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Liu, C., Chen, R., Sera, F., Vicedo-Cabrera, A. M., Guo, Y., Tong, S., . . . Kan, H. (2019). Ambient Particulate Air Pollution and Daily Mortality in 652 Cities. New England Journal of Medicine, 381(8), 705-715
Open this publication in new window or tab >>Ambient Particulate Air Pollution and Daily Mortality in 652 Cities
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2019 (English)In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 381, no 8, p. 705-715Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias.

METHODS: We evaluated the associations of inhalable particulate matter (PM) with an aerodynamic diameter of 10 μm or less (PM10) and fine PM with an aerodynamic diameter of 2.5 μm or less (PM2.5) with daily all-cause, cardiovascular, and respiratory mortality across multiple countries or regions. Daily data on mortality and air pollution were collected from 652 cities in 24 countries or regions. We used overdispersed generalized additive models with random-effects meta-analysis to investigate the associations. Two-pollutant models were fitted to test the robustness of the associations. Concentration-response curves from each city were pooled to allow global estimates to be derived.

RESULTS: On average, an increase of 10 μg per cubic meter in the 2-day moving average of PM10 concentration, which represents the average over the current and previous day, was associated with increases of 0.44% (95% confidence interval [CI], 0.39 to 0.50) in daily all-cause mortality, 0.36% (95% CI, 0.30 to 0.43) in daily cardiovascular mortality, and 0.47% (95% CI, 0.35 to 0.58) in daily respiratory mortality. The corresponding increases in daily mortality for the same change in PM2.5 concentration were 0.68% (95% CI, 0.59 to 0.77), 0.55% (95% CI, 0.45 to 0.66), and 0.74% (95% CI, 0.53 to 0.95). These associations remained significant after adjustment for gaseous pollutants. Associations were stronger in locations with lower annual mean PM concentrations and higher annual mean temperatures. The pooled concentration-response curves showed a consistent increase in daily mortality with increasing PM concentration, with steeper slopes at lower PM concentrations.

CONCLUSIONS: Our data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies. (Funded by the National Natural Science Foundation of China and others.).

Place, publisher, year, edition, pages
Waltham: Massachusetts Medical Society, 2019
National Category
Occupational Health and Environmental Health Environmental Sciences
Identifiers
urn:nbn:se:umu:diva-162609 (URN)10.1056/NEJMoa1817364 (DOI)31433918 (PubMedID)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-28Bibliographically approved
Wang, J., Pindus, M., Janson, C., Sigsgaard, T., Kim, J.-L., Holm, M., . . . Norbäck, D. (2019). Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis. European Respiratory Journal, 53(5), Article ID 1801921.
Open this publication in new window or tab >>Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 53, no 5, article id 1801921Article in journal (Refereed) Published
Abstract [en]

THE QUESTION ADDRESSED BY THE STUDY: Is dampness and indoor mould associated with onset and remission of respiratory symptoms, asthma and rhinitis among adults?

MATERIALS AND METHODS: Associations between dampness, mould and mould odour at home and at work and respiratory health were investigated in cohort of 11 506 adults from Iceland, Norway, Sweden, Denmark and Estonia. They answered a questionnaire at baseline and ten years later, with questions on respiratory health, home and work environment.

RESULTS: Baseline water damage, floor dampness, mould and mould odour at home were associated with onset of respiratory symptoms and asthma (ORs from 1.23 to 2.24). Dampness at home during follow up was associated with onset of respiratory symptoms, asthma and rhinitis (ORs from 1.21 to 1.52). Dampness at work during follow up was associated with onset of respiratory symptoms, asthma and rhinitis (ORs from 1.31 to 1.50). Combined dampness at home and at work increased the risk of onset of respiratory symptoms and rhinitis. Dampness and mould at home and at work decreased remission of respiratory symptoms and rhinitis.

THE ANSWER TO THE QUESTION: Dampness and mould at home and at work can increase onset of respiratory symptoms, asthma and rhinitis, and decrease remission.

