Associations between Weather, Air Quality and Moderate Extreme Cancer-Related Mortality Events in Augsburg, Southern Germany.

While many authors have described the adverse health effects of poor air quality and meteorological extremes, there remain inconsistencies on a regional scale as well as uncertainty about the single and joint effects of atmospheric predictors. In this context, we investigated the short-term impacts of weather and air quality on moderate extreme cancer-related mortality events for the urban area of Augsburg, Southern Germany, during the period 2000-2017. First, single effects were uncovered by applying a case-crossover routine. The overall impact was assessed by performing a Mann-Whitney U testing scheme. We then compared the results of this procedure to extreme noncancer-related mortality events. In a second step, we found periods with contemporaneous significant predictors and carried out an in-depth analysis of these joint-effect periods. We were interested in the atmospheric processes leading to the emergence of significant conditions. Hence, we applied the Principal Component Analysis to large-scale synoptic conditions during these periods. The results demonstrate a strong linkage between high-mortality events in cancer patients and significantly above-average levels of nitrogen dioxide (NO2) and particulate matter (PM2.5) during the late winter through spring period. These were mainly linked to northerly to easterly weak airflow under stable, high-pressure conditions. Especially in winter and spring, this can result in low temperatures and a ground-level increase and the accumulation of air pollution from heating and traffic as well as eastern lateral advection of polluted air. Additionally, above-average temperatures were shown to occur on the days before mortality events from mid-summer through fall, which was also caused by high-pressure conditions with weak wind flow and intense solar radiation. Our approach can be used to analyse medical data with epidemiological as well as climatological methods while providing a more vivid representation of the underlying atmospheric processes.