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Aphea Project: Air Pollution and Health: A European Approach

Katsouyanni, K on behalf of the APHEA Group

ISEE/ISEA 2006 Conference Abstracts Supplement: Symposium Abstracts: Abstracts

Department of Hygiene and Epidemiology, University of Athens Medical School, Greece


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The APHEA project started in 1993. Its main objective was to investigate the short-term effects of air pollution on health establishing a European network of scientists based on a large amount of data are analyzed in a uniform, updated, and standardized way. Eleven research groups participated in the first phase of the project, which resulted in clear estimates for the effects of particles and other pollutants. The results were used for regulatory purposes and received the attention of the press. A new contract with the E.C. led to an enlargement of the network to 22 research groups from 20 countries and the database to 32 cities for which daily data on several health outcomes, pollutant concentrations, and information on confounders and potential effect modifiers were recorded. The APHEA project was also supported by 3 accompanying measures contracts. Through these additional contracts, aspects related to methodology, policy, and international collaborations were addressed.

The results of all stages of the APHEA project have been published in several papers in peer-reviewed journals (and cited for more than 1500 times). They concern many aspects of the short-term effects of ambient particles and gaseous pollutants (ozone, nitrogen dioxide, and sulfur dioxide): the effects of different lags, dose–response curves, the mortality displacement issue, the independent effects of each pollutant, effect modification patterns, and methodological issues.

For example, it was found that when PM10 concentrations increase by 10 μg/m3, the daily number of deaths from all causes increases by 0.52% and that of deaths from cardiovascular and respiratory causes by 0.76% and 0.71%, respectively (all figures are statistically significant). The effects are larger on the first and second day for total and cardiovascular mortality, but persist for longer, whereas for respiratory mortality, there are more pronounced and prolonged lagged effects. The dose–response curve does not deviate from linearity within the range of observed concentrations. A pattern of effect modification has been observed: the particles effects are larger in cities with higher NO2 concentrations, in warmer climates, and in cities with larger proportion of elderly. Effects of ozone on daily mortality were observed only during the warm season. It was found that when 8-hour ozone concentrations increase by 10 μg/m3, the total daily number of deaths increases by 0.22% and the number of respiratory deaths increases by 0.70%.

The APHEA project results have been used for HIA by other European projects and investigators and for regulatory purposes by the U.S. EPA and the E.C.

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