Place, publisher, year, edition, pages
European Respiratory Society, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-157885 (URN)10.1183/13993003.01921-2018 (DOI)000470244000010 ()30880288 (PubMedID)
Funder
Swedish Heart Lung FoundationForte, Swedish Research Council for Health, Working Life and WelfareAFA Insurance, 467801100
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-06-20Bibliographically approved
Reckien, D., Salvia, M., Pietrapertosa, F., Simoes, S. G., Olazabal, M., Hurtado, S. D., . . . Heidrich, O. (2019). Dedicated versus mainstreaming approaches in local climate plans in Europe. Renewable & sustainable energy reviews, 112, 948-959
Open this publication in new window or tab >>Dedicated versus mainstreaming approaches in local climate plans in Europe
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2019 (English)In: Renewable & sustainable energy reviews, ISSN 1364-0321, E-ISSN 1879-0690, Vol. 112, p. 948-959Article in journal (Refereed) Published
Abstract [en]

Cities are gaining prominence committing to respond to the threat of climate change, e.g., by developing local climate plans or strategies. However, little is known regarding the approaches and processes of plan development and implementation, or the success and effectiveness of proposed measures. Mainstreaming is regarded as one approach associated with (implementation) success, but the extent of integration of local climate policies and plans in ongoing sectoral and/or development planning is unclear. This paper analyses 885 cities across the 28 European countries to create a first reference baseline on the degree of climate mainstreaming in local climate plans. This will help to compare the benefits of mainstreaming versus dedicated climate plans, looking at policy effectiveness and ultimately delivery of much needed climate change efforts at the city level. All core cities of the European Urban Audit sample were analyzed, and their local climate plans classified as dedicated or mainstreamed in other local policy initiatives. It was found that the degree of mainstreaming is low for mitigation (9% of reviewed cities; 12% of the identified plans) and somewhat higher for adaptation (10% of cities; 29% of plans). In particular horizontal mainstreaming is a major effort for local authorities; an effort that does not necessarily pay off in terms of success of action implementation. This study concludes that climate change issues in local municipalities are best tackled by either, developing a dedicated local climate plan in parallel to a mainstreamed plan or by subsequently developing first the dedicated and later a mainstreaming plan (joint or subsequent "dual track approach"). Cities that currently provide dedicated local climate plans (66% of cities for mitigation; 26% of cities for adaptation) may follow-up with a mainstreaming approach. This promises effective implementation of tangible climate actions as well as subsequent diffusion of climate issues into other local sector policies. The development of only broad sustainability or resilience strategies is seen as critical.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Local climate policy/ planning, Mitigation, Adaptation, Urban areas/ cities, Urban audit, Europe, EU-28, Mainstreaming, Mitigation/ adaptation tracking, Mitigation/ adaptation stocktaking, Monetoring and evaluation (M&E)
National Category
Climate Research
Identifiers
urn:nbn:se:umu:diva-161807 (URN)10.1016/j.rser.2019.05.014 (DOI)000474208400063 ()
Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2019-08-14Bibliographically approved
Oudin Åström, D., Veber, T., Martinsone, Ž., Kaļužnaja, D., Indermitte, E., Oudin, A. & Orru, H. (2019). Mortality Related to Cold Temperatures in Two Capitals of the Baltics: Tallinn and Riga. Medicina (Kaunas), 55(8), Article ID 429.
Open this publication in new window or tab >>Mortality Related to Cold Temperatures in Two Capitals of the Baltics: Tallinn and Riga
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2019 (English)In: Medicina (Kaunas), ISSN 1010-660X, E-ISSN 1648-9144, Vol. 55, no 8, article id 429Article in journal (Refereed) Published
Abstract [en]

Background and objectives: Despite global warming, the climate in Northern Europe is generally cold, and the large number of deaths due to non-optimal temperatures is likely due to cold temperatures. The aim of the current study is to investigate the association between cold temperatures and all-cause mortality, as well as cause-specific mortality, in Tallinn and Riga in North-Eastern Europe.

Materials and Methods: We used daily information on deaths from state death registries and minimum temperatures from November to March over the period 1997-2015 in Tallinn and 2009-2015 in Riga. The relationship between the daily minimum temperature and mortality was investigated using the Poisson regression, combined with a distributed lag non-linear model considering lag times of up to 21 days.

