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      Contaminantes atmosféricos y su vigilancia Translated title: Air pollutants and the monitoring thereof

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          Abstract

          Se presentan algunos conceptos básicos relativos a la contaminación atmosférica. Aunque, desde un punto de vista sanitario, nuestro interés se centra en los efectos que producen los contaminantes sobre la salud de la población, es importante conocer cuáles son los principales contaminantes, sus fuentes emisoras, sus características fisicoquímicas, los métodos de captación y análisis que utilizan las estaciones de control de la contaminación atmosférica, los límites establecidos por la legislación vigente y las recomendaciones de la Organización Mundial de la Salud respecto a los niveles de inmisión. Este trabajo repasa estos conceptos en relación con los contaminantes que se han analizado en el Estudio Multicéntrico Español de Contaminación Atmosférica y Mortalidad (EMECAM): partículas, dióxido de azufre (SO2), dióxido de nitrógeno (NO2), monóxido de carbono (CO) y ozono (O3). Para ello se han utilizado las publicaciones más recientes en la materia, incluyendo parte de lo que va a ser en un futuro inmediato el eje de actuación frente a la contaminación atmosférica: el nuevo conjunto de directivas de la Unión Europea (algunas en fase de propuesta) y las recomendaciones últimas (aún sin publicar) de la Organización Mundial de la Salud. Por último, se plantea el amplio abanico de aspectos que incumben a la Salud Pública en el campo de la contaminación atmosférica, a pesar de que la vigilancia y control dependen administrativamente de las autoridades ambientales.

          Translated abstract

          Some basic concepts regarding air pollution are set out. Although, from a health care standpoint, our interest revolves around the impact which pollution has on human health, it being important to ascertain the main pollutants, the sources of emissions, the physicochemical properties thereof, the sampling and analysis methods which are used at the air pollution control stations, the limits set by the laws currently in impact and the World Health Organization recommendations with regard to the levels of inmission. This study reviews these concepts with regard to the pollutants which have been analyzed in the Spanish Multicenter Study of Air Pollution and Mortality. (EMECAM): particles, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3). For this purpose, the most recent publications on this subject have been used, including part of what is going to be the line around which all of the measures aimed at combating air pollution are going to be revolving in the very near future, that is, the new set of European Union Directives (some currently in the proposal stage) and the latest recommendations (not as yet published) of the World Health Organization. Lastly, a wide range of aspects are set out which involve Public Health in the field of air pollution, despite the monitoring and control thereof falling to the environmental affairs authorities in terms of government organization.

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          Most cited references38

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          Short term effects of air pollution on health: a European approach using epidemiologic time series data: the APHEA protocol.

          Results from several studies over the past five years have shown that the current levels of pollutants in Europe and North America have adverse short term effects on health. The APHEA project aims to quantifying these in Europe, using standardised methodology. The project protocol and analytical methodology are presented here. Daily time series data were gathered for several air pollutants (sulphur dioxide; particulate matter, measured as total particles or as the particle fraction with an aerodynamic diameter smaller than a certain cut off, or as black smoke; nitrogen dioxide; and ozone) and health outcomes (the total and cause specific number of deaths and emergency hospital admissions). The data included fulfilled the quality criteria set by the APHEA protocol. Fifteen European cities from 10 different countries with a total population over 25 million. The APHEA collaborative group decided on a specific methodological procedure to control for confounding effects and evaluate the hypothesis. At the same time there was sufficient flexibility to allow local characteristics to be taken into account. The procedure included modelling of all potential confounding factors (that is, seasonal and long term patterns, meteorological factors, day of the week, holidays, and other unusual events), choosing the "best" air pollution models, and applying diagnostic tools to check the adequacy of the models. The final analysis used autoregressive Poisson models allowing for overdispersion. Effects were reported as relative risks contrasting defined increases in the corresponding pollutant levels. Each participating group applied the analyses to their own data. This methodology enabled results from many different European settings to be considered collectively. It represented the best available compromise between feasibility, comparability, and local adaptibility when using aggregated time series data not originally collected for the purpose of epidemiological studies.
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            Short-term effects of air pollution on daily mortality in Athens: a time-series analysis.

