Associations between Mortality and Air Pollution in Central Europe
Peters, Annette, Skorkovsky, Jiri, Kotesovec, Frantisek, Brynda, Jaromir, Spix, Claudia, Wichmann, H. Erich, Heinrich, Joachim, Environmental Health Perspectives
Increased mortality has been observed in association with elevated concentrations of air pollutants in European cities and in the United States. We reassessed the effects of particulate matter in Central Europe. Mortality and air pollution data were obtained for a highly polluted region of the Czech Republic and a rural region in Germany. Poisson regression analyses were conducted considering trend, season, meteorology, and influenza epidemics as confounders in both a parametric and a nonparametric approach. The Czech Republic had a 3.8% increase in mortality [95% confidence interval (CI), 0.8-6.9%] in association with 100 [micro]g/[m.sup.3] total suspended particles (TSP) (lagged 2 days) for the time period 1982-1994. During the last 2 year,t of study, 68% of the TSP consisted of particulate matter [is less than or equal to] 10 [micro]m in aerodynamic diameter ([PM.sub.10]). An increase of 100 [micro]g/[m.sup.3] TSP (lagged 1 day) was associated with a 9.5% increase in mortality (CI, 1.2-18.5%) and 100 [micro]g/[m.sup.3] [PM.sub.10] (lagged 1 day) showed a 9.8% increase in mortality (CI, 0.7-19.7%). We found no evidence for an association between mortality and particulate matter in the rural area in Germany at the Czech border. Data from the coal basin in the Czech Republic suggested an increase in mortality associated with the concentration of particulate matter in a highly polluted setting in Central Europe that is consistent with the associations observed in other western European cities and in the United States. Key words: air pollution, epidemiology, mortality, particulate pollution, sulfur dioxide. Environ Health Perspect 108:283-287 (2000). [Online 14 February 2000]
Acute exposure to particulate air pollution has been associated with adverse health effects (1-3). In particular, increases in mortality have been observed in association with particulate matter. Associations between mortality and air pollution were studied in 12 locations in 9 European countries as part of the Air Pollution and Health - a European Approach (APHEA) project (4). The study periods ranged from the mid-1970s to the end of the 1980s, when sulfur dioxide concentrations and total suspended particles (TSP) were still relatively high in Europe. The study confirmed the association between air pollution and mortality in combined analyses (5). Surprisingly, stronger associations between air pollutants and mortality were observed in the western European cities than in the eastern European cities, where local air pollution standards were frequently exceeded in the 1980s (5).
This paper reports data from a highly polluted area in the Czech Republic and a rural area in Germany during the time period 1982-1994. We analyzed a different data set from central Europe and evaluated the possibility that the air pollution effects seen consistently throughout the western world (1-3) are reduced in central Europe despite high exposures in the 1980s. The Czech Republic study region is the coal basin in the northwest of the country. The area is highly industrialized based on its rich resources in brown coal. Large power plants provide [is greater than] 70% of the electric energy consumed in the Czech Republic. The comparison region consists of four districts in northern Bavaria, a rural German area at the Czech border. The main sources of pollution are local combustion, traffic, and regional transport.
Data acquisition. The coal basin includes the districts Chomutov, Most, Teplice, Usti n.L., and Decin. These districts have approximately 630,000 inhabitants in an area of approximately 700 [km.sup.2]. The Bavarian study region includes the districts Hof, Landkreis Hof, Wunsiedel, and Tirschenreuth. The Bavarian districts have approximately 250,000 inhabitants in an area of approximately 1,000 [km.sup.2.].
Mortality data from state authorities were obtained in both locations. …