Background
Several recent studies have shown that current levels of ambient air
particulate pollution, often measured as PM10 or PM2.5, are associated
with increased cardiovascular and respiratory morbidity and mortality.
The main open question is, what are the characteristics of the airborne
particles that are responsible for these health effects. Currently, the
two leading theories are that it is the very large number of ultrafine
particles in urban air or the chemical composition of particles, especially
the transition metal content that determines the health effects.
Objectives
The goal of the ULTRA project is to improve knowledge on human exposure
to particulate matter of different sizes and of different chemical composition
in Europe, and to evaluate the associated health risks. These results can
then be used to develop standards for air quality in Europe, for better
and more efficient monitoring of air quality, and as a bases for designing
control strategies to improve urban air quality and reduce the health effects
associated with exposure to particulate matter in ambient air.
Specifically, the aims of the project are
1. to improve exposure assessment to fine particles in Europe by assessing
the size distributions, including ultrafine particles, and elemental compositions
of fine particles in ambient air in three European cities with different
sources of particulate air pollution, i.e.
a) to describe the levels, variations in time, and intercorrelations
of different types particles with each other and with other air pollutants
b) to describe the elemental composition of particle mass collected
with PM2.5 impactors
2. to improve risk assessment of exposure to fine particles of different
sizes and of different elemental composition with focus both on respiratory
and cardiovascular outcomes. Specifically, to test the following null hypotheses:
a) there is no difference between the health effects associated with
all fine particles (PM2.5) or size fractions of ultrafine and fine particles
b) there is no difference between the health effects associated with
fine particles of varying elemental composition
Methods
The first part of the project consisted of comparisons of particle
counters used in the project. These comparisons included both measurements
of ambient air and test aerosols, and they were conducted during 1996-1997.
The second part of the project, altogether three panel studies were carried out in Amsterdam, the Netherlands, Erfurt, Germany, and Helsinki, Finland, during winter and spring 1998-1999. In all three cities, about 50 elderly persons with coronary heart disease were followed up for six months with biweekly intensive examinations, which included measurements of the function of the heart and lungs, blood pressure and of biomarkers for lung damage from urine. The subjects kept also daily symptom diaries.
Concurrently with the panel study, particle number concentration and size distributions, and levels of gaseous pollutants in ambient air were continuously monitored in an intensive monitoring effort. 24-hour filter samples of PM2.5 were collected, and elemental composition of the filters determined using energy-dispersive XRF.
Additional funding was obtained from Health Effects Institute to conduct also indoor and personal PM2.5 measurements within the ULTRA framework.
Special emphasis was put on the standardization
of the methods. Standard operating procedures (SOPs) and operating procedures were written for the project. The panel studies were therefore conducted
by using identical methodology at three different locations, and this offers
a possibility to evaluate the consistency of associations between particulate
matter and health effects between locations.
The study is conducted within the framework of the
ULTRA - Exposure and risk assessment for fine and ultrafine particles in
ambient air –project. The project is funded by the EU ENVIRONMENT and CLIMATE
Research Programme Contracts ENV4-CT95-0205 and ENV4-CT97-0568. The project
is coordinated by the Unit of Environmental Epidemiology, National Public
Health Institute, P.O.Box 95, 70701 Kuopio, Finland.
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Juha Pekkanen, the coordinator of the project, Unit of Environmental Epidemiology, National Public Health Institute, P.O.Box 95, FIN-70701 Kuopio, Finland. Telephone: +358-71-201368. Fax: +358-71-201265. (The form of e-mail addresses at KTL: firstname.lastname@ktl.fi)
Kirsi Timonen, Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, P.O.Box 1777, FIN-70211 Kuopio, Finland. Telephone: +358-17-173201. (The form of e-mail addresses at Kuopio University Hospital: firstname.lastname@kuh.fi)
Päivi Aarnio, Helsinki Metropolitan Area Council. Environmental office. Opastinsilta 6 A, FIN-00520 Helsinki. Telephone +358-9-156 1222. Fax: +358-9-156 1334.
Markku Kulmala, prof., Department of Physics, University of Helsinki. P.O.Box 9 (Siltavuorenpenger 20 D) FIN-00014 Helsinki University, Finland. Telephone: +358-9-1911 Fax: +358-9-191 8680.
Aadu Mirme, Institute of Environmental Physics, University of Tartu, Ülikooli Str 18., EE2400 Tartu, Estonia Telephone +372-7-433450. Fax +372-7-465440.
Juhani Ruuskanen, prof., Department of Environmental Sciences, University of Kuopio, P.O.Box 1627, FIN-70211, Kuopio, Finland. Telephone: +358-71-163227. Fax: +358-71-163230. (The form of e-mail addresses at Kuopio University: firstname.lastname@uku.fi)
Alfred M. Bernard, prof., Unit of Industrial Toxicology,
30.54 clos Chapelle-aux-Champs, B-1200 Brussels, Belgium. Telephone: +32-2-764
3934, Fax: +32-2-764 3228.
Joachim Heinrich, Institute of Epidemiology, GSF-Forschungszentrum für Umwelt und Gesundheit, Ingol städter Landstr. 1, D-85758 Oberschleissheim, Germany. Telephone: +49-89-3187-4150. Fax: +49-89-3187-3380.
