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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The Canary Islands are probably one of the areas located outside the African mainland most affected by Saharan dust&#46; Their citizens have always unerringly perceived that Saharan dust has an impact on health&#44; worsening respiratory conditions&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">African dust is transported over long distances and meets these Islands &#40;100<span class="elsevierStyleHsp" style=""></span>km from the western coast of Morocco&#41; at the beginning of its westward path across the North Atlantic Ocean to The Caribbean&#44; North and South America&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a> During Saharan dust episodes &#40;SDEs&#41;&#44; daily particulate matter &#40;PM&#41; concentrations in both capital cities rise for several days&#44; exceeding the European daily limit value for PM<span class="elsevierStyleInf">10</span> &#40;50<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The existence of an association between the urban exposure to anthropogenic PM in continental cities &#40;dominated by PM<span class="elsevierStyleInf">2&#46;5</span>&#41; and respiratory outcomes has been widely documented&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a> Fewer studies have evaluated this association with coarse particles &#40;particles with an aerodynamic diameter between 2&#46;5 and 10<span class="elsevierStyleHsp" style=""></span>mm&#59; PM<span class="elsevierStyleInf">10&#8211;2&#46;5</span>&#41;&#46; Brunekreef and Forsberg<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a> concluded that PM<span class="elsevierStyleInf">10&#8211;2&#46;5</span> &#40;mainly constituted by desert dust&#44; crustal material&#44; sea salt&#44; pollen&#44; spores&#44; fly ash&#44; and plant and insect parts&#41; has as strong short-term effect as PM<span class="elsevierStyleInf">2&#46;5</span>&#46; However&#44; only several tens of the articles examining this association have been published&#46; Most of them&#44; concentrate on Southern European countries and some others have been carried out in the Caribbean&#46; Some authors have highlighted the need to carry out studies in areas closer to dust sources&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">4&#8211;6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The provincial capitals of the Canary Islands &#91;Las Palmas &#40;L&#47;P&#41; de Gran Canaria and Santa Cruz &#40;S&#47;C&#41; de Tenerife&#93; constitute two optimal urban environments to assess the impact of Saharan dust on health&#59; firstly&#44; their citizens are exposed to a high frequency of Saharan dust days &#40;SDDs&#41; as well as higher levels of natural PM compared to other European cities due to their proximity to the western Sahara &#40;200<span class="elsevierStyleHsp" style=""></span>km&#41;&#59; and secondly&#44; with respect to other urban environments located in west Africa&#44; they have systematic and consolidated air quality and health information systems in accordance with European regulations&#46; Preliminary work has shown that in both cities there is a short-term association between daily levels of PM<span class="elsevierStyleInf">10</span>&#44; PM<span class="elsevierStyleInf">10&#8211;2&#46;5</span> and PM<span class="elsevierStyleInf">2&#46;5</span> with an increased risk of heart and respiratory morbidity and mortality and the lack of confounding by gases or between PM fractions&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#8211;9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this study is to assess the short-term association between SDDs and emergency hospital admissions due to all respiratory system diseases &#40;ARSD&#41;&#44; chronic obstructive pulmonary disease &#40;COPD&#41; and asthma&#44; in the cities of L&#47;P de Gran Canaria and S&#47;C de Tenerife according to the type&#44; stage and intensity of SDDs as well as the duration of the episodes&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Design</span><p id="par0030" class="elsevierStylePara elsevierViewall">This is a time-series study with the day as unit of analysis and aggregate data at the city level during the period 2001&#8211;2005&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Setting</span><p id="par0035" class="elsevierStylePara elsevierViewall">L&#47;P de Gran Canaria and S&#47;C de Tenerife are in the northeastern areas of the islands of Gran Canaria and Tenerife&#44; respectively&#44; approximately 200<span class="elsevierStyleHsp" style=""></span>km&#46; off the northwest African coast &#40;see supplemental material&#44; Figure S1&#41;&#46; They are characterized by very mild temperatures with low seasonal variation &#40;7<span class="elsevierStyleHsp" style=""></span>&#176;C difference in daily average between the warmest and coldest months&#44; Fig&#46; S2&#41;&#46; L&#47;P de Gran Canaria&#44; &#40;374&#44;000 inhabitants&#41; is located largely on an isthmus that allows free