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Introduction: Urban air pollution is a major threat to child and adolescent health. Children are more vulnerable to its effects, being associated with higher morbidity and mortality due to acute and chronic diseases, especially respiratory ones. A study is performed on the relationship between urban air pollution and the rate of hospital admissions due to acute respiratory diseases., Patients and Methods: An ecological study was conducted on young people under 17 years-old in the city of Murcia, who had visited hospital emergency departments due to respiratory diseases (ICD-9) during 2015. A logistic regression was performed on the risk of hospital admission that included consultations in relation to the average daily levels of environmental pollutants (NO 2 , O 3 , PM10, SO 2 ) obtained from the Air Quality Surveillance and Control network of the Region of Murcia. Other control variables, such as gender, age, average daily ambient temperature, and season of the year., Results: A total of 12,354 (56% boys and 44% girls) children consulted in the emergency department for respiratory disease. Of those, 3.5% were admitted, with a mean age of 2.54 (95% CI; 2.16-2.91) years. The odds ratio (OR) of hospital admission for respiratory diseases: NO 2 1.02 (95% CI; 1.01-1.04; P<.01), O 3 1.01 (95% CI; 1.00-1.03; P<.01) male 1.4 (95% CI 1.11-1.79; P<.01) and winter 2.10 (95% CI 1.40-3.21; P<.01). Admissions for asthma: PM10 1.02 (95% CI; 1.01-1.04; P<.05), O 3 1.04 (95% CI; 1.01-1.06; P<.01). Admissions for bronchiolitis: Age 0.69 (95% CI; 0.48-0.99; P<.05); NO 2 1.03 (95% CI; 1.01-1.05; P<.01)., Conclusions: Urban air pollution increases hospital admissions in children due to acute respiratory diseases, especially asthma and bronchiolitis. Implementing preventive measures, expanding time series and collaborative studies with open data, would help improve public health and air quality in the cities., (Copyright © 2020. Publicado por Elsevier España, S.L.U.)

Objectives: Air pollutant concentrations in many urban areas are still above the legal and recommended limits that are set to protect the citizens' health. Madrid is one of the cities where traffic causes high NO 2 levels. In this context, Madrid City Council launched the Air Quality and Climate Change Plan for the city of Madrid (Plan A), a local strategy approved by the previous government in 2017. The aim of this study was to conduct a quantitative health impact assessment to evaluate the number of premature deaths that could potentially be prevented by the implementation of Plan A in Madrid in 2020, at both citywide and within-city level. The main purpose was to support decision-making processes in order to maximize the positive health impacts from the implementation of Plan A measures., Methods: The Regional Statistical Office provided information on population and daily mortality in Madrid. For exposure assessment, we estimated PM 2.5 , NO 2 and O 3 concentration levels for Madrid city in 2012 (baseline air-quality scenario) and 2020 (projected air-quality scenario based on the implementation of Plan A), by means of an Eulerian chemical-transport model with a spatial resolution of 1 km × 1 km and 30 vertical levels. We used the concentration-response functions proposed by two relevant WHO projects to calculate the number of attributable annual deaths corresponding to all non-accidental causes (ICD-10: A00-R99) among all-ages and the adult population (>30 years old) for each district and for Madrid city overall. This health impact assessment was conducted dependant on health-data availability., Results: In 2020, the implementation of Plan A would imply a reduction in the Madrid citywide annual mean PM 2.5 concentration of 0.6 μg/m 3 and 4.0 μg/m 3 for NO 2 . In contrast, an increase of 1 μg/m 3 for O 3 would be expected. The annual number of all-cause deaths from long-term exposure (95% CI) that could be postponed in the adult population by the expected air-pollutant concentration reduction was 88 (57-117) for PM 2.5 and 519 (295-750) for NO 2 ; short-term exposure accounted for 20 (7-32) for PM 2.5 and 79 (47-111) for NO 2 in the total population. According to the spatial distribution of air pollutants, the highest mortality change estimations were for the city centre - including Madrid Central and mainly within the M-30 ring road -, as compared to peripheral districts. The positive health impacts from the reductions in PM 2.5 and NO 2 far exceeded the adverse mortality effects expected from the increase in O 3 ., Conclusions: Effective implementation of Plan A measures in Madrid city would bring about an appreciable decline in traffic-related air-pollutant concentrations and, in turn, would lead to significant health-related benefits., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health. None of the funders