Integrating Shared Socioeconomic Pathway-informed adaptation into temperature-related mortality projections under climate change

The extent to which populations will successfully adapt to continued warming temperatures will be a crucial factor in determining future health burdens. Previous health impact assessments of future temperature-related mortality burdens mostly disregard adaptation or make simplistic assumptions. We apply a novel evidence-based approach to model adaptation that takes into account the fact that adaptation potential is likely to vary at different temperatures. Temporal changes in age-specific mortality risk associated with low and high temperatures were characterised for Scotland between 1974 and 2018 using temperature-specific RR ratios to reflect past changes in adaptive capacity. Three scenarios of future adaption were constructed consistent with the SSPs. These adaptation projections were combined with climate and population projections to estimate the mortality burdens attributable to high (above the 90th percentile of the historical temperature distribution) and low (below the 10th percentile) temperatures up to 2080 under five RCP-SSP scenarios. A decomposition analysis was conducted to attribute the change in the mortality burden into adaptation, climate and population. In 1980-2000, the heat burden (21 deaths/year) was smaller than the colder burden (312 deaths/year). In the 2060-2080 period, the heat burden was projected to be the highest under RCP8.5-SSP5 (1285 deaths/year), and the cold burden was the highest under RCP4.5-SSP4 (320 deaths/year). The net burden was lowest under RCP2.6-SSP1 and highest under RCP8.5-SSP5. Improvements in adaptation was the largest factor reducing the cold burden under RCP2.6-SSP1 whilst temperature increase was the biggest factor contributing to the high heat burdens under RCP8.5-SSP5. Ambient heat will become a more important health determinant than cold in Scotland under all climate change and socio-economic scenarios. Adaptive capacity will not fully counter projected increases in heat deaths, underscoring the need for more ambitious climate mitigation measures for Scotland and elsewhere.

Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets

BACKGROUND

Adverse health impacts have been found under extreme temperatures in many parts of the world. The majority of such research to date for the UK has been conducted on populations in England, whilst the impacts of ambient temperature on health outcomes in Scottish populations remain largely unknown.

METHODS

This study uses time-series regression analysis with distributed lag non-linear models to characterise acute relationships between daily mean ambient temperature and mortality in Scotland including the four largest cities (Aberdeen, Dundee, Edinburgh and Glasgow) and three regions during 1974-2018. Increases in mortality risk under extreme cold and heat in individual cities and regions were aggregated using multivariate meta-analysis. Cold results are summarised by comparing the relative risk (RR) of death at the 1st percentile of localised temperature distributions compared to the 10th percentile, and heat effects as the RR at the 99th compared to the 90th percentile.

RESULTS

Adverse cold effects were observed in all cities and regions, and heat effects were apparent in all cities and regions except northern Scotland. Aggregate all-cause mortality risk in Scotland was estimated to increase by 10% (95% confidence interval, CI: 7%, 13%) under extreme cold and 4% (CI: 2%, 5%) under extreme heat. People in urban areas experienced higher mortality risk under extreme cold and heat than those in rural regions. The elderly had the highest RR under both extreme cold and heat. Males experienced greater cold effects than females, whereas the reverse was true with heat effects, particularly among the elderly. Those who were unmarried had higher RR than those married under extreme heat, and the effect remained after controlling for age. The younger population living in the most deprived areas experienced higher cold and heat effects than in less deprived areas. Deaths from respiratory diseases were most sensitive to both cold and heat exposures, although mortality risk for cardiovascular diseases was also heightened, particularly in the elderly. Cold effects were lower in the most recent 15 years, which may be linked to policies and actions in preventing the vulnerable population from cold impacts. No temporal trend was found with the heat effect.

CONCLUSIONS

This study assesses mortality risk associated with extreme temperatures in Scotland and identifies those groups who would benefit most from targeted actions to reduce cold- and heat-related mortalities.