circulation of the northeast trade winds&#44; providing regular dispersive conditions and without industrial sources of air pollution&#46; In S&#47;C de Tenerife&#44; 219&#44;000 inhabitants&#41;&#44; such dispersive conditions are diminished because The Anaga Massif surrounds the city on its north&#47;northwest side&#46; In addition&#44; there was the added influence of a local oil refinery&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Air Pollution&#44; Meteorological and Covariate Data</span><p id="par0040" class="elsevierStylePara elsevierViewall">Daily emergency hospital admissions of both cities&#8217; residents between January 1&#44; 2001 and December 31&#44; 2005 were provided by the Canary Islands Regional Health Authority&#46; The emergency hospital admissions with primary diagnosis &#91;International Classification of Diseases&#44; 9th Revision &#40;ICD-9&#41;&#59; World Health Organization&#93; for&#58; &#40;1&#41; ARSD &#91;ICD-9&#58; 460&#8211;519&#93;&#44; &#40;2&#41; COPD &#91;ICD-9&#58; 490&#8211;492&#44; 494&#8211;496&#93; and &#40;3&#41; asthma &#91;ICD-9&#58; 493&#93; were considered&#46; Weekly influenza counts were provided by the Regional Epidemiological Surveillance System&#46; Data on PM were obtained from the Canary Islands Air Quality Network &#40;CIAQN&#41;&#46; Two monitoring sites were selected in S&#47;C de Tenerife and one in L&#47;P de Gran Canaria &#40;94&#37; of valid days&#41;&#46; PM<span class="elsevierStyleInf">10-2&#46;5</span> concentrations were calculated as the difference between daily PM<span class="elsevierStyleInf">10</span> and PM<span class="elsevierStyleInf">2&#46;5</span> means&#46; Daily mean temperature &#40;&#176;C&#41;&#44; relative humidity &#40;&#37;&#41; and barometric pressure &#40;mbar&#41; for each city were provided by the National Meteorological Agency&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Sahara Dust Advections</span><p id="par0045" class="elsevierStylePara elsevierViewall">The low troposphere over the Islands is strongly stratified&#46; The thermal inversion layer that limits the top of the fresh and wet marine boundary layer &#40;MBL&#41; is located at an approximate height of 800<span class="elsevierStyleHsp" style=""></span>m above sea level during the summer and at 1500 during the winter&#46; This feature is essential in order to understand the levels of particles that can be reached&#59; some authors have described two main types of African dust intrusions over the Canary Islands&#58; low altitude in winter &#40;October to March&#41; and high altitude atmospheric intrusions in summer &#40;April to September&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">10&#44;11</span></a> This means that in summer&#44; this transport affects coastal cities for gravitational deposition from high altitude&#44; whereas in winter&#44; with the increase in the height of the thermal inversion layer&#44; the transport takes place within the MBL and consequently very high levels of particulate matter can be registered&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Saharan Dust Days&#44; SDDs</span><p id="par0050" class="elsevierStylePara elsevierViewall">Dates with confirmed Saharan dust intrusion over the Canary Islands&#8217; atmosphere &#40;at a regional level&#41;&#44; were obtained from the Directorate-General for Environmental Quality &#38; Assessment at the Ministry for Agriculture&#44; food and Environment&#44; available at &#40;<a href="http://www.calima.ws/">http&#58;&#47;&#47;www&#46;calima&#46;ws&#47;</a>&#44; last accessed May 17th&#44; 2017&#41;&#46; Saharan dust intrusion assessment is based on operational models &#91;through back-trajectory analysis &#40;Hysplit model&#41;&#44; information from NRL SKIRON and BSCDREAM dust maps&#93; and satellite images provided by the NASA SeaWiFS&#46; This procedure is the result of the application of the methodology accepted by the UE Environmental Office&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">12</span></a> In order to determine if Sahara dust advections impacted on PM concentrations at ground levels&#44; the previous data were revised and combined with local information on air pollutant series and meteorological information by CIAQN experts&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Other Variables</span><p id="par0055" class="elsevierStylePara elsevierViewall">Aiming to evaluate whether the association between SDD and hospital admissions was different regarding specific features of the SDDs&#44; additional categorical variables were defined&#58;</p><p id="par0060" class="elsevierStylePara elsevierViewall">&#8220;<span class="elsevierStyleBold">Type&#8221;&#44;</span> factor with three categories according to the altitude of the African dust transport &#91;0&#58; &#8220;<span class="elsevierStyleItalic">non-SDD&#8221;</span>&#59; 1&#58; &#8220;<span class="elsevierStyleItalic">high altitude SDD&#8221;</span>&#44; SDD occurring from April to September&#59; 2&#58; &#8220;<span class="elsevierStyleItalic">low