played any role in conducting research or writing the paper., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: In recent years, Spain has implemented a number of air quality control measures that are expected to lead to a future reduction in fine particle concentrations and an ensuing positive impact on public health., Objectives: We aimed to assess the impact on mortality attributable to a reduction in fine particle levels in Spain in 2014 in relation to the estimated level for 2007., Methods: To estimate exposure, we constructed fine particle distribution models for Spain for 2007 (reference scenario) and 2014 (projected scenario) with a spatial resolution of 16×16km(2). In a second step, we used the concentration-response functions proposed by cohort studies carried out in Europe (European Study of Cohorts for Air Pollution Effects and Rome longitudinal cohort) and North America (American Cancer Society cohort, Harvard Six Cities study and Canadian national cohort) to calculate the number of attributable annual deaths corresponding to all causes, all non-accidental causes, ischemic heart disease and lung cancer among persons aged over 25 years (2005-2007 mortality rate data). We examined the effect of the Spanish demographic shift in our analysis using 2007 and 2012 population figures., Results: Our model suggested that there would be a mean overall reduction in fine particle levels of 1µg/m(3) by 2014. Taking into account 2007 population data, between 8 and 15 all-cause deaths per 100,000 population could be postponed annually by the expected reduction in fine particle levels. For specific subgroups, estimates varied from 10 to 30 deaths for all non-accidental causes, from 1 to 5 for lung cancer, and from 2 to 6 for ischemic heart disease. The expected burden of preventable mortality would be even higher in the future due to the Spanish population growth. Taking into account the population older than 30 years in 2012, the absolute mortality impact estimate would increase approximately by 18%., Conclusions: Effective implementation of air quality measures in Spain, in a scenario with a short-term projection, would amount to an appreciable decline in fine particle concentrations, and this, in turn, would lead to notable health-related benefits. Recent European cohort studies strengthen the evidence of an association between long-term exposure to fine particles and health effects, and could enhance the health impact quantification in Europe. Air quality models can contribute to improved assessment of air pollution health impact estimates, particularly in study areas without air pollution monitoring data., (© 2013 Elsevier Inc. All rights reserved.)

Background: Records kept as a result of the implementation of Integrated Pollution Prevention and Control (IPPC) and the European Pollutant Release and Transfer Register (E-PRTR) constitute a public inventory of industries, created by the European Commission, which is a valuable resource for monitoring industrial pollution. Our objective is to ascertain whether there might be excess colorectal cancer mortality among populations residing in the vicinity of Spanish industrial installations that are governed by the IPPC Directive and E-PRTR Regulation and report their emissions to air., Methods: An ecological study was designed to examine colorectal cancer mortality at a municipal level (8098 Spanish towns), over the period 1997-2006. We conducted an exploratory "near vs. far" analysis to estimate the relative risks (RR) of towns situated at a distance of less than 2 km from industrial installations. The analysis was repeated for each of the 24 industrial groups. RR and their 95% credible/confidence intervals (95%CI) were estimated on the basis of Poisson regression models, using two types of modelling: a) the conditional autoregressive Bayesian model proposed by Besag, York and Mollié, with explanatory variables; and b) a mixed regression model. Integrated nested Laplace approximations were used as a Bayesian inference tool., Results: Statistically significant RRs were detected in the vicinity of mining industry (RR 1.258; 95%CI 1.082 - 1.463), paper and wood production (RR 1.071; 95%CI 1.007 - 1.140), food and beverage sector (RR 1.069; 95%CI 1.029 - 1.111), metal production and processing installations (RR 1.065; 95% CI 1.011 - 1.123) and ceramics (RR 1.050 ; 95%CI 1.004 - 1.099)., Conclusions: Given the exploratory nature of this study, it would seem advisable to check in other countries or with other designs, if the proximity of industries that emit pollutants into the air could be an added risk factor for colorectal cancer mortality. Nevertheless, some of the differences between men and women observed in the analyses of the industrial groups suggest that there may be a component of occupational exposure, little-studied in the case of cancers of the digestive system.

