Fine particles : effects on cardiovascular and respiratory mortality and morbidity

Starting with the quasi-experimental situations (or "natural experiments") of the London smog episode of 1952 and the sudden ban on coal sales in Dublin in 1990, which highlighted the short-term effects of air pollution on cardiovascular and respiratory mortality, we will illustrate the range of approaches used by epidemiologists working on fine atmospheric particles: time series for short-term effects, cohort studies for longer-term effects, and health impact studies, enabling effects to be translated into numbers of cases attributable to exposure to fine particles (several tens of thousands of deaths a year in France) and to assess the effectiveness of planned management measures. The results of interventional studies in humans, molecular epidemiology and animal toxicology complement these findings, making the effects of fine particles on cardiovascular and respiratory diseases, despite their complex nature as a heterogeneous mixture, one of the environmental health effects for which the level of evidence is highest.