H.Erich Wichmann, prof., Institute of Epidemiology, GSF-Forschungszentrum für Umwelt und Gesundheit, Ingol städter Landstr. 1, D-85758 Oberschleissheim, Germany. Telephone: +49-89-3187-4067. Fax: +49-89-3187-4499
Joachim Heyder, prof., Institute of Inhalation Biology, GSF-Forschungszentrum für Umwelt und Gesundheit, Ingol städter Landstr. 1, D-85758 Oberschleissheim, Germany. Telephone: +49-89-3187-3070. Fax: +49-89-3187-2400.
Wolfgang G. Kreyling, Institute of Inhalation Biology, GSF-Forschungszentrum für Umwelt und Gesundheit, Ingol städter Landstr. 1, D-85758 Oberschleissheim, Germany. Telephone: +49-89-3187-2309. Fax: +49-89-3187-3397.
Annette Peters, Institute of Epidemiology, GSF-Forschungszentrum
für Umwelt und Gesundheit, Ingol städter Landstr. 1, D-85758
Oberschleissheim, Germany. Telephone: +49-89-3187-4566. Fax: +49-89-3187-3380.
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Bert Brunekreef, prof., University of Utrecht, Environmental and Occupational Health Unit, P.O.Box 80176, 3508 TD Utrecht, The Netherlands. Telephone: +31-30-253 9490.
Gerard Hoek, University of Utrecht, Environmental and Occupational Health Unit, P.O.Box 80176, 3508 TD Utrecht, The Netherlands. Telephone: +31-30-253 9498.
Harry ten Brink, Netherlands Energy Research Foundation (ECN), P.O.Box 1, 1755 ZG, Petten, The Netherlands. Telephone:+31-224-564568. Fax: +31-224-563488.
Joop van Wijnen, Environmental medicine department,
Gemeentelijke Geneeskundige en Gezondheidsdienst Amsterdam (GGGD), Nieuwe
Achtergracht 100, P.O.Box 20244, 100 HE Amsterdan, The Netherlands. Telephone
+31-20-5555 352. Fax:+31-20-5555 533.
Timonen KL, Hoek G, Heinrich J, Bernard A, Brunekreef B, de Hartog J, Hameri K, Ibald-Mulli A, Peters A, Tiittanen P, Kreyling WG, Pekkanen J. Daily variation in fine and ultrafine particulate air pollution and urinary concentrations of lung Clara cell protein CC16. Occup Environ Med 2004;61:908-914.
Ibald-Mulli A, Timonen KL, Peters A, Heinrich J, Wölke G, Lanki T, Buzorius G, Kreyling WG, ten Brink HM, Pekkanen J. Effects of particulate air pollution on blood pressure and heart rate in subjects with cardiovascular disease: a multi-centre approach. Environmental Health Perspectives 2004;112:369-377.
de Hartog JJ, Hoek G, Peters A, Timonen KL, Ibald-Mulli A, Brunekreef B, Heinrich J, Tiittanen P, Wijnen JH van, Kreyling W, Kulmala M, Pekkanen J. Effects of fine and ultrafine particles on cardiorespiratory symptoms in elderly subjects with coronary heart disease: the ULTRA study. American Journal of Epidemiology 2003;157:613-623.
Vallius M, Lanki T, Tiittanen P, Koistinen K, Ruuskanen J, Pekkanen J. Source apportionment of urban ambient PM2.5 in two successive measurement campaigns in Helsinki, Finland. Atmospheric Environment 2003; 37: 615-623.
Mirme A, Kreyling WG, Khlystov A, ten Brink H, Ruuskanen J, Tuch T, Pekkanen J. Intercomparison of Aerosol Spectrometers for Ambient Air Monitoring. Aerosol Science and Technology 2002; 36: 866-876.
Pekkanen J, Peters A, Hoek G, Tiittanen P, Brunekreef B, de Hartog J, et al. Particulate air pollution and risk of ST-segment depression during repeated submaximal exercise tests among subjects with coronary heart disease. The exposure and risk assessment for fine and ultrafine particles in ambient air (ULTRA) study. Circulation 2002; 20: 933-938.
Khlystov A, Kos GPA, ten Brink HM, Mirme A, Tuch Th, Roth Ch, Kreyling WG. Comparability of three spectrometers for monitoring urban aerosol. Atmos Environ 2001; 35: 2045-2051.
Ruuskanen J, Tuch Th, Ten Brink H, Peters A, Khlystov A, Mirme A, Kos GPA, Brunekreef B, Wichmann HE, Buzorius G, Vallius M, Kreyling W, Pekkanen J. Concentrations of ultrafine, fine and PM2.5 particles in three European cities. Atmos Environ 2001; 35: 3729-3738.
Janssen NA, de Hartog JJ, Hoek G, Brunekreef B, Lanki T, Timonen KL, Pekkanen J. Personal exposure to fine particulate matter in elderly subjects: relation between personal, indoor and outdoor concentrations. J Air Waste Manag Assoc 2000;50:1133-1143.
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