Pleural cancer mortality is an acknowledged indicator of exposure to asbestos and mesothelioma mortality but in 15%-20% of cases no exposure can be recalled. In the past, asbestos was used in many industries and it is still found in many installations. Our objective was to ascertain whether there might be excess pleural cancer mortality among populations residing in the vicinity of Spanish industrial installations that are governed by the Integrated Pollution Prevention and Control (IPPC) Directive and the European Pollutant Release and Transfer Register Regulation and report their emissions to air. An ecological study was designed to examine pleural cancer mortality at a municipal level (8098 Spanish towns) over the period 1997-2006, during which 2146 deaths were registered. We conducted an exploratory "near vs. far" analysis to estimate the relative risks (RRs) of towns situated at a distance of <2 km from installations. This analysis was repeated for each of the 24 industrial groups. RR and their 95% credible intervals (95% CIs) were estimated on the basis of a Poisson conditional autoregressive Bayesian model with explanatory variables. Integrated nested Laplace approximations were used as a Bayesian inference tool. Analysis showed statistically significant RRs in both sexes in the vicinity of 7 of the 24 industrial groups studied (RR, 95% CI), namely, biocide facilities (2.595, 1.459-4.621), ship-building (2.321, 1.379-3.918), glass and mineral fibre production (1.667, 1.041-2.665), non-hazardous waste treatment (1.737, 1.077-2.799), galvanising (1.637, 1.139-2.347), organic chemical plants (1.386, 1.075-1.782) and the food and beverage sector (1.255, 1.006-1.562). In the proximity of sources pertaining to the biocide, organic chemical and galvanising sectors, the risk was seen to be rising among men and women, a finding that could indicate airborne environmental exposure. These results support that residing in the vicinity of IPPC-registered industries that release pollutants to the air constitutes a risk factor for pleural cancer., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: Health effects linked to exposure to high air pollutant levels have been described in depth, and many recent epidemiologic studies have also consistently reported positive associations between exposure to air pollutants at low concentrations (particularly PM(2.5)) and adverse health outcomes., Objective: To estimate the number of avoidable deaths associated with reducing PM(2.5) levels in Spain., Materials and Methods: For exposure assessment, we used the US Environmental Protection Agency's Community Multiscale Air Quality model to simulate air pollution levels with a spatial resolution of 18×18 km(2). Two different scenarios were compared, namely, a baseline 2004 scenario based on Spain's National Emissions Inventory and a projected 2011 scenario in which a reduction in PM(2.5) was estimated on the basis of the benefits that might be attained if specific air quality policies were implemented. Using an 18×18 km(2) grid, air pollution data were estimated for the entire Iberian Peninsula, the Balearic Islands, Ceuta and Melilla. For these strata, crude all-cause mortality rates (ICD-10: A00-Y98) were then calculated for the over-30 and 25-74 age groups, taking into account the 2004 population figures corresponding to these same age groups, selected in accordance with the concentration-response functions (Pope CA 3rd, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 2002; 287:1132-41; Laden F, Schwartz J, Speizer FE, Dockery DW. Reduction in fine particulate air pollution and mortality: extended follow-up of the Harvard Six Cities study. Am J Respir Crit Care Med 2006; 173:667-72.). Health impacts were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP)., Results: Air quality improvement was defined as an average annual reduction of 0.7 μg/m(3) in PM(2.5) levels. Using long-term health impact assessment analysis, we estimated that 1720 (673-2760) all-cause deaths (6 per 100,000 population) in the over-30 age group and 1450 (780-2108) all-cause deaths (5 per 100,000 population) in the 25-74 age group could be prevented annually., Conclusions: The results showed the potential benefits in general mortality which could be expected if pollution control policies were successfully implemented by 2011. A specifically adapted BenMAP could be used as a tool for estimating health impacts associated with changes in air pollution in Spain., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: Releases to the environment of toxic substances stemming from industrial metal production and processing installations can pose a health problem to populations in their vicinity., Objectives: To investigate whether there might be excess leukemia-related mortality in populations residing in towns in the vicinity of Spanish metal industries included in the European Pollutant Emission Register., Methods: Ecologic study designed to examine mortality due to leukemia at a municipal level, during the period 1994-2003. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using Poisson regression models, we analyzed: risk of dying from leukemia in a 5-kilometer zone around installations which had become operational prior to 1990; effect of pollution discharge route and type of industrial activity; and risk gradient within a 50-kilometer radius of such installations., Results: Excess mortality (relative risk, 95% confidence interval) was detected in the vicinity of pre-1990 installations (1.07, 1.02-1.13 in men; 1.05, 1.00-1.11 in women), with this being more elevated in the case of installations that released pollution to air versus water. On stratifying by type of industrial activity, statistically significant associations were also observed among women residing in the vicinity of galvanizing installations (1.58, 1.09-2.29) and surface-treatment installations using an electrolytic or chemical process (1.34, 1.10-1.62), which released pollution to air. There was an effect whereby risk increased with proximity to certain installations., Conclusions: The results suggest an association between risk of dying due to leukemia and proximity to Spanish metal industries., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Background: Toxic substances released into the environment (to both air and water) by many types of industries might be related with the occurrence of some malignant tumours and other diseases. The publication of the EPER (European Pollutant Emission Register) Spanish data allows to investigate the presence of geographical mortality patterns related to industrial pollution. The aim of this paper is to describe industrial air and water pollution in Spain in 2001, broken down by activity group and specific pollutant, and to plot maps depicting emissions of carcinogenic substances., Methods: All information on industrial pollution discharge in 2001 was drawn from EPER-Spain public records provided by the European Commission server. We described the distribution of the number of industries and amounts discharged for each pollutant, as well as emission by pollutant group and the industrial activities associated with each pollutant. Maps of Spain were drawn up, with UTM coordinates being used to plot pollutant foci, and circles with an area proportional to the emission to depict pollution emission values., Results: The EPER-Spain contained information on 1,437 industrial installations. The industrial plants that discharge pollutant substances into air and water above the pollutant-specific EPER threshold were mainly situated in the Autonomous Regions of Aragon, Andalusia and Catalonia and in Catalonia, the Basque Country and Andalusia respectively. Pollution released in 2001 into air approached 158 million Mt. Emissions into water were over 8 million Mt., Conclusion: A few single industrial plants are responsible for the highest percentage of emissions, thus rendering monitoring of their possible health impact on the surrounding population that much simpler. Among European countries Spain is the leading polluter in almost one third of all EPER-registered pollutant substances released into the air and ranks among the top three leading polluters in two-thirds of all such substances. Information obtained through publication of EPER data means that the possible consequences of reported pollutant foci on the health of neighbouring populations can now be studied.

Spatial aggregation of different industrial facilities leads to simultaneous release of pollutant emissions. Our objective is to study cancer mortality risk associated with residence in the vicinity of pollutant factories. We used data on industries for year 2007 (3458 facilities). For the 8,098 Spanish towns, we defined a factor with 4 levels based on the number of factories in a radius of 2.5 km from the centroid of each town (industrial factor).We also used data of land cover use to approximate the percentage of municipal land used for industrial activities in each Spanish town (land-used variable). For both variables we fitted Poisson models with random terms to account for spatial variation. We estimated risk trends related with increasing number of factories or percentage of land used for industrial activities. We studied 33 cancer causes. For the industrial factor, 11 causes showed trend associated with increasing factor level. For the land use variable, 8 causes showed statistically significant risks. Almost all tumours related to the digestive system and the respiratory system showed increased risks. Thus mortality by these tumours could be associated to residence in towns nearby industrial areas with positive trend linked to increasing levels of industrial activity. [ABSTRACT FROM AUTHOR]

Abstract: Background: Health effects linked to exposure to high air pollutant levels have been described in depth, and many recent epidemiologic studies have also consistently reported positive associations between exposure to air pollutants at low concentrations (particularly PM2.5) and adverse health outcomes. Objective: To estimate the number of avoidable deaths associated with reducing PM2.5 levels in Spain. Materials and methods: For exposure assessment, we used the US Environmental Protection Agency''s Community Multiscale Air Quality model to simulate air pollution levels with a spatial resolution of 18×18km2. Two different scenarios were compared, namely, a baseline 2004 scenario based on Spain''s National Emissions Inventory and a projected 2011 scenario in which a reduction in PM2.5 was estimated on the basis of the benefits that might be attained if specific air quality policies were implemented. Using an 18×18km2 grid, air pollution data were estimated for the entire Iberian Peninsula, the Balearic Islands, Ceuta and Melilla. For these strata, crude all-cause mortality rates (ICD-10: A00-Y98) were then calculated for the over-30 and 25–74 age groups, taking into account the 2004 population figures corresponding to these same age groups, selected in accordance with the concentration–response functions (Pope CA 3rd, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 2002; 287:1132–41; Laden F, Schwartz J, Speizer FE, Dockery DW. Reduction in fine particulate air pollution and mortality: extended follow-up of the Harvard Six Cities study. Am J Respir Crit Care Med 2006; 173:667–72.). Health impacts were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP). Results: Air quality improvement was defined as an average annual reduction of 0.7μg/m3 in PM2.5 levels. Using long-term health impact assessment analysis, we estimated that 1720 (673–2760) all-cause deaths (6 per 100,000 population) in the over-30 age group and 1450 (780–2108) all-cause deaths (5 per 100,000 population) in the 25–74 age group could be prevented annually. Conclusions: The results showed the potential benefits in general mortality which could be expected if pollution control policies were successfully implemented by 2011. A specifically adapted BenMAP could be used as a tool for estimating health impacts associated with changes in air pollution in Spain. [Copyright &y& Elsevier]

The article presents a study concerning the health impact of environmental tobacco smoke (ETS) which causes sudden death of infant and number of asthma cases in Europe. The study uses available information from European countries and health impact assessment (HIA) to asses the potential health impact of ETS. It founds that ETS is a significant factor of air pollution and is linked with adverse health effect in children which needs further health education to recognize the danger of smoking.