altitude SDD&#8221;</span>&#44; from October to March&#93;&#46; This classification matches the categories &#8220;warm and cold months&#8221; carried out by other authors&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">&#8220;<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Intensity&#8221;</span>&#44;</span> factor with four categories according to the daily average of PM<span class="elsevierStyleInf">10</span> during an SDD &#91;0&#58; &#8220;<span class="elsevierStyleItalic">non-SDD&#8221;</span>&#59; 1&#58; &#8220;<span class="elsevierStyleItalic">light SDD&#8221;&#44;</span> SDD with PM<span class="elsevierStyleInf">10</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>&#956;&#47;m<span class="elsevierStyleSup">3</span>&#59; 2&#58; &#8220;<span class="elsevierStyleItalic">medium SDD&#8221;&#44;</span> SDD with PM<span class="elsevierStyleInf">10</span> between 50 and 150<span class="elsevierStyleHsp" style=""></span>&#956;&#47;m<span class="elsevierStyleSup">3</span>&#59; 3&#58; &#8220;<span class="elsevierStyleItalic">heavy SDD&#8221;</span>&#44; SDD with PM<span class="elsevierStyleInf">10</span><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>150<span class="elsevierStyleHsp" style=""></span>&#956;&#47;m<span class="elsevierStyleSup">3</span>&#93;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">&#8220;<span class="elsevierStyleBold">Duration&#8221;&#44;</span> factor with three categories according to the length of the SDE in which the SDD is located &#91;0&#58; &#8220;<span class="elsevierStyleItalic">non-SDD&#8221;</span>&#59; 1&#58; &#8220;<span class="elsevierStyleItalic">short episode SDD&#8221;&#44;</span> SDD belonging to a SDE fewer than 5 days&#59; 2&#58; &#8220;<span class="elsevierStyleItalic">long episode SDD&#8221;&#44;</span> SDD belonging to a SDE of 5 or more SDDs&#93;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">&#8220;<span class="elsevierStyleBold">Stage&#8221;</span>&#44; factor with three categories according to the position of the SDD within the SDE &#91;0&#58; <span class="elsevierStyleItalic">non-SDD</span>&#59; 1&#58; &#8220;<span class="elsevierStyleItalic">early SDD&#8221;&#44;</span> from current to fourth SDD&#59; 2&#58; &#8220;<span class="elsevierStyleItalic">late SDD&#8221;&#44;</span> from fifth SDD onwards&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical Analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">In each city Generalized Additive Models &#40;GAM&#41; in Poisson regression for ARSD and in negative binomial regression for COPD and asthma were adjusted &#40;core models&#41;&#46; Long-term trend and seasonality were non-parametrically controlled by using smoothing functions of time as explanatory variable&#46; Potential confounding caused by daily influenza counts&#44; temperature&#44; humidity and calendar variables was also controlled as well as possible residual autocorrelation&#46; Cumulative pattern of the association between SDD and emergency admission risk was examined by means of third-degree polynomial distributed lag models until five days after de exposure &#40;PDLM05&#41;&#46; Once the core model for each cause of hospitalization and city was adjusted&#44; each SDD categorical variable was introduced into the model&#46; The significance of these variables was tested by likelihood ratio &#40;LR&#41; test &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The PM fractions &#40;PM<span class="elsevierStyleInf">2&#46;5</span>&#44; PM<span class="elsevierStyleInf">10-2&#46;5</span>&#44; and PM<span class="elsevierStyleInf">10</span>&#41; effect on hospital admission in the presence and absence of SDD was explored using an interaction term between the SDD indicator &#40;yes&#47;no&#41; and each of the lag 0 PM fractions&#46; All interaction terms with <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;15 were considered statistically significant&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;14</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The effect-size estimates were expressed as the percentage of change and 95&#37; confidence interval &#40;95&#37;CI&#41; in emergency hospital admission risk in SDDs with respect to non-SDD&#46; All analyses were carried out using R 2&#46;12&#46;2 statistical analysis software &#40;R Project for Statistical Computing&#44; <a href="http://www.r-project.org/">http&#58;&#47;&#47;www&#46;r-project&#46;org</a>&#41;&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Data Description</span><p id="par0095" class="elsevierStylePara elsevierViewall">From 2001 to 2005&#44; 32&#37; of total days were classified as SDDs&#46; As shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; during cold months&#44; the number of SDDs was more frequent and PM fractions levels&#44; higher&#46; The average duration of Saharan dust episodes &#40;consecutive SDDs&#41; was 4&#46;2 days &#40;range 1&#8211;23&#41;&#46; In both cities &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; more than 50&#37; of <span