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NOTE OF MEETING: FRIDAY 21st FEBRUARY 2003
- The Chairman congratulated Professor Stephen Holgate, a previous
Chairman of COMEAP, on his appointment as the new Chairman of EPAQS.
Minutes
- The minutes were agreed subject to a clarification that, although
there was sufficient evidence to quantify an effect of ozone on lung
function, the clinical significance of the quantified effects would
be difficult to interpret.
Matters arising
- The 2001 Annual Report was now on the website and the 1999/2000 Annual
Report had been completed and should be on the website shortly.
- An advert for replacements for retiring members was in preparation.
It was hoped that interviews could be held in early May.
- The COMEAP meeting on 24th October would be replaced with 2 meetings,
provisionally on 19th September and 14th November 2003. This was to
allow time to consider the draft report on air pollution and cardiovascular
disease.
- The Committee was encouraged that the COMEAP website had around 5000
hits (excluding repeat hits) in the last quarter.
Ozone - associations of 1 hour and 24 hour average concentrations
with mortality and hospital admissions
- The US EPA had requested reanalysis of around 20 studies on particles,
following recent developments in generalised additive modelling. This
would be published in April. This might also result in some reanalysed
coefficients for ozone.
- The Committee agreed that the data on associations with 1 hour and
24 average ozone concentrations mostly confirmed previous conclusions
based on 8 hour average data. Clear associations were found with all
cause mortality, respiratory mortality, respiratory admissions, pneumonia
admissions and COPD admissions. Evidence for associations with asthma
admissions, cardiovascular admissions, ischaemic heart disease admissions
and heart failure admissions were not convincing. An association with
cardiovascular mortality was slightly more likely on the basis of the
1 hour average concentration evidence than on the basis of the equivocal
evidence on 8 hour average concentrations. However, more work was required
to assess whether these associations were causal.
- The Committee agreed that, for those outcomes where associations had
been found, the evidence against a linear response was not convincing.
However, the evidence for a linear response was not sufficiently strong
to rule out other shapes for the association.
- The Committee agreed that it was important to use non-linear models
for the effect of temperature on health outcomes as emphasised by Thurston
and Ito (2001)* but the authors' proposed criteria for overall model
selection were considered more debatable.
*Thurston G and Ito K (2001) Epidemiological Studies
of Acute Ozone Exposure and Mortality. J. Exposure Anal. And Env.
Epidemiol. 11 (4): 286-294.
- The Committee confirmed that there was an absence of evidence for
a threshold in the trend tests for plots of all-cause mortality dose-response
coefficients against city mean or maximum 8-hour average ozone concentrations.
However, it was also agreed that this approach would only indicate whether
or not a threshold existed and would not give information on the numerical
value of the threshold.
Ozone - pulmonary responses in healthy adults
- The Committee considered that meta-analysis of human volunteer studies
was a useful approach. There was discussion over the best methodology
to determine at what point the proportion of neutrophils in the airways
could be considered to have risen above the baseline. This, and other
comments from the Committee, will be incorporated into the review before
publication.
Unflued gas fires
- The Committee gave final comments on a statement on the use of outdoor
air quality standards for nitrogen dioxide and carbon monoxide in assessing
the health implications of indoor levels of these pollutants.
Air pollution and cardiovascular disease
- The sub-group on air pollution and cardiovascular disease had met
in January and was preparing contributions for a first draft of a report.
A later draft would come to the full Committee at an additional meeting
in September.
Asthma and air pollution
- The Committee provided comments on a first draft of a report 'Does
Air Pollution Cause Asthma?'. A more complete draft would be considered
by the Committee at the June meeting.
The Air Quality Strategy and EC Directives on Air Pollutants
- The Committee considered 2 background papers on the air quality strategy
and on EC directives for air pollutants.
Date of next meeting
- 20th June 2003 in Skipton House.
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