Future air pollution related health burdens associated with RCP emission changes in the UK

Three Intergovernmental Panel on Climate Change (IPCC) Representative Concentration Pathways (RCPs) are used to simulate future ozone (O₃), nitrogen dioxide (NO₂), and fine particulate matter (PM_2.5) in the United Kingdom (UK) for the 2050s relative to the 2000s with an air quality model (AQUM) at a 12 km horizontal resolution. The present-day and future attributable fractions (AF) of mortality associated with long-term exposure to annual mean O₃, NO₂ and PM_2.5 have accordingly been estimated for the first time for regions across England, Scotland and Wales. Across the three RCPs (RCP2.6, RCP6.0 and RCP8.5), simulated annual mean of the daily maximum 8-h mean (MDA8) O₃ concentrations increase compared to present-day, likely due to decreases in NO_x (nitrogen oxides) emissions, leading to less titration of O₃ by NO. Annual mean NO₂ and PM_2.5 concentrations decrease under all RCPs for the 2050s, mostly driven by decreases in NO_x and sulphur dioxide (SO₂) emissions, respectively. The AF of mortality associated with long-term exposure to annual mean MDA8 O₃ is estimated to increase in the future across all the regions and for all RCPs. Reductions in NO₂ and PM_2.5 concentrations lead to reductions in the AF estimated for future periods under all RCPs, for both pollutants. Total mortality burdens are also highly sensitive to future population projections. Accounting for population projections exacerbates differences in total UK-wide MDA8 O₃-health burdens between present-day and future by up to a factor of ~3 but diminishes differences in NO₂-health burdens. For PM_2.5, accounting for future population projections results in additional UK-wide deaths brought forward compared to present-day under RCP2.6 and RCP6.0, even though the simulated PM_2.5 concentrations for the 2050s are estimated to decrease. Thus, these results highlight the sensitivity of future health burdens in the UK to future trends in atmospheric emissions over the UK as well as future population projections.

Climate change impacts on human health over Europe through its effect on air quality

This review examines the current literature on the effects of future emissions and climate change on particulate matter (PM) and O₃ air quality and on the consequent health impacts, with a focus on Europe. There is considerable literature on the effects of climate change on O₃ but fewer studies on the effects of climate change on PM concentrations. Under the latest Intergovernmental Panel on Climate Change (IPCC) 5th assessment report (AR5) Representative Concentration Pathways (RCPs), background O₃ entering Europe is expected to decrease under most scenarios due to higher water vapour concentrations in a warmer climate. However, under the extreme pathway RCP8.5 higher (more than double) methane (CH₄) abundances lead to increases in background O₃ that offset the O₃ decrease due to climate change especially for the 2100 period. Regionally, in polluted areas with high levels of nitrogen oxides (NO_x), elevated surface temperatures and humidities yield increases in surface O₃ - termed the O₃ climate penalty - especially in southern Europe. The O₃ response is larger for metrics that represent the higher end of the O₃ distribution, such as daily maximum O₃. Future changes in PM concentrations due to climate change are much less certain, although several recent studies also suggest a PM climate penalty due to high temperatures and humidity and reduced precipitation in northern mid-latitude land regions in 2100.A larger number of studies have examined both future climate and emissions changes under the RCP scenarios. Under these pathways the impact of emission changes on air quality out to the 2050s will be larger than that due to climate change, because of large reductions in emissions of O₃ and PM pollutant precursor emissions and the more limited climate change response itself. Climate change will also affect climate extreme events such as heatwaves. Air pollution episodes are associated with stagnation events and sometimes heat waves. Air quality during the 2003 heatwave over Europe has been examined in numerous studies and mechanisms for enhancing O₃ have been identified.There are few studies on health effects associated with climate change impacts alone on air quality, but these report higher O₃-related health burdens in polluted populated regions and greater PM_2.5 health burdens in these emission regions. Studies that examine the combined impacts of climate change and anthropogenic emissions change under the RCP scenarios report reductions in global and European premature O₃-respiratory related and PM mortalities arising from the large decreases in precursor emissions. Under RCP 8.5 the large increase in CH₄ leads to global and European excess O₃-respiratory related mortalities in 2100. For future health effects, besides uncertainty in future O₃ and particularly PM concentrations, there is also uncertainty in risk estimates such as effect modification by temperature on pollutant-response relationships and potential future adaptation that would alter exposure risk.

