Joint effect of heat and air pollution on mortality in 620 cities of 36 countries
Stafoggia, Massimo; Michelozzi, Paola; Schneider, Alexandra; Armstrong, Ben; Scortichini, Matteo; Rai, Masna; Achilleos, Souzana; Alahmad, Barrak; Analitis, Antonis; Åström, Christofer; Bell, Michelle L.; Calleja, Neville; Krage Carlsen, Hanne; Carrasco, Gabriel; Paul Cauchi, John; DSZS Coelho, Micheline; Correa, Patricia M.; Diaz, Magali H.; Entezari, Alireza; Forsberg, Bertil; Garland, Rebecca M.; Leon Guo, Yue; Guo, Yuming; Hashizume, Masahiro; Holobaca, Iulian H.; Íñiguez, Carmen; Jaakkola, Jouni J.K.; Kan, Haidong; Katsouyanni, Klea; Kim, Ho; Kyselý, Jan; Lavigne, Eric; Lee, Whanhee; Li, Shanshan; Maasikmets, Marek; Madureira, Joana; Mayvaneh, Fatemeh; Fook Sheng Ng, Chris; Nunes, Baltazar; Orru, Hans; V Ortega, Nicolás; Osorio, Samuel; Palomares, Alfonso D.L.; Pan, Shih Chun; Pascal, Mathilde; Ragettli, Martina S.; Rao, Shilpa; Raz, Raanan; Roye, Dominic; Ryti, Niilo; HN Saldiva, Paulo; Samoli, Evangelia; Schwartz, Joel; Scovronick, Noah; Sera, Francesco; Tobias, Aurelio; Tong, Shilu; DLC Valencia, César; Maria Vicedo-Cabrera, Ana; Urban, Aleš; Gasparrini, Antonio; Breitner, Susanne; de' Donato, Francesca K. (2023-10-10)
Elsevier
10.10.2023
Stafoggia, Massimo, et al. “Joint Effect of Heat and Air Pollution on Mortality in 620 Cities of 36 Countries.” Environment International, vol. 181, Nov. 2023, p. 108258. https://doi.org/10.1016/j.envint.2023.108258.
https://creativecommons.org/licenses/by-nc-nd/4.0/
© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by nc-nd/4.0/).
https://creativecommons.org/licenses/by-nc-nd/4.0/
© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by nc-nd/4.0/).
https://creativecommons.org/licenses/by-nc-nd/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202312073536
https://urn.fi/URN:NBN:fi:oulu-202312073536
Tiivistelmä
Abstract
Background:
The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent.
Objectives:
To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries.
Methods:
We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995–2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants.
Results:
We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2.
Conclusions:
Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
Background:
The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent.
Objectives:
To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries.
Methods:
We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995–2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants.
Results:
We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2.
Conclusions:
Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
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