Table 4– Interaction of dust storms on air pollution effects: evidence from European studies
Author [ref.], yearCountry, periodStudy designPopulationHealth indicatorMethod to detect interactionResults
Middleton [60], 2008Nicosia (Cyprus)
1995–2004		Time-seriesAll agesHospital admissions (total and specific causes)Stratification by dust days and PM quartilesThe effects of PM10 on dust-storm days on all-cause and cardiovascular admissions was comparable to the effects seen on non-storm days with the highest PM10 levels
No significant effect on respiratory admissions
Perez [95], 2008Barcelona (Spain)
2003–2004		Case-crossoverAll agesMortality (total causes)Stratification by dust days; interaction termsEffect of PM2.5–10 greater during dust days compared with non-dust days
No evidence of interaction for PM2.5
Jiménez [96], 2010Madrid (Spain)
2003–2005		Time-seriesAll agesMortality (total and specific causes)Stratification by dust days; interaction termsEffects of PM10 only on dust days, on all-cause, cardiovascular and respiratory mortality; no effect of PM2.5 or PM2.5–10 on dust days
Mallone [97], 2011Rome (Italy)
2001–2004		Case-crossoverAll agesMortality (total and specific causes)Stratification by dust days; interaction termsEffect of PM2.5–10 greater during dust days compared with non-dust days for all causes and cardiac causes and diseases of circulatory system; suggestion of positive interaction on respiratory causes
Positive interaction of PM10 with dust days on cardiac mortality
No evidence of interaction for PM2.5
Samoli [98], 2011Athens (Greece)
2001–2006		Time-seriesAll agesMortality (total and specific causes)Stratification by dust days; interaction termsEffect of PM10 higher in non-dust days and essentially null effects during dust days; significant interactions except for respiratory and cardiovascular causes among those <75 years
Samoli [59], 2011Athens (Greece)
2001–2006		Time-seriesAll agesPaediatric asthma emergency admissionsStratification by dust days; interaction termsEffects of PM10 greater on dust days compared with non-dust days
Tobías [99], 2011Madrid (Spain)
2003–2005		Case-crossoverAll agesMorbidity (total causes)Stratification by dust days; interaction termsEffect of PM2.5–10 greater during dust days compared with non-dust days for all causes
No evidence of interaction for PM2.5
Zauli Sajani [100], 2011Emilia-Romagna region (Italy)
2002–2006		Case-crossoverAll agesMortality (total and specific causes)Stratification by dust days; interaction termsEvidence of increased respiratory mortality on dust days in hot season in >75 years old, although interaction was not significant
No evidence of effect modification for any season for natural and cardiovascular mortality
Alessandrini [101], 2012Rome (Italy)
2001–2004		Case-crossoverAll agesMorbidity (total and specific causes)Stratification by dust days; interaction termsEffect of PM2.5–10 greater during dust days compared with non-dust days for respiratory causes; suggestion of positive interaction of PM10 on cerebrovascular causes
Díaz [102], 2012Madrid (Spain)
2003–2005		Case-crossoverAll agesMorbidity (total and specific causes)Stratification by dust days; interaction termsEffect of PM10 greater during dust days compared with non-dust days for respiratory causes during cold season, for cardiovascular causes during warm season
Perez [103], 2012Barcelona (Spain)
2003–2007		Case-crossoverAll agesMortality (total and specific causes)Stratification by dust days; interaction termsEffect of PM2.5–10 greater during dust days compared with non-dust days for cardiovascular causes; suggestion of positive interaction of PM2.5 during dust days for cardiovascular and respiratory mortality
Thalib [104], 2012Kuwait
1996–2000		Time-seriesAll agesRespiratory and asthma hospital admissionsStratification by dust daysEvidence of greater risk for asthma admission in <15 year-olds and all ages during the dust days compared with non-dust days (lag 0); not significant for older age groups
Effect on respiratory admissions in <15 years, 15–64 years, all ages
No effect on >65 years old

  • PM: particulate matter; PM10: particulate matter with a diameter <10 μm; PM2.5–10: particulate matter with a diameter ≥2.5 μm and <10 μm; PM2.5: particulate matter with a diameter <2.5 μm.