Socioeconomic and urban-rural differentials in exposure to air pollution and mortality burden in England

BACKGROUND

Socioeconomically disadvantaged populations often have higher exposures to particulate air pollution, which can be expected to contribute to differentials in life expectancy. We examined socioeconomic differentials in exposure and air pollution-related mortality relating to larger scale (5 km resolution) variations in background concentrations of selected pollutants across England.

METHODS

Ozone and particulate matter (sub-divided into PM₁₀, PM_2.5, PM_2.5-10, primary, nitrate and sulphate PM_2.5) were simulated at 5 km horizontal resolution using an atmospheric chemistry transport model (EMEP4UK). Annual mean concentrations of these pollutants were assigned to all 1,202,578 residential postcodes in England, which were classified by urban-rural status and socioeconomic deprivation based on the income and employment domains of the 2010 English Index of Multiple Deprivation for the Lower-level Super Output Area of residence. We used life table methods to estimate PM_2.5-attributable life years (LYs) lost in both relative and absolute terms.

RESULTS

Concentrations of the most particulate fractions, but not of nitrate PM_2.5 or ozone, were modestly higher in areas of greater socioeconomic deprivation. Relationships between pollution level and socioeconomic deprivation were non-linear and varied by urban-rural status. The pattern of PM_2.5 concentrations made only a small contribution to the steep socioeconomic gradient in LYs lost due to PM_2.5 per 10³ population, which primarily was driven by the steep socioeconomic gradient in underlying mortality rates. In rural areas, the absolute burden of air pollution-related LYs lost was lowest in the most deprived deciles.

CONCLUSIONS

Air pollution shows modest socioeconomic patterning at 5 km resolution in England, but absolute attributable mortality burdens are strongly related to area-level deprivation because of underlying mortality rates. Measures that cause a general reduction in background concentrations of air pollution may modestly help narrow socioeconomic differences in health.

The influence of mid-latitude cyclones on European background surface ozone

The relationship between springtime mid-latitude cyclones and background ozone (O₃) is explored using a combination of observational and reanalysis data sets. First, the relationship between surface O₃ observations at two rural monitoring sites on the west coast of Europe - Mace Head, Ireland and Monte Velho, Portugal - and cyclone track frequency in the surrounding regions is examined. Second, detailed case study examination of four individual mid-latitude cyclones and the influence of the associated frontal passage on surface O₃ is performed. Cyclone tracks have a greater influence on the O₃ measurements at the more northern coastal European station, Mace Head, located within the main North Atlantic (NA) storm track. In particular, when cyclones track north of 53° N, there is a significant relationship with high levels of surface O₃ (> 75th percentile). The further away a cyclone is from the NA storm track, the more likely it will be associated with both high and low (< 25th percentile) levels of O₃ at the observation site during the cyclone's life cycle. The results of the four case studies demonstrate a) the importance of the passage of a cyclone's cold front in relation to surface O₃ measurements, b) the ability of mid-latitude cyclones to bring down high levels of O₃ from the stratosphere and c) that accompanying surface high pressure systems and their associated transport pathways play an important role in the temporal variability of surface O₃. The main source of high O₃ to these two sites in springtime is from the stratosphere, either from direct injection into the cyclone or associated with aged airstreams from decaying downstream cyclones that can become entrained and descend toward the surface within new cyclones over the NA region.

Myocardial infarction, ST-elevation and non-ST-elevation myocardial infarction and modelled daily pollution concentrations: a case-crossover analysis of MINAP data

Objectives

To investigate associations between daily concentrations of air pollution and myocardial infarction (MI), ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI).

Methods

Modelled daily ground-level gaseous, total and speciated particulate pollutant concentrations and ground-level daily mean temperature, all at 5 km×5 km horizontal resolution, were linked to 202 550 STEMI and 322 198 NSTEMI events recorded on the England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. The study period was 2003–2010. A case-crossover design was used, stratified by year, month and day of the week. Data were analysed using conditional logistic regression, with pollutants modelled as unconstrained distributed lags 0–2 days. Results are presented as percentage change in risk per 10 µg/m³ increase in the pollutant relevant metric, having adjusted for daily mean temperature, public holidays, weekly influenza consultation rates and a sine-cosine annual cycle.