            Athens has a serious air pollution problem which became evident in the early 1970s. Studies for the years 1975-1982 have indicated a positive association of sulphur dioxide (SO2) with total daily mortality. Since 1983 the pollution profile in Athens has gradually changed but the levels of smoke, SO2 and carbon monoxide (CO) remain relatively high. The association of air pollution with daily all-cause mortality in Athens for the years 1984-1988 was investigated using daily values of SO2, smoke and CO. Autoregressive models with log-transformed daily mortality as the dependent variable, were used to adjust for temperature and relative humidity (both lagged by 1 day), year, season and day of week, as well as for serial correlations in mortality. Graphic analysis revealed non-linear monotonically increasing relationships between total mortality and SO2, smoke and CO, with steeper exposure-response slopes at lower air pollution levels. Air pollution data lagged by 1 day had the strongest association with daily mortality. In three separate autoregression models for log(SO2), log(smoke) and log(CO) the regression coefficients for each were highly statistically significant (P < 0.001). Further multiple regression modelling showed that SO2 and smoke are both independent predictors of daily mortality, though to a lesser extent than temperature and relative humidity. The inclusion of CO in the model did not further improve the prediction of daily mortality. The magnitude of association is small, for instance, a 10% reduction in smoke is estimated to decrease daily mortality by 0.75% (95% confidence interval [CI]: 0.51-0.99). However, it cannot be accounted for by climatic and seasonal effects, so that a causal influence of air pollution on daily mortality seems plausible. These findings suggest that current air pollution levels in Athens (and many other industrialized cities) may be responsible for substantial numbers of premature deaths, and hence remain an important public health issue.
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              Effects of urban air pollution on emergency room admissions for chronic obstructive pulmonary disease.

              The authors assessed the relation between sulfur dioxide and other air pollutants (black smoke, carbon monoxide, nitrogen dioxide, and ozone) and daily emergency room admissions for chronic obstructive pulmonary disease in Barcelona, Spain, during 1985-1986. Barcelona is a Mediterranean city of 1.7 million inhabitants that has air pollution levels lower than standard values. A weak but statistically significant association between emergency room admissions and levels of sulfur dioxide, black smoke, and carbon monoxide was observed. Daily emergency room admissions for chronic obstructive pulmonary disease increased by 0.02 and 0.01 for each microgram of sulfur dioxide and black smoke per cubic meter, respectively, and 0.11 for each milligram of carbon monoxide per cubic meter, after adjusting for meteorologic and temporal variables. Similar estimations were obtained after controlling for the autocorrelation effect by means of time series analysis. In addition, when the data were stratified by season, the effects remained in summer. This strengthened the conclusion that the relation observed in winter, spring, and throughout the study period was indeed real. After truncating the data according to sulfur dioxide or black smoke levels, the authors still found effects for these pollutants at levels below the air quality guideline of 100 micrograms/m3 established by the World Health Organization. The consistency of these results with other recent toxicologic and epidemiologic observations suggest that current air pollution standards do not totally protect public health with a margin of safety in specific places.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad Servicios Sociales e Igualdad (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                March 1999
                : 73
                : 2
                : 123-132
                Affiliations
                [03] orgnameCentro Nacional de Sanidad Ambiental orgdiv1 Instituto de Salud Carlos III
                [01] orgnameComunidad de Madrid orgdiv1 Consejería de Sanidad y Servicios Sociales
                [02] orgnameJunta de Andalucía orgdiv1 Consejería de Medio Ambiente
                Article
                S1135-57271999000200003
                10.1590/s1135-57271999000200003
                757ef14d-4f83-40b8-9cd4-358a943e9121

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 10
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                SciELO Spain


                Contaminación atmosférica,Salud pública,Partículas,Dióxido de azufre,Dióxido de nitrógeno,Monóxido de carbono,Ozono,Air pollution,Public health,Particles,Sulfur dioxide,Nitrogen dioxide,Carbon monoxide,Ozone

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