| Summary: | <p>Abstract</p> <p>Background</p> <p>Saharan dust intrusions are a common phenomenon in the Madrid atmosphere, leading induce exceedances of the 50 μg/m<sup>3</sup>- EU 24 h standard for PM<sub>10</sub>.</p> <p>Methods</p> <p>We investigated the effects of exposure to PM<sub>10 </sub>between January 2003 and December 2005 in Madrid (Spain) on daily case-specific mortality; changes of effects between Saharan and non-Saharan dust days were assessed using a time-stratified case-crossover design.</p> <p>Results</p> <p>Saharan dust affected 20% of days in the city of Madrid. Mean concentration of PM<sub>10 </sub>was higher during dust days (47.7 μg/m<sup>3</sup>) than non-dust days (31.4 μg/m<sup>3</sup>). The rise of mortality per 10 μg/m<sup>3 </sup>PM<sub>10 </sub>concentration were always largely for Saharan dust-days. When stratifying by season risks of PM<sub>10</sub>, at lag 1, during Saharan dust days were stronger for respiratory causes during cold season (IR% = 3.34% (95% CI: 0.36, 6.41) versus 2.87% (95% CI: 1.30, 4.47)) while for circulatory causes effects were stronger during warm season (IR% = 4.19% (95% CI: 1.34, 7.13) versus 2.65% (95% CI: 0.12, 5.23)). No effects were found for cerebrovascular causes.</p> <p>Conclusions</p> <p>We found evidence of strongest effects of particulate matter during Saharan dust days, providing a suggestion of effect modification, even though interaction terms were not statistically significant. Further investigation is needed to understand the mechanism by which Saharan dust increases mortality.</p>
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