Role of Saharan dust in the relationship between particulate matter and short-term daily mortality among the elderly in Madrid (Spain)

Background Saharan dust outbreaks are a common phenomenon in the Madrid atmosphere The current Directive 2008/50 CE governing air quality in European cities, draws no distinction between which particulate matter (PM10, PM25 or PM10-25) would be the best indicator on days with/without Saharan dust intrusions. This study sought to identify the role played by Saharan dust in the relationship between particulate matter (PM10, PM25 and PM10-25) concentrations and daily mortality among the elderly in the city of Madrid. Methods. We conducted an ecological longitudinal time-series study on daily mortality among the over-75 age group from 2003 to 2005 Poisson regression models were constructed for days with and without Saharan dust intrusions The following causes of daily mortality were analysed total organic causes except accidents (International Classification of Disease-10th revision (ICD-10): A00-R99), circulatory causes (ICD-10 100-199); and respiratory causes (ICD-10 J00-J99) Daily mean PM10, PM25 and PM10-25 levels were used as independent variables Control variables were other ambient pollutants (chemical, biotic and acoustic). trend, seasonalities, influenza epidemics, and autocorrelations between mortality series Results While daily mean PM25 concentrations in Madrid displayed a significant statistical association with daily mortality for all the above causes on days without Saharan dust intrusions, this association was not in evidence for PM10 or PM10-25 in the multivariate models. The relative risks (RRS) obtained for an increase of 10 mu g/m(3) in PM25 concentrations were: 1.023 (1.010-1.036) for total organic causes, 1 033 (1 031-1 035) for circulatory causes, and 1 032 (1004-1.059) for respiratory causes On Saharan dust days, a significant statistical association was detected between PM10 (though not PM25 or PM10-25) and mortality for all 3 causes analysed with RRs statistically similar to those reported for PM25 Conclusions The best air quality indicators for evaluating the short-term health effect of particulate matter in Madrid are therefore PM10 concentrations on days with and PM25 concentrations on days without Saharan dust outbreaks This fact should be taken into account in a European Directive regulating ambient air quality in almost all countries in the Mediterranean area (C) 2010 Elsevier B V. All rights reserved.