• Massimo Stafoggia, Evangelia Samoli, Ester Alessandrini, Ennio Cadum, Bart Ostro, Giovanna Berti, Annunziata Faustini, Benedicte Jacquemin, Cristina Linares, Mathilde Pascal, Giorgia Randi, Andrea Ranzi, Elisa Stivanello, Francesco Forastiere, and MED-PARTICLES Study Group.
• Department of Epidemiology, Lazio Region Health Service, Rome, Italy. m.stafoggia@deplazio.it
• Environ. Health Perspect. 2013 Sep 1;121(9):1026-33.

BackgroundEvidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent.ObjectivesWe aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project.MethodsCity-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5-10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration-response curves were estimated using a meta-smoothing approach.ResultsWe found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m3 in PM2.5, 6.3 μg/m3 in PM2.5-10, and 14.4 μg/m3 in PM10 (lag 0-1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM10 to 1.36% (95% CI: 0.23, 2.49) for PM2.5 (lag 0-5 days).ConclusionsPM2.5 and PM2.5-10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards.

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