class="elsevierStyleItalic">SDD</span>s&#44; were classified as <span class="elsevierStyleItalic">low altitude SDDs</span>&#44; <span class="elsevierStyleItalic">light SDDs</span>&#44; <span class="elsevierStyleItalic">long episode SDDs</span> and <span class="elsevierStyleItalic">early SDDs</span>&#46; Table S1 shows the episodes with heavy SDDs and their duration&#44; Figure S3 illustrates the SDEs occurred between January 1th and March 2004 31st&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the summary statistics for the study&#39;s variables&#46; Significantly higher average levels during <span class="elsevierStyleItalic">SDD</span>s were found for all PM fractions &#40;from 2&#46;1 to 2&#46;8-fold higher with respect to <span class="elsevierStyleItalic">non</span>-<span class="elsevierStyleItalic">SDD</span>s&#41;&#44; for NO<span class="elsevierStyleInf">2</span> and temperature in both cities&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Analysis of the Association</span><p id="par0105" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> shows the estimated percentage change and 95&#37;CI in risk of hospitalization associated with SDD at lag 0 and for PDLM05 in both cities&#46; Overall&#44; both models showed a positive pattern of association&#46; In S&#47;C de Tenerife&#44; the risk of admission due to ARSD increased on the current &#91;7&#46;9&#37; &#40;95&#37;CI&#58; 0&#46;4&#44; 15&#46;9&#41;&#93; and during the 5 next days&#58; 22&#46;6&#37; &#40;95&#37;CI&#58; 10&#46;4&#44; 36&#46;0&#41;&#46; Harmful SDDs according to the features previously described &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41; were&#58; SDDs at <span class="elsevierStyleItalic">late stage</span> and those belonging to <span class="elsevierStyleItalic">long episodes</span>&#44; <span class="elsevierStyleItalic">low altitude</span> SDDs and <span class="elsevierStyleItalic">medium and heavy</span> SDDs&#46; In both cities&#44; a linear trend in the estimates was appreciated regarding intensity &#40;the higher intensity&#44; the bigger effects&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">With respect to emergency COPD admissions&#44; a very similar pattern was found &#40;<a class="elsevierStyleCrossRefs" href="#fig0015">Figs&#46; 3 and 4</a>&#41;&#44; unless a significant effect was also observed in L&#47;P de Gran Canaria for SDDs in the highest category of intensity&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Regarding emergency admissions due to asthma&#44; no association was found in S&#47;C de Tenerife&#46; In L&#47;P de Gran Canaria&#44; the cumulative effect &#40;PDLM05&#41; was marginally significant&#58; 33&#46;4&#37; &#40;CI95&#37;&#58; &#8722;2&#46;1&#44; 81&#46;9&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#44; and according to the specific features of the SDDs&#44; the SDDs&#39;s categories with highest effect were&#58; <span class="elsevierStyleItalic">low altitude</span> and <span class="elsevierStyleItalic">medium&#47;heavy</span> SDDs &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Table S2 shows the effect modification of PM fractions caused by SDD&#46; During non-SDDs&#44; no statistically significant PM effects were observed on hospital admissions due to the analyzed causes&#46; In both cities&#44; during SDDs&#44; the estimated effects on COPD admissions were positive and statistically significant for all PM fractions as well as the estimated effects for PM<span class="elsevierStyleInf">2&#46;5</span> on ARSD admissions&#44; however none of the interaction terms were statistically significant&#44; being close to significance the interaction with PM<span class="elsevierStyleInf">10</span> for ARSD in S&#47;C de Tenerife &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;18&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">Our results show that&#44; overall&#44; there is a solid pattern of short-term association spreading over successive days&#44; between the exposure to SDDs and respiratory emergency hospital admissions in both cities&#46; We found that during an SDD&#44; the risk of being hospitalized due to ARSD and COPD increases in S&#47;C de Tenerife and the risk of asthma hospitalizations increases in L&#47;P de Gran Canaria compared to non-SDDs&#46; Our findings suggest the existence of different effect on the three analyzed outcomes according to some features of SDDs&#58; during <span class="elsevierStyleItalic">low SDDs</span>&#44; the risk of being hospitalized for ARSD and COPD in S&#47;C de Tenerife and asthma in L&#47;P de Gran Canaria&#44; significantly increased with respect to <span class="elsevierStyleItalic">non-SDDs</span>&#46; Both cities are located at sea level&#44; so during <span class="elsevierStyleItalic">low SDDs</span>&#44; Saharan dust has a higher impact on local particulate matter levels &#40;worsening the air quality&#41; than those recorded during <span class="elsevierStyleItalic">high SDDs</span> in summer&#46; The <span class="elsevierStyleItalic">intensity</span> of the SDD also determined