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Concentration response functions for ultrafine particles and all-cause mortality and hospital admissions: an expert panel
Toxicological studies have provided evidence of the toxicity of ultrafine particles, but epidemiological evidence for health effects of ultrafines is limited. No quantitative summary currently exists of concentration-response functions for ultrafine particles, that can be used in health impact assessmentii. The goal was to specify concentration response functions for ultrafine particles in urban air including their uncertainty through an expert panel elicitation.
Eleven European experts from the disciplines of epidemiology, toxicology and clinical medicine selected using a systematic peer-nomination procedure participated. Using individual ratings supplemented with group discussion, probability distributions of effect estimates were obtained for all-cause mortality and cardiovascular and respiratory hospital admissions.
Experts were willing to quantify effects of UFP on all-cause mortality and to a lesser extent hospital admissions. Substantial differences in the estimated UFP health effect and its uncertainty were found between experts. The lack of studies on long-term exposurei to UFP was rated as the most important factor contributing to the overall uncertainty. Effects on cardiovascular and respiratory hospital admissions were considered more uncertain.
This expert elicitation provides the first quantitative evaluation of estimates of concentration response functions between urban air ultrafine particles and all cause mortality and hospital admissions. The assessment was hampered by the small database of epidemiological studies.