Results: We found significantly higher all-cause mortality owing to cold temperatures both in Tallinn (Relative Risk (RR) = 1.28, 95% Confidence Interval (CI) 1.01-1.62) and in Riga (RR = 1.41, 95% CI 1.11-1.79). In addition, significantly increased mortality due to cold temperatures was observed in the 75+ age group (RR = 1.64, 95% CI 1.17-2.31) and in cardiovascular mortality (RR = 1.83, 95% CI 1.31-2.55) in Tallinn and in the under 75 age group in Riga (RR = 1.58, 95% CI 1.12-2.22). In this study, we found no statistically significant relationship between mortality due to respiratory or external causes and cold days. The cold-related attributable fraction (AF) was 7.4% (95% CI -3.7-17.5) in Tallinn and 8.3% (95% CI -0.5-16.3) in Riga. This indicates that a relatively large proportion of deaths in cold periods can be related to cold in North-Eastern Europe, where winters are relatively harsh.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
Baltics, all-cause mortality and cause-specific mortality, cold-related attributable fraction, distributed lag non-linear models, temperature-related mortality, winter mortality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162421 (URN)10.3390/medicina55080429 (DOI)31382432 (PubMedID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-22Bibliographically approved
Orru, H., Åström, C., Andersson, C., Tamm, T., Ebi, K. L. & Forsberg, B. (2019). Ozone and heat-related mortality in Europe in 2050 significantly affected by changes in climate, population and greenhouse gas emission. Environmental Research Letters, 14(7), Article ID 074013.
Open this publication in new window or tab >>Ozone and heat-related mortality in Europe in 2050 significantly affected by changes in climate, population and greenhouse gas emission
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2019 (English)In: Environmental Research Letters, ISSN 1748-9326, E-ISSN 1748-9326, Vol. 14, no 7, article id 074013Article in journal (Refereed) Published
Abstract [en]

Climate change is expected to increase to extreme temperatures and lead to more intense formation of near-surface ozone. Higher temperatures can cause heat stress and ozone is a highly oxidative pollutant; both increase cardiorespiratory mortality. Using greenhouse gas and ozone precursor emission scenarios, global and regional climate and chemistry-transport models, epidemiological data, and population projections, we projected ozone- and heat-related health risks under a changing climate. European near-surface temperature was modelled with the regional climate model (RCA4), forced by the greenhouse gas emission scenario RCP4.5 and the global climate model EC-EARTH, and near-surface ozone was modelled with the Multi-scale Atmospheric Transport and Chemistry (MATCH) model. Two periods were compared: recent climate in 1991-2000 and future climate in 2046-2055, projecting around a 2 degrees increase in global temperatures by that time. Projections of premature mortality considered future climate, future population, and future emissions separately and jointly to understand the relative importance of their contributions. Ozone currently causes 55 000 premature deaths annually in Europe due to long-term exposure, including a proportion of the estimated 26 000 deaths per year due to short-term exposures. When only taking into account the impact of a changing climate, up to an 11% increase in ozone-associated mortality is expected in some countries in Central and Southern Europe in 2050. However, projected decreases in ozone precursor emissions are expected to result in a decrease in ozone-related mortality (-30% as EUaverage). Due to aging and increasingly susceptible populations, the decrease in 2050 would be smaller, up to -24%. During summer months, ozone risks could combine with increasing temperatures, especially during the hottest periods and in densely populated urban areas. While the heat burden is currently of the same order of magnitude as ozone, due to increasing temperatures and decreasing ozone precursor emissions, heat-related mortality could be twice as large as ozone-related mortality in 2050.

Keywords
air quality, temperature, health, climate change, modelling
National Category
Climate Research Meteorology and Atmospheric Sciences
Identifiers
urn:nbn:se:umu:diva-161836 (URN)10.1088/1748-9326/ab1cd9 (DOI)000474788900001 ()
Available from: 2019-08-08 Created: 2019-08-08 Last updated: 2019-08-08Bibliographically approved
Lee, J. Y., Kim, H., Gasparrini, A., Armstrong, B., Bell, M. L., Sera, F., . . . Guo, Y. (2019). Predicted temperature-increase-induced global health burden and its regional variability. Environment International, 131, Article ID 105027.
Open this publication in new window or tab >>Predicted temperature-increase-induced global health burden and its regional variability
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 131, article id 105027Article in journal (Refereed) Published
Abstract [en]

