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Short-term effects of particulate matter on mortality during forest fires in Southern Europe: results of the MED-PARTICLES Project
  1. Annunziata Faustini1,
  2. Ester R Alessandrini1,
  3. Jorge Pey1,2,3,
  4. Noemi Perez2,
  5. Evangelia Samoli4,
  6. Xavier Querol2,
  7. Ennio Cadum5,
  8. Cinzia Perrino6,
  9. Bart Ostro7,
  10. Andrea Ranzi8,
  11. Jordi Sunyer7,
  12. Massimo Stafoggia1,
  13. Francesco Forastiere1,
  14. the MED-PARTICLES study group
  1. 1Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy
  2. 2Institute of Environmental Assessment and Water Research, IDAEA-CSIC, Barcelona, Spain
  3. 3Aix Marseille Université, CNRS, Marseille, France
  4. 4Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
  5. 5Department of Epidemiology and Environmental Health, Regional Environmental Protection Agency, Piedmont, Italy
  6. 6Institute of Atmospheric Pollution, National Research Council, Rome, Italy
  7. 7Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  8. 8Regional Centre for Environment and Health, Regional Agency for Environmental Protection of Emilia-Romagna, Modena, Italy
  1. Correspondence to Dr Annunziata Faustini, Department of Epidemiology, Regional Health Service of Lazio, via Santa Costanza, 53, Rome 00198, Italy; a.faustini{at}


Background An association between occurrence of wildfires and mortality in the exposed population has been observed in several studies with controversial results for cause-specific mortality. In the Mediterranean area, forest fires usually occur during spring–summer, they overlap with Saharan outbreaks, are associated with increased temperature and their health effects are probably due to an increase in particulate matter.

Aim and methods We analysed the effects of wildfires and particulate matter (PM10) on mortality in 10 southern European cities in Spain, France, Italy and Greece (2003–2010), using satellite data for exposure assessment and Poisson regression models, simulating a case-crossover approach.

Results We found that smoky days were associated with increased cardiovascular mortality (lag 0–5, 6.29%, 95% CIs 1.00 to 11.85). When the effect of PM10 (per 10 µg/m3) was evaluated, there was an increase in natural mortality (0.49%), cardiovascular mortality (0.65%) and respiratory mortality (2.13%) on smoke-free days, but PM10-related mortality was higher on smoky days (natural mortality up to 1.10% and respiratory mortality up to 3.90%) with a suggestion of effect modification for cardiovascular mortality (3.42%, p value for effect modification 0.055), controlling for Saharan dust advections.

Conclusions Smoke is associated with increased cardiovascular mortality in urban residents, and PM10 on smoky days has a larger effect on cardiovascular and respiratory mortality than on other days.

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