the probability of emergency admission&#44; so that SDDs with medium or high PM<span class="elsevierStyleInf">10</span> daily levels associated with higher risk estimates than <span class="elsevierStyleItalic">light SDDs</span>&#46; Finally&#44; we also observed that for ARSD and COPD&#44; effect-size estimates were higher on late SDDs and when SDDs belonged to long episodes&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">M</span>ost of the studies assessing the possible health effects of SDD&#44; have been carried out in cites located in Southern Europe and have analyzed the short-term effect on daily mortality&#46; Only three analyzed SDD as an independent risk factor on daily admissions&#58; in Nycosia&#44; Middleton et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a> found a 10&#46;4&#37; increase &#40;95&#37;CI&#58; &#8722;4&#46;7&#44; 27&#46;9&#41; in the risk of hospitalization on dust days for cardiovascular disease&#46; MED-PARTICLE project<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a> found weak evidence of dust being a risk factor per se for respiratory admissions&#58; 0&#46;85&#37; &#40;95&#37; CI&#58; &#8722;0&#46;75&#44; 2&#46;47&#37;&#41;&#44; we found higher effect-size estimates&#58; 7&#46;9&#37; &#40;95&#37;CI&#58; 0&#46;4&#44; 15&#46;9&#41; in S&#47;C de Tenerife&#46; Zauli Sajani et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> in Emilia-Romagna&#44; concluded that Saharan dust showed an increased risk of respiratory mortality for people aged 75 or older&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In Be&#8217;er Shera&#44; Israel&#44; Vodonos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> identified 445 dust storm days and found a 16&#37; &#40;95&#37; CI&#58; 8&#46;0&#44; 24&#41; risk increase for admissions due to COPD during concurrent SDD&#44; in line with our findings&#46; In our study&#44; the estimated risks for COPD are globally positive for the different indicators analyzed&#46; In Tenerife&#44; the prevalence of COPD is 6&#46;1&#37; &#40;95&#37;CI&#58; 3&#46;8&#44; 8&#46;8&#41; and 8&#46;4&#37; &#40;95&#37;CI&#58; 6&#46;4&#44; 10&#46;6&#41; in Gran Canaria<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a> while in the rest of Spain the estimated prevalence is 10&#46;2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a> This fact suggest that our estimated risks cannot be attributed to the existence of a high proportion of vulnerable population to SDD exposure due to COPD and may support the hypothesis of the potential capability of SDD to trigger COPD&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Asthma has also been associated with exposure to SDD&#59; this fact is corroborated by local health professionals during their clinical practice&#44; who consider it one of the triggers of this disease&#46; A higher prevalence of asthma &#40;between 15&#46; 4 and 25&#37;&#41; has been reported in areas exposed to dust episodes such as Kuwait&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a> United Arab Emirates&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">22</span></a> Saudi Arabia<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a> or Qatar&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a> Juli&#224; Cerd&#224; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> have estimated that&#44; in the adult population&#44; the prevalence of asthma in the Canary Islands is 17&#46;2&#37; &#40;95&#37;CI&#58; 16&#46;3&#44; 18&#46;1&#41; compared with an average of 5&#37; of the whole of Spain&#46; For that reason&#44; it seems that there is a large population susceptible to the Saharan dust effects&#44; generating a public health problem&#46; Our estimate of accumulated effect on asthma admissions&#44; from day 0 to 5 was 29&#46;9&#37; &#40;95&#37;CI&#58; 6&#46;6&#44; 58&#46;4&#41;&#46; This impact has been studied thousands Km away from the Sahara Desert&#44; in the Caribbean&#46; In Trinidad<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">26&#44;27</span></a> and Grenada&#44;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">28</span></a> an association between SDD and pediatric asthma emergency room visits was found&#44; meanwhile Prospero et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a> did not find any association in Barbados&#46; In Kuwait&#44; Thalib et al&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a> reported 7&#37; &#40;95&#37;CI&#58; 2&#46;0&#44; 12&#46;0&#41; increase in admission risk by asthma&#44; under the influence of the same day SDD&#44; which is consistent with our results&#46; Some of the studies examining the effect of Asian dust have analyzed its effect on the risk of being hospitalized&#58; due to asthma&#44; in Taipei<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">31&#44;32</span></a> that estimated a 0&#46;92&#37; &#40;95&#37; CI&#58; 0&#46;81&#44; 6&#46;41&#41; risk increase and due to COPD<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a>&#58; 5&#46;7&#37; increase &#40;95&#37; CI&#58; &#8722;2&#46;0&#44; 