Results

There was no evidence of an association between MI or STEMI and any of O₃, NO₂, PM_2.5, PM₁₀ or selected PM_2.5 components (sulfate and elemental carbon). For NSTEMI, there was a positive association with daily maximum 1-hour NO₂ (0.27% (95% CI 0.01% to 0.54%)), which persisted following adjustment for O₃ and adjustment for PM_2.5. The association appeared to be confined to the midland and southern regions of England and Wales.

Conclusions

The study found no evidence of an association between the modelled pollutants (including components) investigated and STEMI but did find some evidence of a positive association between NO₂ and NSTEMI. Confirmation of this association in other studies is required.

Assessing chemistry schemes and constraints in air quality models used to predict ozone in London against the detailed Master Chemical Mechanism

Air pollution is the environmental factor with the greatest impact on human health in Europe. Understanding the key processes driving air quality across the relevant spatial scales, especially during pollution exceedances and episodes, is essential to provide effective predictions for both policymakers and the public. It is particularly important for policy regulators to understand the drivers of local air quality that can be regulated by national policies versus the contribution from regional pollution transported from mainland Europe or elsewhere. One of the main objectives of the Coupled Urban and Regional processes: Effects on AIR quality (CUREAIR) project is to determine local and regional contributions to ozone events. A detailed zero-dimensional (0-D) box model run with the Master Chemical Mechanism (MCMv3.2) is used as the benchmark model against which the less explicit chemistry mechanisms of the Generic Reaction Set (GRS) and the Common Representative Intermediates (CRIv2-R5) schemes are evaluated. GRS and CRI are used by the Atmospheric Dispersion Modelling System (ADMS-Urban) and the regional chemistry transport model EMEP4UK, respectively. The MCM model uses a near-explicit chemical scheme for the oxidation of volatile organic compounds (VOCs) and is constrained to observations of VOCs, NOx, CO, HONO (nitrous acid), photolysis frequencies and meteorological parameters measured during the ClearfLo (Clean Air for London) campaign. The sensitivity of the less explicit chemistry schemes to different model inputs has been investigated: Constraining GRS to the total VOC observed during ClearfLo as opposed to VOC derived from ADMS-Urban dispersion calculations, including emissions and background concentrations, led to a significant increase (674% during winter) in modelled ozone. The inclusion of HONO chemistry in this mechanism, particularly during wintertime when other radical sources are limited, led to substantial increases in the ozone levels predicted (223%). When the GRS and CRIv2-R5 schemes are run with the equivalent model constraints to the MCM, they are able to reproduce the level of ozone predicted by the near-explicit MCM to within 40% and 20% respectively for the majority of the time. An exception to this trend was observed during pollution episodes experienced in the summer, when anticyclonic conditions favoured increased temperatures and elevated O3. The in situ O3 predicted by the MCM was heavily influenced by biogenic VOCs during these conditions and the low GRS [O3] : MCM [O3] ratio (and low CRIv2-R5 [O3] : MCM [O3] ratio) demonstrates that these less explicit schemes under-represent the full O3 creation potential of these VOCs. To fully assess the influence of the in situ O3 generated from local emissions versus O3 generated upwind of London and advected in, the time since emission (and, hence, how far the real atmosphere is from steady state) must be determined. From estimates of the mean transport time determined from the NOx : NOy ratio observed at North Kensington during the summer and comparison of the O3 predicted by the MCM model after this time, ∼60% of the median observed [O3] could be generated from local emissions. During the warmer conditions experienced during the easterly flows, however, the observed [O3] may be even more heavily influenced by London's emissions.