An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010-2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (-0.92%p/°C) and Australia (-0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Climate change, Mortality, Projection, Regional variation, Vulnerability
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162419 (URN)10.1016/j.envint.2019.105027 (DOI)31351381 (PubMedID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-22Bibliographically approved
Idavain, J., Julge, K., Rebane, T., Lang, A. & Orru, H. (2019). Respiratory symptoms, asthma and levels of fractional exhaled nitric oxide in schoolchildren in the industrial areas of Estonia. Science of the Total Environment, 650(Pt 1), 65-72
Open this publication in new window or tab >>Respiratory symptoms, asthma and levels of fractional exhaled nitric oxide in schoolchildren in the industrial areas of Estonia
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2019 (English)In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 650, no Pt 1, p. 65-72Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Exposure to air pollutants in the ambient environment has been associated with various respiratory symptoms, and with increased asthma diagnosis, in both children and adults. Most research to date has focussed on core pollutants, such as PM10, PM2.5, SO2 and NO2, and less attention has been given to the effects of industry-specific contamination. The current study aimed to examine the associations between respiratory symptoms, asthma, increased levels of fractional exhaled nitric oxide (FeNO) (as a marker of eosinophilic airway inflammation) and ambient levels of industrial pollutants (such as benzene, phenol, formaldehyde and non-methane hydrocarbons) for schoolchildren living near oil shale industries in Ida-Viru County, Estonia.

METHODS: A total of 1326 schoolchildren from Ida-Viru, Lääne-Viru and Tartu Counties participated in a cross-sectional study, consisting of questionnaires on respiratory symptoms and asthma, as well as clinical examinations to measure FeNO. Dispersion modelling was used to characterize individual-level exposure to industrial air pollutants at each subject's home address. Associations between exposure and respiratory health were investigated using logistic regression analysis, and differences in results between regions were analysed using the Chi-squared test.

RESULTS: The prevalence of respiratory symptoms (p < 0.05) in children living near (i.e. within 5 km) of an oil shale industry site in Ida-Viru County was 2-4 times higher than in children living in the reference area of Tartu County. Children exposed to 1 μg/m3 higher levels of benzene and formaldehyde had a higher odds ratio (OR) of having rhinitis without a cold (OR 1.03, 95% confidence interval (CI) 1.01-1.06), of ever having had attacks of asthma (OR 1.05, 95% CI 1.01-1.10) and of having a dry cough a few days per year (OR 1.05, 95% CI 1.01-1.10). Children exposed to 1 μg/m3 higher levels of benzene, formaldehyde, phenol and non-methane hydrocarbons had a higher odds ratio of having high FeNO levels (≥30 ppb): OR and 95% CI of 1.05, 1.01-1.09; 1.22, 1.06-1.41; 1.01, 1.00-1.01; and 1.75, 1.75-2.62, respectively.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Air pollution, Asthma, Children, FeNO, Oil shale, Respiratory symptoms
National Category
Respiratory Medicine and Allergy Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-152112 (URN)10.1016/j.scitotenv.2018.08.391 (DOI)000447092700008 ()30195132 (PubMedID)
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2019-10-16Bibliographically approved
Reckien, D., Salvia, M., Heidrich, O., Church, J. M., Pietrapertosa, F., De Gregorio-Hurtado, S., . . . Dawson, R. (2018). How are cities planning to respond to climate change?: Assessment of local climate plans from 885 cities in the EU-28. Journal of Cleaner Production, 191, 207-219
Open this publication in new window or tab >>How are cities planning to respond to climate change?: Assessment of local climate plans from 885 cities in the EU-28
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2018 (English)In: Journal of Cleaner Production, ISSN 0959-6526, E-ISSN 1879-1786, Vol. 191, p. 207-219Article in journal (Refereed) Published
Abstract [en]

The Paris Agreement aims to limit global mean temperature rise this century to well below 2 degrees C above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial greenhouse gas emissions. This paper reports the state of local planning for climate change by collecting and analysing information about local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and framework for analysis was developed that classifies local climate plans in terms of their alignment with spatial (local, national and international) and other climate related policies. Out of eight types of local climate plans identified in total we document three types of stand-alone local climate plans classified as type Al (autonomously produced plans), A2 (plans produced to comply with national regulations) or A3 (plans developed for international climate networks). There is wide variation among countries in the prevalence of local climate plans, with generally more plans developed by central and northern European cities. Approximately 66% of EU cities have a type Al, A2, or A3 mitigation plan, 26% an adaptation plan, and 17% a joint adaptation and mitigation plan, while about 33% lack any form of stand-alone local climate plan (i.e. what we classify as Al, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but planning for mitigation does not always precede planning for adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 80% of the cities with above 500,000 inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (Al). Cities in four countries with national climate legislation (A2), i.e. Denmark, France, Slovakia and the United Kingdom, are nearly twice as likely to produce local mitigation plans, and five times more likely to produce local adaptation plans, compared to cities in countries without such legislation. Al and A2 mitigation plans are particularly numerous in Denmark, Poland, Germany, and Finland: while Al and A2 adaptation plans are prevalent in Denmark, Finland, UK and France. The integration of adaptation and mitigation is country-specific and can mainly be observed in two countries where local climate plans are compulsory, i.e. France and the UK. Finally, local climate plans produced for international climate networks (A3) are mostly found in the many countries where autonomous (type Al) plans are less common. This is the most comprehensive analysis of local climate planning to date. The findings are of international importance as they will inform and support decision making towards climate planning and policy development at national, EU and global level being based on the most comprehensive and up-to-date knowledge of local climate planning available to date. 

