Philippe Saviuc

Short-Term Effects of Air Pollution on Mortality in Nine French Cities: A Quantitative Summary

Abstract Between 1990 and 1995, 9 French cities provided data on daily air pollution, total mortality, cardiovascular mortality, and respiratory mortality. Personnel in individual cities performed Poisson regressions, controlling for trends in seasons, calendar effects, influenza epidemics, temperature, and humidity, to assess the short-term effects of air pollution. The authors describe results obtained from the quantitative pooling of these local analyses. When no heterogeneity could be detected, a fixed-effect model was used; otherwise, a random-effect model was used. Significant and positive associations were found between total daily deaths in these cities and the 4 air pollution indicators studied: (1) Black Smoke, (2) sulfur dioxide, (3) nitrogen dioxide, and (4) ozone. A 50-μg/m3 increase in Black Smoke (24 hr), sulfur dioxide (24 hr), nitrogen dioxide (24 hr), or ozone (8 hr) was associated with increases in total mortality of 2.9% (95% confidence interval [Cl]) = 1.3, 4.4), 3.6% (95% Cl = 2.1, 5.2), 3.8% (95% Cl = 2.0, 5.5), and 2.7% (95% Cl = 1.3,4.1), respectively. Similar results were obtained for cardiovascular mortality. Except for sulfur dioxide, positive—but not significant—associations were found with respiratory mortality. The internal consistency among the cities studied, as well as consistency with previously published results, favors a causal interpretation of these associations.

Short-term health effects of an industrial toxic waste landfill: a retrospective follow-up study in Montchanin, France.

A retrospective follow-up study was conducted in 1990 to assess the short-term health impacts of an industrial waste landfill. The site, located since 1979 in a French town of 6,000 inhabitants (about 100 m from the nearest houses) released volatile organic compounds (VOCs) into the air and provoked intense health concern in the community. The landfill was subsequently closed in 1988. Subjects were 694 inhabitants residing in three different parts of town. Individual exposure was estimated, using a dispersion model of volatile air pollutants and accommodated the daily activity patterns of each individual within the area under investigation. Surrogate morbidity data were derived from measurement of the consumption of drugs prescribed for specific therapeutic categories over a 3-y period (18 mo before and 18 mo after the site was closed). Although differences were not statistically significant, the most exposed subjects had been prescribed more drugs for diseases possibly linked to emissions from the site before it closed than the least exposed individuals. There was a suggestion of a slight trend in the consumption of drugs for ear, nose, and throat and pulmonary ailments with individual exposure levels. These results, and the review of toxicological data for some of the VOCs released by the dump, support the decision to close the site.

Retentissement de la pollution atmosphérique sur la santé: Le Programme de Surveillance Air et Santé 9 villes

OBJECTIVESnTo quantify the short term effects of air pollution on mortality and hospitalisation for cardiovascular or respiratory disorders in the nine French cities (Bordeaux, Le Havre, Lille, Lyon, Marseille, Paris, Rouen, Strasbourg and Toulouse) of the Surveillance Air et Santé program.nnnMETHODSnData were available on mortality and hospitalisation were available, respectively, from 1990 to 1997 and 1995 to 1999. Exposure data were the concentrations of sulphur dioxide, particles with a diameter of less than or equal to 10 mm, black smoke, nitrogen dioxide, ozone, and carbon monoxide. The analysis assessed the relationships, in each of the cities, between the daily numbers of deaths and hospitalisations and the daily levels of polluting agents, taking into account confounding factors. A combined relative risk was calculated for all the cities. The number of deaths and hospitalisations attributable to air pollution was then estimated for each of the cities, based on the relative risk.nnnRESULTSnSignificant relationships were found for mortality, from whatever cause, and for hospitalisations for respiratory disorders in children aged under 15. If the levels of air pollution were reduced to 10 microg/m3 in the nine cities, 2800 premature deaths and 750 hospitalisations for respiratory disorders in children would be avoided, every year.nnnCONCLUSIONnToday, it is possible to assess the benefits of reducing air pollution in terms of health in the short term. These analyses would provide a sanitary dimension to the strategies for the reduction of urban pollution on local and European level.Resume Objectif Quantifier les effets a court terme de la pollution atmospherique sur la mortalite et les admissions hospitalieres d’origine cardio-vasculaire ou respiratoire, dans les 9 villes (Bordeaux, Le Havre, Lille, Lyon, Marseille, Paris, Rouen, Strasbourg et Toulouse) du Programme de Surveillance Air et Sante. Methodes Les donnees de mortalite et d’hospitalisation etaient disponibles, respectivement, de 1990 a 1997 et de 1995 a 1999. Les donnees d’exposition concernaient les concentrations du dioxyde de soufre, des particules de diametre inferieur ou egal a 10 mm, des fumees noires, du dioxyde d’azote, de l’ozone, du monoxyde de carbone. L’analyse a mis en relation, dans chacune des villes, les nombres journaliers de deces et d’hospitalisations avec les niveaux journaliers des polluants, en tenant compte d’un ensemble de facteurs de confusion. Un risque relatif combine a ete calcule pour l’ensemble des villes. Les nombres de deces et d’hospitalisations attribuables a la pollution atmospherique dans chacune des villes ont ete estimes a partir de ce risque relatif. Resultats Des associations significatives ont ete observees pour la mortalite, quelle que soit la cause, et pour les hospitalisations pour motifs respiratoires chez les moins de 15 ans. Si les niveaux de pollution atmospherique etaient ramenes a 10 μg/m 3 sur les 9 villes, 2800 deces anticipes au total et 750 hospitalisations respiratoires chez les enfants seraient evitables chaque annee. Conclusion Il est possible d’estimer l’impact de la reduction de la pollution sur la sante pour le court terme. Ces analyses permettent de donner une dimension sanitaire aux politiques de reduction de la pollution urbaine au niveau local et europeen.