The effect of future ambient air pollution on human premature mortality to 2100 using output from the ACCMIP model ensemble

Ambient air pollution from ground-level ozone and fine particulate matter (PM_2.5) is associated with premature mortality. Future concentrations of these air pollutants will be driven by natural and anthropogenic emissions and by climate change. Using anthropogenic and biomass burning emissions projected in the four Representative Concentration Pathway scenarios (RCPs), the ACCMIP ensemble of chemistry-climate models simulated future concentrations of ozone and PM_2.5 at selected decades between 2000 and 2100. We use output from the ACCMIP ensemble, together with projections of future population and baseline mortality rates, to quantify the human premature mortality impacts of future ambient air pollution. Future air pollution-related premature mortality in 2030, 2050 and 2100 is estimated for each scenario and for each model using a health impact function based on changes in concentrations of ozone and PM_2.5 relative to 2000 and projected future population and baseline mortality rates. Additionally, the global mortality burden of ozone and PM_2.5 in 2000 and each future period is estimated relative to 1850 concentrations, using present-day and future population and baseline mortality rates. The change in future ozone concentrations relative to 2000 is associated with excess global premature mortality in some scenarios/periods, particularly in RCP8.5 in 2100 (316 thousand deaths/year), likely driven by the large increase in methane emissions and by the net effect of climate change projected in this scenario, but it leads to considerable avoided premature mortality for the three other RCPs. However, the global mortality burden of ozone markedly increases from 382,000 (121,000 to 728,000) deaths/year in 2000 to between 1.09 and 2.36 million deaths/year in 2100, across RCPs, mostly due to the effect of increases in population and baseline mortality rates. PM_2.5 concentrations decrease relative to 2000 in all scenarios, due to projected reductions in emissions, and are associated with avoided premature mortality, particularly in 2100: between -2.39 and -1.31 million deaths/year for the four RCPs. The global mortality burden of PM_2.5 is estimated to decrease from 1.70 (1.30 to 2.10) million deaths/year in 2000 to between 0.95 and 1.55 million deaths/year in 2100 for the four RCPs, due to the combined effect of decreases in PM_2.5 concentrations and changes in population and baseline mortality rates. Trends in future air pollution-related mortality vary regionally across scenarios, reflecting assumptions for economic growth and air pollution control specific to each RCP and region. Mortality estimates differ among chemistry-climate models due to differences in simulated pollutant concentrations, which is the greatest contributor to overall mortality uncertainty for most cases assessed here, supporting the use of model ensembles to characterize uncertainty. Increases in exposed population and baseline mortality rates of respiratory diseases magnify the impact on premature mortality of changes in future air pollutant concentrations and explain why the future global mortality burden of air pollution can exceed the current burden, even where air pollutant concentrations decrease.

Measurement error in time-series analysis: a simulation study comparing modelled and monitored data

Background

Assessing health effects from background exposure to air pollution is often hampered by the sparseness of pollution monitoring networks. However, regional atmospheric chemistry-transport models (CTMs) can provide pollution data with national coverage at fine geographical and temporal resolution. We used statistical simulation to compare the impact on epidemiological time-series analysis of additive measurement error in sparse monitor data as opposed to geographically and temporally complete model data.

Methods

Statistical simulations were based on a theoretical area of 4 regions each consisting of twenty-five 5 km × 5 km grid-squares. In the context of a 3-year Poisson regression time-series analysis of the association between mortality and a single pollutant, we compared the error impact of using daily grid-specific model data as opposed to daily regional average monitor data. We investigated how this comparison was affected if we changed the number of grids per region containing a monitor. To inform simulations, estimates (e.g. of pollutant means) were obtained from observed monitor data for 2003–2006 for national network sites across the UK and corresponding model data that were generated by the EMEP-WRF CTM. Average within-site correlations between observed monitor and model data were 0.73 and 0.76 for rural and urban daily maximum 8-hour ozone respectively, and 0.67 and 0.61 for rural and urban log_e(daily 1-hour maximum NO₂).

Results

When regional averages were based on 5 or 10 monitors per region, health effect estimates exhibited little bias. However, with only 1 monitor per region, the regression coefficient in our time-series analysis was attenuated by an estimated 6% for urban background ozone, 13% for rural ozone, 29% for urban background log_e(NO₂) and 38% for rural log_e(NO₂). For grid-specific model data the corresponding figures were 19%, 22%, 54% and 44% respectively, i.e. similar for rural log_e(NO₂) but more marked for urban log_e(NO₂).

