Particulate Air Pollution and Mortality: The Particle Epidemiology Evaluation Project

Abstract

The second colloquium on particulate air pollution marks the reemergence of air pollution, generated by combustion sources, as a serious public health concern throughout the developed world. This article provides a perspective on the epidemiologic evidence on particulate air pollution and health. It addresses the evolution of methods for investigating air pollution and mortality and morbidity and the inter-pretational framework for the findings of the studies. Our work at the Johns Hopkins University School of Hygiene and Public Health, funded by the Health Effects Institute as part of its Particle Epidemiology Evaluation Project, provides the foundation; data are from public-use resources and are analyzed using Poisson regression. Data from previous analyses were replicated, and a detailed analysis for Philadelphia 1974–1988 was conducted to explore the sensitivity of the findings to key modeling assumptions. Our findings show that the association of total suspended particles with mortality persisted; an effect of ozone was also noted that remained unchanged as other pollutants were considered. Varying measures of air pollution are associated with mortality in diverse communities and have been robust to choices of analytic methods. Similar analyses with single locations will contribute little to our understanding of air pollution and mortality unless there are special pollution patterns. Nonetheless, the weight of evidence from single locations indicates an adverse effect of air pollution. In deciding about the particulate matter standard, it must be remembered that we lack necessary toxicologic information. A need exists for a research program covering exposure assessment and epidemiology and clinical and experimental toxicology; such a program could benefit the regulatory process on air pollution and health.