Introduction: This study provides an economic assessment of the health effects due to exposure to particulate matter PM2.5 in three medium-size cities of northwestern Mexico: Los Mochis, Culiacan and Mazatlán. People in these cities are exposed to high pollutant concentrations that exceed limits suggested in domestic and international guidelines. PM2.5 is an air contaminant negatively associated with people's health when is highly concentrated in the atmosphere; its diameter is below 2.5 µm and causes the air to appear hazy when levels are elevated. To account for the economic impact of air pollution, a Health Impact Assessment (HIA) was used by the means of the European Aphekom Project. We figured the cost-savings of complying with current environmental standards and computed gains in life expectancy, total avoidable premature mortality, preventable cardiovascular disease, and the economic costs of air pollution related to PM2.5. A formal analysis of air pollution epidemiology is not pursued in this paper. Results: The cost of reducing PM2.5 pollution associated with negative health outcomes was based on two different scenarios: Official Mexican Standard (NOM, Spanish acronym) and World Health Organization (WHO) environmental standards. The mean PM2.5 concentrations in 2017 were 22.8, 22.4 and 14.1 µg/m3 for Los Mochis, Mazatlán and Culiacan, respectively. Conclusions: The mean avoidable mortality for all causes associated to PM2.5 exposure in these cities was 638 for the NOM scenario (i.e., with a reduction to 12 µg/m3) compared to 739 for the WHO scenario (reduction to 10 µg/m3). Complying with the WHO guideline of 10 µg/m3 in annual PM2.5 mean would add up to 15 months of life expectancy at age 30, depending on the city. The mean economic cost per year of the PM2.5 effects on human life in these three cities was USD 600 million (NOM scenario) and USD 695 million (WHO scenario). Thus, effective public health and industrial policy interventions to improve air quality are socially advantageous and cost-saving to promote better health. [ABSTRACT FROM AUTHOR]

Cancer can be caused by exposure to air pollution released by industrial facilities. The European Pollutant Release and Transfer Register (E-PRTR) has made it possible to study exposure to industrial pollution. This study seeks to describe the industrial emissions in the vicinity of Spanish towns and their temporal changes, and review our experience studying industrial pollution and cancer. Data on industrial pollutant sources (2007–2010) were obtained from the E-PRTR registries. Population exposure was estimated by the distance from towns to industrial facilities. We calculated the amount of carcinogens emitted into the air in the proximity (<5 km) of towns and show them in municipal maps. We summarized the most relevant results and conclusions reported by ecological E-PRTR-based on studies of cancer mortality and industrial pollution in Spain and the limitations and result interpretations of these types of studies. There are high amounts of carcinogen emissions in the proximity of towns in the southwest, east and north of the country and the total amount of emitted carcinogens is considerable (e.g. 20 Mt of arsenic, 63 Mt of chromium and 9 Mt of cadmium). Although the emissions of some carcinogens in the proximity of certain towns were reduced during the study period, emissions of benzene, dioxins+furans and polychlorinated biphenyls rose. Moreover, the average population of towns lying within a 5 km radius from emission sources of carcinogens included in the International Agency for Research on Cancer list of carcinogens was 9 million persons. On the other hand, the results of the reviewed studies suggest that those Spanish regions exposed to the pollution released by certain types of industrial facilities have around 17% cancer excess mortality when compared with those unexposed. Moreover, excess mortality is focused on digestive and respiratory tract cancers, leukemias, prostate, breast and ovarian cancers. Despite their limitations, ecological studies are a useful tool in environmental epidemiology, not only for proposing etiological hypotheses about the risk of living close to industrial pollutant sources, but also for providing data to account for situations of higher mortality in specific areas. Nevertheless, the reduction of emissions should be a goal, with special relevance given to establishing limits for known carcinogens and other toxic substances in the environs of population centers, as well as industry-specific emission limits. [ABSTRACT FROM AUTHOR]