| Short-Term Mortality Rates during a Decade of Improved Air Quality in Erfurt, Germany Susanne Breitner,1 Matthias Stölzel,1,2 Josef Cyrys,1,3 Mike Pitz,3 Gabriele Wölke,1 Wolfgang Kreyling,2,4 Helmut Küchenhoff,5 Joachim Heinrich,1 H.-Erich Wichmann,1,6 and Annette Peters1 1Institute of Epidemiology, and 2Focus Network Nanoparticles and Health (NanoHealth), Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany; 3Environment Science Center, University of Augsburg, Augsburg, Germany; 4Institute of Inhalation Biology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany; 5Department of Statistics and 6IBE-Chair of Epidemiology, Ludwig-Maximilians-University, Munich, Germany 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 µm 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 µm 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. Key words: accountability research, air pollution, improved air quality, mortality, particulate matter, ultrafine particles. Environ Health Perspect 117:448–454 (2009) . doi:10.1289/ehp.11711 available via http://dx.doi.org/ [Online 7 October 2008]
Address correspondence to S. Breitner, Helmholtz Zentrum München–German Research Center for Environmental Health, Institute of Epidemiology, Building 56, Room 226, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany. Telephone: 49-89-3187-4481. Fax: 49-89-3187-3380. E-mail: susanne.breitner@helmholtz-muenchen.de Supplemental Material is available online at http://www.ehponline.org/members/2008/11711/suppl.pdf The Focus Network Nanoparticles and Health (NanoHealth) coordinates and focuses all Helmholtz Zentrum München research on health effects and the characterization of aerosols. It comprises research projects of the Institutes of Ecological Chemistry, Epidemiology, Inhalation Biology, Radiation Protection, and Toxicology at Helmholtz Zentrum München. This research was conducted under contract to the Health Effects Institute (HEI) , an organization jointly funded by the U.S. Environmental Protection Agency (U.S. EPA assistance agreement R82811201) and automotive manufacturers. A.P. and H.-E.W. were supportedr in part by the U.S. EPA through STAR grants R827354 and RD832415 to the University of Rochester. The contents of this article do not necessarily reflect the views of HEI, nor do they necessarily reflect the views of motor vehicle and engine manufactures. This research has not been subjected to the agency's required peer and policy review and therefore does not necessarily reflect the views of the agency and no official endorsement should be inferred. The authors declare they have no competing financial interests. Received 19 May 2008 ; accepted 7 October 2008.
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