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Climate change, Paris agreement, Local climate plans, Cities, Urban areas, Urban audit cities, Europe, Adaptation, Mitigation, SEAP/SECAP
National Category
Climate Research
Identifiers
urn:nbn:se:umu:diva-150662 (URN)10.1016/j.jclepro.2018.03.220 (DOI)000435058200020 ()2-s2.0-85046339015 (Scopus ID)
Available from: 2018-08-28 Created: 2018-08-28 Last updated: 2018-08-28Bibliographically approved
Orru, K., Tillmann, M., Ebi, K. L. & Orru, H. (2018). Making Administrative Systems Adaptive to Emerging Climate Change-Related Health Effects: Case of Estonia. Atmosphere, 9(6), Article ID 221.
Open this publication in new window or tab >>Making Administrative Systems Adaptive to Emerging Climate Change-Related Health Effects: Case of Estonia
2018 (English)In: Atmosphere, ISSN 2073-4433, E-ISSN 2073-4433, Vol. 9, no 6, article id 221Article in journal (Refereed) Published
Abstract [en]

To facilitate resilience to a changing climate, it is necessary to go beyond quantitative studies and take an in-depth look at the functioning of health systems and the variety of drivers shaping its effectiveness. We clarify the factors determining the effectiveness of the Estonian health system in assessing and managing the health risks of climate change. Document analyses, expert interviews with key informants from health systems whose responsibilities are relevant to climate change, and analysis of a population-based survey conducted in 2015, indicate that the health effects of climate change have not been mainstreamed into policy. Therefore, many of the potential synergistic effects of combining information on health systems, environment, and vulnerable populations remain unexploited. The limited uptake of the issue of climate change-related health risks may be attributed to the lack of experience with managing extreme weather events; limited understanding of how to incorporate projections of longer-term health risks into policies and plans; unclear divisions of responsibility; and market liberal state approaches. Minority groups and urban dwellers are placing strong pressure on the health system to address climate change-related risks, likely due to their lower levels of perceived control over their physical wellbeing. The results have implications for national, community, and individual resilience in upper-middle income countries in Eastern Europe.

Keywords
health systems, climate adaptation, health infrastructure, rescue services, Northern Europe
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-150862 (URN)10.3390/atmos9060221 (DOI)000436271900019 ()2-s2.0-85048434049 (Scopus ID)
Available from: 2018-09-03 Created: 2018-09-03 Last updated: 2018-12-17Bibliographically approved
Orru, H., Pindus, M., Harro, H.-R., Maasikmets, M. & Herodes, K. (2018). Metallic Fumes at Indoor Military Shooting Ranges: Lead, Copper, Nickel, and Zinc in Different Fractions of Airborne Particulate Matter. Propellants, explosives, pyrotechnics, 43(3), 228-233
Open this publication in new window or tab >>Metallic Fumes at Indoor Military Shooting Ranges: Lead, Copper, Nickel, and Zinc in Different Fractions of Airborne Particulate Matter
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2018 (English)In: Propellants, explosives, pyrotechnics, ISSN 0721-3115, E-ISSN 1521-4087, Vol. 43, no 3, p. 228-233Article in journal (Refereed) Published
Abstract [en]

Small firearm shooting emits residues of energetic materials as well as heavy metals of different particle sizes into the air, posing a risk to human health. The current study assessed concentrations of Pb, Cu, Ni and Zn in 14 different size fractions of particulate matter at indoor military shooting ranges. Air samples were collected using ELPI+ over two hour period and filters analysed with ICP-MS and ICP-OES.

Keywords
Shooting, indoor, military, heavy metals, particles
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-147476 (URN)10.1002/prep.201700225 (DOI)000428343400002 ()
Available from: 2018-05-22 Created: 2018-05-22 Last updated: 2018-06-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7965-9451

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