Review, discussion, and summary of epidemiological studies.

This paper reviews and summarizes the epidemiological studies presented at the Symposium on the Health Effects of Acid Aerosols. Two studies of acute episodes examined different indicators of respiratory morbidity before, during, and after the January 1985 air pollution event in western Europe. In the U.K. no increase in respiratory morbidity, as reported by a group of general practitioners, was observed, but measured concentrations of air pollutants failed to substantiate the existence of an identifiable episode. In the Federal Republic of Germany, the air pollution episode was documented and was associated with a 10 to 25% increase in several indicators of respiratory and cardiovascular morbidity, but could not be attributed to acidic aerosols as such. In two further studies, investigators related day-to-day variations in air pollution with admissions to acute care hospitals in southern Ontario for respiratory disease over a 9-year period, and with daily mortality in London from 1963 to 1972. In the study of hospital admissions, significant correlations were observed with sulfate, ozone, and SO2 pollution, but the data were insufficient to isolate the separate or combined effects of these pollutants. In the London mortality analysis, the strongest correlations were observed for sulfuric acid levels of the prior day, but prefiltering of the mortality data may have dampened the true relationship, and age- and cause-specific analyses would have been desirable. Finally two reports on chronic effects of residence in high air pollution areas have thus far made little contribution to the evidence for an adverse effect of specific pollutants.