13&#46;8&#41;&#44; although evidence was limited because the exposure assessment was inadequately described and potential confounders were insufficiently controlled&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a> In Japan&#44; Kanatani et al&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">35</span></a> reported an association between heavy dust events with the risk of asthma admissions for children with asthma &#91;83&#37;&#40;95CI&#58; 31&#44; 156&#41;&#93;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In the Canary Islands&#44; several studies have characterized the composition of PM&#44; quantifying the mineral load on the bulk PM<span class="elsevierStyleInf">10</span> during SDDs &#40;76&#37;&#8211;78&#37;&#41; and non-SDDs &#40;26&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">36&#44;37</span></a> The biogenic load of Saharan particles has also been analyzed<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">38&#44;39</span></a>&#59; Rodr&#237;guez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a> observed that dust particles in the free troposphere at the Iza&#241;a Global Atmospheric Watch&#47;Observatory &#40;Tenerife&#41; can carry anthropogenic pollutants such as nitrate&#44; sulphate and ammonium from the crude oil refineries and the phosphate based fertilizer industry and power plants located in the Atlantic coast of Morocco&#44; northern and eastern Algeria and Tunisia&#46; We observed that on SDDs particulate matter effect was stronger than those on non-SDDs&#44; enhancing the hospital admissions risk due to ARSD and COPD associated with particulate matter&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The relatively low number of daily counts of emergency hospital admissions limits our ability to draw precise conclusions about size estimates but global and robust patterns of association can be considered&#46; One of our major strengths is the use of the standard methodology for the detection of SDDs&#44; besides the fact that our cities located very close to the Sahara Desert&#44; with a greater number of SDDs and with higher PM levels than those conducted in other European cities&#46; Likewise&#44; with respect to other urban environments in west Africa&#44; we have information systems on exposure &#40;PM&#44; episodes characterization&#41; and on hospital admissions&#44; absolutely consolidated and in accordance with European Union standards&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In Spain&#44; a system of &#8220;<span class="elsevierStyleItalic">prediction of Saharan dust intrussions&#8221;</span> exists at national level&#44; as well as some measures currently carried out at local level&#44; such us monitoring&#44; an early warning system for SDDs from the health and environmental authorities to the citizens and their recommendations to reduce exposure&#46; The high prevalence of asthma in the Canary Islands and the positive association between this disease and COPD with SDDs observed in this research&#44; highlights the importance that those strategies should be implemented&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In conclusion&#44; our results provide evidence that an SDD carries a risk of emergency hospital admission from respiratory diseases in the Canary Islands that spreads over successive days&#46; Our analyses indicate that observed association is robust during SDDs with medium or high PM<span class="elsevierStyleInf">10</span> levels&#44; when African air masses are transported at low altitude&#44; when SDDs belong to long episodes and from the fifth SDD onwards&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Funding</span><p id="par0165" class="elsevierStylePara elsevierViewall">This work was supported in the course of study by the Canarian Research and Health Foundation&#44; in Spanish&#58; <span class="elsevierStyleItalic">Fundaci&#243;n Canaria de Investigaci&#243;n y Salud</span> &#40;FUNCIS&#41; PI&#47;42&#47;08&#46; FUNCANIS FUNCIS has not participated in the study design or the collection&#44; analysis&#44; interpretation of data&#44; drafting the article or the decision to submit the article for publication&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conflict of Interest</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper&#46;</p></span></span>"
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    "fechaRecibido" => "2019-11-04"
    "fechaAceptado" => "2020-03-12"
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            0 => "Saharan dust"
            1 => "Hospital admissions"
            2 => "Respiratory diseases"
            3 => "Particulate matter"
            4 => "Time-series"
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            6 => "African air intrusions"
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            0 => "Calima sahariana"
            1 => "Ingresos hospitalarios"
            2 => "Enfermedades respiratorias"
            3 => "Part&#237;culas en suspensi&#243;n"
            4 => "Series temporales"
