Short-term Associations between Fine and Coarse Particulate Matter and Hospitalizations in Southern Europe: Results from the MED-PARTICLES Project

Background: Evidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent.Objectives: We aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project.Methods: City-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM_2.5), ≤ 10 μm (PM₁₀), and their difference (PM_2.5–10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration–response curves were estimated using a meta-smoothing approach.Results: We found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m³ in PM_2.5, 6.3 μg/m³ in PM_2.5–10, and 14.4 μg/m³ in PM₁₀ (lag 0–1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM₁₀ to 1.36% (95% CI: 0.23, 2.49) for PM_2.5 (lag 0–5 days).Conclusions: PM_2.5 and PM_2.5–10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards.Citation: Stafoggia M, Samoli E, Alessandrini E, Cadum E, Ostro B, Berti G, Faustini A, Jacquemin B, Linares C, Pascal M, Randi G, Ranzi A, Stivanello E, Forastiere F, the MED-PARTICLES Study Group. 2013. Short-term associations between fine and coarse particulate matter and hospitalizations in Southern Europe: results from the MED-PARTICLES project. Environ Health Perspect 121:1026–1033; http://dx.doi.org/10.1289/ehp.1206151