Short-term associations between fine and coarse particulate matter and hospitalizations in Southern Europe: results from the MED-PARTICLES project

Environ Health Perspect. 2013 Sep;121(9):1026-33. doi: 10.1289/ehp.1206151. Epub 2013 Jun 18.


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 (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5-10) 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 PM2.5, 6.3 μg/m3 in PM2.5-10, 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 PM2.5 (lag 0-5 days).

Conclusions: PM2.5 and PM2.5-10 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cities*
  • Europe / epidemiology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Models, Theoretical
  • Particle Size
  • Particulate Matter / analysis*
  • Poisson Distribution
  • Respiratory Tract Diseases / epidemiology*
  • Respiratory Tract Diseases / etiology


  • Particulate Matter