            5 => "Modelos aditivos generalizados"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Background</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Saharan dust meets the Canary Islands at the beginning of its westward path across the North Atlantic&#44; exceeding the European daily levels for PM10&#59; for this reason&#44; their two provincial capital cities&#44; constitute optimal sites where to evaluate the health effects of this natural event&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objectives</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">To assess the short-term association between Saharan Dust Days &#40;SDDs&#41; and respiratory morbidity in the two capital cities&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Methods</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We carried out a time-series analysis with daily emergency hospital admissions due to all respiratory system diseases&#44; chronic obstructive pulmonary disease &#40;COPD&#41; and asthma between 2001 and 2005&#44; assessing the independent effect of SDDs&#44; defined according to the application of the methodology accepted by the European Environmental Office&#46; We also examined accumulated effect&#44; and some other specific SDDs&#8217; features&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We found a short-term association between SDDs and the increase in admission risk for the three outcomes during concurrent SDDs&#44; compared to non-SDDs&#44; that spread from 0 to 5th day&#58; 22&#46;6&#37; &#40;95&#37; confidence interval &#91;CI&#93;&#44; 10&#46;4&#44; 36&#46;0&#41; for all respiratory diseases and 29&#46;9&#37; &#40;95&#37;CI&#58; 6&#46;6&#44; 58&#46;4&#41; for COPD in Santa Cruz de Tenerife&#44; and 33&#46;4&#37; &#40;95&#37;CI&#58; &#8722;2&#46;1&#44;82&#46;0&#41; for asthma in Las Palmas de Gran Canaria&#46; We obtained a robust association when Saharan dust transported at low altitude&#44; when SDDs belonged to long episodes &#40;&#8805;5<span class="elsevierStyleHsp" style=""></span>days&#41;&#44; from the fifth SDD onwards and those SDDs with medium &#40;50<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>PM&#60;<span class="elsevierStyleHsp" style=""></span>150&#41; or high &#40;&#8805;150&#41; PM10 levels&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We found evidence that SDDs carry a risk of emergency hospital admission from respiratory diseases in the Canary Islands&#46;</p></span>"
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        "resumen" => "<span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Contexto general</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El polvo del Sahara se encuentra con las Islas Canarias al comienzo de su viaje en direcci&#243;n oeste atravesando el Atl&#225;ntico Norte&#59; esto hace que se superen los niveles l&#237;mite diarios europeos de PM10&#46; Por este motivo&#44; sus 2 capitales de provincia constituyen entornos &#243;ptimos para evaluar los efectos de este fen&#243;meno natural en la salud&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objetivos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Evaluar la asociaci&#243;n a corto plazo entre los d&#237;as de calima sahariana &#40;DCS&#41; y la morbilidad respiratoria en las 2 ciudades&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">M&#233;todos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Llevamos a cabo un an&#225;lisis de series temporales con los ingresos hospitalarios urgentes diarios debido a todas las enfermedades del sistema respiratorio&#44; enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; y asma entre 2001 y 2005&#44; evaluando el efecto independiente de los DCS&#44; que definimos siguiendo la aplicaci&#243;n de la metodolog&#237;a aceptada por la Oficina Europea del Medio Ambiente&#46; Tambi&#233;n estudiamos el efecto acumulado y otras caracter&#237;sticas espec&#237;ficas de los DCS&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Encontramos una asociaci&#243;n a corto plazo entre los DCS y el aumento en el riesgo de ingreso para las 3 variables durante los DCS concurrentes&#44; en comparaci&#243;n con los no DCS&#44; que se extend&#237;a desde 0 a los 5 d&#237;as&#58; 22&#44;6&#37; &#40;intervalo de confianza &#91;IC&#93; del 95&#37;&#58; 10&#44;4-36&#44;0&#41; para todas las enfermedades respiratorias&#44; el 29&#44;9&#37; &#40;IC 95&#37;&#58; 6&#44;6-58&#44;4&#41; para la EPOC en Santa Cruz de Tenerife y el 33&#44;4&#37; &#40;IC 95&#37;&#58; &#8722;2&#44;1-82&#44;0&#41; para asma en Las Palmas de Gran Canaria&#46; Obtuvimos una asociaci&#243;n fuerte cuando el polvo del Sahara se transportaba a baja altitud&#44; cuando los DCS formaban parte de episodios largos &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>5 d&#237;as&#41;&#44; desde el quinto DCS en adelante y aquellos DCS con niveles de PM10 medios &#40;50<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>PM&#60;<span class="elsevierStyleHsp" style=""></span>150&#41; o altos &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>150&#41;&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusiones</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Demostramos que los DCS conllevan un riesgo de ingreso hospitalario de emergencia por enfermedades respiratorias en las Islas Canarias&#46;</p></span>"
