The Bruxair Study: Associations between Ambient Air Pollution and Acute Health Effects in Brussels

Ambient air pollution levels in Brussels (Belgium) remained relatively large throughout the last decade. In addition, few health effect estimates have been made available for this region. To investigate the association between air pollution and acute respiratory health effects, we constructed an ecological time series, combining air pollution with medication reimbursement data. Because health insurance is mandatory in Belgium and by the extent of the air quality sampling network, this database is nearly exhaustive. All reimbursed medication in ATC (anatomic therapeutic classification, WHO) groups R03A (adrenergics, inhalants) and RO3B (other drugs for obstructive airway diseases, inhalants) were included, for the years 2006 up until 2010. We used Generalized Additive Models and corrected for temperature, relative humidity, day of week and influenza. We included lags of up to 10 days, constrained by using cubic M-Splines (five degrees of freedom). Single pollutant models for NO2 and PM10 revealed stronger ...