Conclusion

Even if correlations between model and monitor data appear reasonably strong, additive classical measurement error in model data may lead to appreciable bias in health effect estimates. As process-based air pollution models become more widely used in epidemiological time-series analysis, assessments of error impact that include statistical simulation may be useful.

Health burdens of surface ozone in the UK for a range of future scenarios

Exposure to surface ozone (O3), which is influenced by emissions of precursor chemical species, meteorology and population distribution, is associated with excess mortality and respiratory morbidity. In this study, the EMEP-WRF atmospheric chemistry transport model was used to simulate surface O3 concentrations at 5km horizontal resolution over the British Isles for a baseline year of 2003, for three anthropogenic emissions scenarios for 2030, and for a +5°C increase in air temperature on the 2003 baseline. Deaths brought forward and hospitalisation burdens for 12 UK regions were calculated from population-weighted daily maximum 8-hour O3. The magnitude of changes in annual mean surface O3 over the UK for +5°C temperature (+1.0 to +1.5ppbv, depending on region) was comparable to those due to inter-annual meteorological variability (-1.5 to +1.5ppbv) but considerably less than changes due to precursor emissions changes by 2030 (-3.0 to +3.5ppbv, depending on scenario and region). Including population changes in 2030, both the 'current legislation' and 'maximum feasible reduction' scenarios yield greater O3-attributable health burdens than the 'high' emission scenario: +28%, +22%, and +16%, respectively, above 2003 baseline deaths brought forward (11,500) and respiratory hospital admissions (30,700), using O3 exposure over the full year and no threshold for health effects. The health burdens are greatest under the 'current legislation' scenario because O3 concentrations increase as a result of both increases in background O3 concentration and decreases in UK NOx emissions. For the +5°C scenario, and no threshold (and not including population increases), total UK health burden increases by 500 premature deaths (4%) relative to the 2003 baseline. If a 35ppbv threshold for O3 effects is assumed, health burdens are more sensitive to the current legislation and +5°C scenarios, although total health burdens are roughly an order of magnitude lower. In all scenarios, the assumption of a threshold increases the proportion of health burden in the south and east of the UK compared with the no threshold assumption. The study highlights that the total, and geographically-apportioned, O3-attributable health burdens in the UK are highly sensitive to the future trends of hemispheric, regional and local emissions of O3 precursors, and to the assumption of a threshold for O3 effect.

Concentration-response function for ozone and daily mortality: results from five urban and five rural U.K. populations

BACKGROUND

Short-term exposure to ozone has been associated with increased daily mortality. The shape of the concentration-response relationship-and, in particular, if there is a threshold-is critical for estimating public health impacts.

OBJECTIVE

We investigated the concentration-response relationship between daily ozone and mortality in five urban and five rural areas in the United Kingdom from 1993 to 2006.

METHODS

We used Poisson regression, controlling for seasonality, temperature, and influenza, to investigate associations between daily maximum 8-hr ozone and daily all-cause mortality, assuming linear, linear-threshold, and spline models for all-year and season-specific periods. We examined sensitivity to adjustment for particles (urban areas only) and alternative temperature metrics.

RESULTS

In all-year analyses, we found clear evidence for a threshold in the concentration-response relationship between ozone and all-cause mortality in London at 65 µg/m3 [95% confidence interval (CI): 58, 83] but little evidence of a threshold in other urban or rural areas. Combined linear effect estimates for all-cause mortality were comparable for urban and rural areas: 0.48% (95% CI: 0.35, 0.60) and 0.58% (95% CI: 0.36, 0.81) per 10-µg/m3 increase in ozone concentrations, respectively. Seasonal analyses suggested thresholds in both urban and rural areas for effects of ozone during summer months.

CONCLUSIONS

Our results suggest that health impacts should be estimated across the whole ambient range of ozone using both threshold and nonthreshold models, and models stratified by season. Evidence of a threshold effect in London but not in other study areas requires further investigation. The public health impacts of exposure to ozone in rural areas should not be overlooked.

Current and future climate- and air pollution-mediated impacts on human health

BACKGROUND

We describe a project to quantify the burden of heat and ozone on mortality in the UK, both for the present-day and under future emission scenarios.

