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. 2009 Mar;117(3):448-54.
doi: 10.1289/ehp.11711. Epub 2008 Oct 7.

Short-term mortality rates during a decade of improved air quality in Erfurt, Germany

Susanne Breitner  1 , Matthias Stölzel, Josef Cyrys, Mike Pitz, Gabriele Wölke, Wolfgang Kreyling, Helmut Küchenhoff, Joachim Heinrich, H-Erich Wichmann, Annette Peters
Affiliations

Short-term mortality rates during a decade of improved air quality in Erfurt, Germany

Susanne Breitner et al. Environ Health Perspect. 2009 Mar.

Abstract

Background: Numerous studies have shown associations between ambient air pollution and daily mortality.

Objectives: Our goal was to investigate the association of ambient air pollution and daily mortality in Erfurt, Germany, over a 10.5-year period after the German unification, when air quality improved.

Methods: We obtained daily mortality counts and data on mass concentrations of particulate matter (PM)<10 microm in aerodynamic diameter (PM10), gaseous pollutants, and meteorology in Erfurt between October 1991 and March 2002. We obtained ultrafine particle number concentrations (UFP) and mass concentrations of PM<2.5 microm in aerodynamic diameter (PM2.5) from September 1995 to March 2002. We analyzed the data using semiparametric Poisson regression models adjusting for trend, seasonality, influenza epidemics, day of the week, and meteorology. We evaluated cumulative associations between air pollution and mortality using polynomial distributed lag (PDL) models and multiday moving averages of air pollutants. We evaluated changes in the associations over time in time-varying coefficient models.

Results: Air pollution concentrations decreased over the study period. Cumulative exposure to UFP was associated with increased mortality. An interquartile range (IQR) increase in the 15-day cumulative mean UFP of 7,649 cm(-3) was associated with a relative risk (RR) of 1.060 [95% confidence interval (CI), 1.008-1.114] for PDL models and an RR/IQR of 1.055 (95% CI, 1.011-1.101) for moving averages. RRs decreased from the mid-1990s to the late 1990s.

Conclusion: Results indicate an elevated mortality risk from short-term exposure to UFP. They further suggest that RRs for short-term associations of air pollution decreased as pollution control measures were implemented in Eastern Germany.

Keywords: accountability research; air pollution; improved air quality; mortality; particulate matter; ultrafine particles.

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Figures

Figure 1
Figure 1
Daily average concentrations of air pollutants and meteorologic data in Erfurt, Germany, between 1991 and 2002. aPlausible data only; data from 1 April 1994 to 31 January 1995 omitted. bImputed time series.
Figure 2
Figure 2
Cumulative RR of mortality (together with 95% CI) for different periods in association with NO2, CO, PM10, PM2.5, and UFP in Erfurt estimatedusing 6-day (circles) and 15-day (triangles) averages. Periods: period 2, 1 September 1995 to 28 February 1998; and period 3, 1 March 1998 to 31 March 2002. Overall IQR values: for the 6-day average: NO2, 12.7 μg/m3; CO, 0.31 mg/m3; PM10, 17.2 μg/m3; PM2.5, 13.3 μg/m3; and UFP 8,439 cm−3; for the 15-day average: NO2, 11.0 μg/m3; CO, 0.31 mg/m3; PM10, 14.5 μg/m3; PM2.5, 11.5 μg/m3; and UFP 7,649 cm−3. Cumulative RRs were estimated for mortality within new city limits. aImputed time series.
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