Touloumi G, Samoli E, Katsouyanni K
Department of Hygiene and Epidemiology, University of Athens Medical School, Greece.
J Epidemiol Community Health. 1996 Apr;50 Suppl 1(Suppl 1):s47-51. doi: 10.1136/jech.50.suppl_1.s47.
There is evidence that air pollution in Athens between 1975 and 1987 had adverse short term health effects. The short term effects of "winter type" air pollution on the daily total number of deaths are investigated for the period 1987-91 as part of the European Community multi centre APHEA project.
A temporal study using aggregated data is presented. The associations of the daily time series of three pollutants, sulphur dioxide (SO2), black smoke (BS), and carbon monoxide (CO) and the daily total number of deaths in the Athens area were assessed.
The average measurement from three stations was used for each pollutant. The daily number of deaths was recorded from the Athens Town Registry and the registries of the 18 municipalities contiguous to Athens. Data on the mean daily temperature (degree C) and relative humidity (%) were also used. Poisson autoregressive models that also allowed for overdispersion were used. Seasonality, other long term patterns, temperature, humidity, day of the week, and holidays were adjusted for. Several a priori defined pollutant transformations and lags were investigated. One day measurements as well as cumulative exposure effects were assessed. Effect modification by season as well as among pollutants was tested.
Linear terms were used for all pollutants. The magnitude of the effect was greater at lags 0 for CO and 1 for BS and SO2 gradually declining after lag 1. For an increase of 100 micrograms/m3 in SO2 and BS there were corresponding increases (95% CI) of 12% (7%, 16%) and 5% (3%, 8%) in the daily total numbers of deaths, while for an increase of 10 micrograms/m3 in CO the increase (95% CI) in the daily total number of deaths was 10% (5%, 15%). A significant interaction of the effects of SO2 with season were found. The strongest effect was observed during the winter, when higher levels of SO2 were observed. A stronger effect of SO2 on the daily total number of deaths was observed when the levels of BS were > 100 micrograms/m3.
These results strengthen the evidence of a causal association between ambient particle, SO2, or CO levels in the air and the daily total number of deaths and points to an important public health issue for the Athens population.
有证据表明，1975年至1987年间雅典的空气污染对健康产生了短期不利影响。作为欧洲共同体多中心APHEA项目的一部分，对1987 - 1991年期间“冬季型”空气污染对每日死亡总数的短期影响进行了调查。
呈现了一项使用汇总数据的时间序列研究。评估了三种污染物（二氧化硫（SO₂）、黑烟（BS）和一氧化碳（CO））的每日时间序列与雅典地区每日死亡总数之间的关联。
每种污染物使用三个监测站的平均测量值。每日死亡人数记录自雅典城镇登记处以及雅典周边18个市镇的登记处。还使用了每日平均温度（摄氏度）和相对湿度（%）的数据。使用了允许过度离散的泊松自回归模型。对季节性、其他长期模式、温度、湿度、星期几和节假日进行了调整。研究了几种预先定义的污染物转换和滞后情况。评估了一天的测量值以及累积暴露效应。测试了季节以及污染物之间的效应修正。
所有污染物均使用线性项。CO在滞后0时效应幅度更大，BS和SO₂在滞后1时效应幅度更大，滞后1后逐渐下降。SO₂和BS每增加100微克/立方米，每日死亡总数相应增加（95%置信区间）12%（7%，16%）和5%（3%，8%），而CO每增加10微克/立方米，每日死亡总数增加（95%置信区间）10%（5%，15%）。发现SO₂的效应与季节之间存在显著交互作用。在冬季观察到最强效应，此时SO₂水平较高。当BS水平>100微克/立方米时，观察到SO₂对每日死亡总数有更强的效应。
这些结果强化了空气中环境颗粒物、SO₂或CO水平与每日死亡总数之间存在因果关联的证据，并指出了雅典人群面临的一个重要公共卫生问题。