METHODS

Mortality burdens attributable to heat and ozone exposure are estimated by combination of climate-chemistry modelling and epidemiological risk assessment. Weather forecasting models (WRF) are used to simulate the driving meteorology for the EMEP4UK chemistry transport model at 5 km by 5 km horizontal resolution across the UK; the coupled WRF-EMEP4UK model is used to simulate daily surface temperature and ozone concentrations for the years 2003, 2005 and 2006, and for future emission scenarios. The outputs of these models are combined with evidence on the ozone-mortality and heat-mortality relationships derived from epidemiological analyses (time series regressions) of daily mortality in 15 UK conurbations, 1993-2003, to quantify present-day health burdens.

RESULTS

During the August 2003 heatwave period, elevated ozone concentrations > 200 microg m-3 were measured at sites in London and elsewhere. This and other ozone photochemical episodes cause breaches of the UK air quality objective for ozone. Simulations performed with WRF-EMEP4UK reproduce the August 2003 heatwave temperatures and ozone concentrations. There remains day-to-day variability in the high ozone concentrations during the heatwave period, which on some days may be explained by ozone import from the European continent.Preliminary calculations using extended time series of spatially-resolved WRF-EMEP4UK model output suggest that in the summers (May to September) of 2003, 2005 & 2006 over 6000 deaths were attributable to ozone and around 5000 to heat in England and Wales. The regional variation in these deaths appears greater for heat-related than for ozone-related burdens.Changes in UK health burdens due to a range of future emission scenarios will be quantified. These future emissions scenarios span a range of possible futures from assuming current air quality legislation is fully implemented, to a more optimistic case with maximum feasible reductions, through to a more pessimistic case with continued strong economic growth and minimal implementation of air quality legislation.

CONCLUSION

Elevated surface ozone concentrations during the 2003 heatwave period led to exceedences of the current UK air quality objective standards. A coupled climate-chemistry model is able to reproduce these temperature and ozone extremes. By combining model simulations of surface temperature and ozone with ozone-heat-mortality relationships derived from an epidemiological regression model, we estimate present-day and future health burdens across the UK. Future air quality legislation may need to consider the risk of increases in future heatwaves.

The contribution from shipping emissions to air quality and acid deposition in Europe

A global three-dimensional Lagrangian chemistry-transport model STOCHEM is used to describe the European regional acid deposition and ozone air quality impacts along the Atlantic Ocean seaboard of Europe, from the SO2, NOx, VOCs and CO emissions from international shipping under conditions appropriate to the year 2000. Model-derived total sulfur deposition from international shipping reaches over 200 mg S m(-2) yr(-1) over the southwestern approaches to the British Isles and Brittany. The contribution from international shipping to surface ozone concentrations during the summertime, peaks at about 6 ppb over Ireland, Brittany and Portugal. Shipping emissions act as an external influence on acid deposition and ozone air quality within Europe and may require control actions in the future if strict deposition and air quality targets are to be met.

The solubility of gases and vapours in ethanol - the connection between gaseous solubility and water-solvent partition

Ostwald solubility coefficients, as log L, for solutes in water and ethanol have been combined to give log PEtOH for partition between the two pure solvents. Sixty-four such values have been correlated through our solvation equation, the coefficients of which lead to the conclusion that ethanol and water solvents are equally strong hydrogen-bond bases, but that ethanol is much weaker as a hydrogen-bond acid. A slightly different solvation equation has been used to correlate 68 values of log LEtOH; the coefficients in this equation yield the same conclusions as to the hydrogen-bond acidity and basicity of bulk ethanol. In addition, an analysis of the various terms in the log LEtOH correlation equation allows the elucidation of the various chemical factors that govern the solubility of gaseous solutes in ethanol solvent at 298 K.Key words: solubility, partition, hydrogen-bonding, ethanol, water.

Impaired left atrial mechanical function after cardioversion: relation to the duration of atrial fibrillation

OBJECTIVES

We hypothesized that the time course of the recovery of atrial systolic function may be related to the duration of atrial fibrillation before cardioversion and sought to study noninvasively the recovery of left atrial mechanical function utilizing serial transthoracic Doppler studies.