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            "titulo" => "Supplementary Data"
            "identificador" => "sec0090"
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Monthly distribution of daily average and 95&#37;CI &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41; of PM<span class="elsevierStyleInf">10</span> &#40;shown in light circles&#41; and PM<span class="elsevierStyleInf">10-2&#46;5</span> &#40;shown in dark rectangles&#41; during Saharan Dust Days &#40;2001&#8211;2005&#41;&#46; &#40;B&#41; Monthly frequency of Saharan dust days &#40;2001&#8211;2005&#41;&#46;</p>"
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Percentage distribution of Saharan dust days according to type&#44; intensity&#44; duration and stage in L&#47;P de Gran Canaria and S&#47;C de Tenerife&#46; 2001&#8211;2005&#46;</p>"
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Percentage of change in daily emergency hospital admission risk and 95&#37; CI for concurrent and accumulated exposure &#40;PDLM05&#41; with respect to <span class="elsevierStyleItalic">non-SDD&#46;</span></p>"
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Range<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Range&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Range<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PM<span class="elsevierStyleInf">10</span>-24h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;2 &#40;6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;7&#8211;50&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#46;5 &#40;60&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;0&#8211;612&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;7 &#40;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;9&#8211;63&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#46;6 &#40;61&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;6&#8211;600&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PM<span class="elsevierStyleInf">10</span>-1h<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;2 &#40;16&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;1&#8211;171&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#46;1 &#40;133&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;2&#8211;1002&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;1 &#40;16&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;5&#8211;158&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">129&#46;6 &#40;139&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;5&#8211;1050&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PM<span class="elsevierStyleInf">2&#46;5</span>-24h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;0 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&#8211;30&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;8 &#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;9&#8211;242&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;1 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;5&#8211;34&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;5 &#40;30&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;6&#8211;291&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PM<span class="elsevierStyleInf">25</span>-1h<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;3 &#40;8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&#8211;128&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#46;5 &#40;66&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;0&#8211;646&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;7 &#40;12&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;1&#8211;142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;4 &#40;67&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;6&#8211;503&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PM<span class="elsevierStyleInf">10&#8211;25</span>-24h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;2 &#40;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;0&#8211;38&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;7 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;1&#8211;401&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;6 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;3&#8211;40&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;0 &#40;38&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;9&#8211;372&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PM<span class="elsevierStyleInf">10&#8211;25</span>-1h<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;6 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;3&#8211;124&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Humidity&nbsp;\t\t\t\t\t\t\n
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