be identified during the cold season. View Full-Text
Keywords: temperature; air pollution; climate change and extreme weather events; interaction; short-term health effect; vulnerability temperature; air pollution; climate change and extreme weather events; interaction; short-term health effect; vulnerability
MDPI and ACS Style

Analitis, A.; De’ Donato, F.; Scortichini, M.; Lanki, T.; Basagana, X.; Ballester, F.; Astrom, C.; Paldy, A.; Pascal, M.; Gasparrini, A.; Michelozzi, P.; Katsouyanni, K. Synergistic Effects of Ambient Temperature and Air Pollution on Health in Europe: Results from the PHASE Project. Int. J. Environ. Res. Public Health 2018, 15, 1856.

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