BACKGROUND

Recovery of atrial mechanical function may be delayed for several weeks after successful cardioversion of atrial fibrillation to sinus rhythm.

METHODS

After successful cardioversion, 60 patients with atrial fibrillation of brief (< or = 2 weeks, 17 patients), moderate (> 2 to 6 weeks, 22 patients) or prolonged (> 6 weeks, 21 patients) duration were followed up with serial transmitral pulsed Doppler echocardiography immediately (60 patients) and at 24 h (45 patients), 1 week (41 patients), 1 month (31 patients) and > 3 months (30 patients) after cardioversion.

RESULTS

Atrial mechanical function is greater immediately and at 24 h and 1 week after cardioversion in patients with "brief" compared with "prolonged" atrial fibrillation. In all groups, atrial mechanical function increases over time, ultimately achieving similar levels. Full recovery of atrial mechanical function, however, is achieved within 24 h in patients with brief atrial fibrillation, within 1 week in patients with moderate-duration atrial fibrillation and within 1 month in patients with prolonged atrial fibrillation.

CONCLUSIONS

Recovery of left atrial mechanical function is related to the duration of atrial fibrillation before cardioversion. These findings have important implications for assessing the early hemodynamic benefit of successful cardioversion.

Solvent effects in organic chemistry — recent developments

Solvent effects on a number of different processes have been surveyed, and results of the application of multiple linear regression analysis are discussed. The processes examined include examples of solubility of gases or vapours, distribution coefficients of solutes between water and a series of solvents, and solvent effects on conformational equilibria, on keto–enol tautomerism, and on reaction rates. It is shown that two particular equations, that due to Koppel and Palm and extended by Makitra and Pirig, and that due to Abraham, Kamlet, and Taft, can cope quite satisfactorily with solvent effects on these various processes. It is pointed out that interpretation of parameters obtained from equations that involve macroscopic quantities such as ΔG≠ or ΔG0 is not necessarily straightforward, and that some model is needed in order to interpret these macroscopic quantities in terms of microscopic quantities that can characterise, for example, solute–solvent interactions.

Solubility properties in polymers and biological media. II. A new method for the characterisation of the adsorption of gases and vapours on solids

Henry's constants at zero solute pressure have been determined by the gas chromatographic peak shape method for twenty-two solutes on four adsorbents (Rohm and Haas Ambersorb XE-348F carbonaceous adsorbent at 323 and 373 K, Sutcliffe Speakman 207A and 207C at 323 K, and Calgon Filtrasorb activated carbon at 323 K). The limiting values of log KH have been analysed in terms of solute dipolarity (pi 2*), solute hydrogen-bond acidity (alpha 2), and basicity (beta 2), and a new solute parameter (log L16), the solute Ostwald absorption coefficient on eta-hexadecane. The multiple linear regression equation, SP = SP0 + l.log L16 + s(pi 2* + d delta 2) + a alpha 2 + b beta 2 where in this instance SP = -log KH, can be used to identify the nature of the solute-adsorbent interactions, and to predict further values of log KH. For the solutes and solids we have studied, only the l.log L16 term is statistically significant, and hence--log KH is proportional to l.log L16. It is concluded that interactions between the gaseous solutes (that include alcohols and amines) and the four adsorbents involve just general dispersion forces.

Solubility properties in biological media 9: prediction of solubility and partition of organic nonelectrolytes in blood and tissues from solvatochromic parameters

Solubilities in and partition among human blood, brain, lung, kidney, muscle, and fat tissue are well correlated by linear solvation energy relationships of the form: XYZ = XYZo + mVI/100 + s pi + b beta m where XYZ is the logarithm of the solubility property, VI is the intrinsic (van der Waals') molar volume, pi and beta are the solvatochromic parameters that measure solute dipolarity/polarizability and hydrogen-bond acceptor basicity, respectively, and the subscript m indicates that for self-associating compounds, the parameter applies to the non-self-associated "monomer" solute. The equation for log K(brain--blood) indicates that increasing molar volume favors, whereas increasing dipolarity and hydrogen-bond acceptor basicity oppose, solute transfer from blood into brain.