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1. Differential mortality risks associated with PM2.5 components:a multi-country, multi-city study

Author

Masselot, P. (Pierre), Sera, F. (Francesco), Schneider, R. (Rochelle), Kan, H. (Haidong), Lavigne, É. (Éric), Stafoggia, M. (Massimo), Tobias, A. (Aurelio), Chen, H. (Hong), Burnett, R. T. (Richard T.), Schwartz, J. (Joel), Zanobetti, A. (Antonella), Bell, M. L. (Michelle L.), Chen, B.-Y. (Bing-Yu), Guo, Y. L. (Yue-Liang Leon), Ragettli, M. S. (Martina S.), Vicedo-Cabrera, A. M. (Ana Maria), Åström, C. (Christofer), Forsberg, B. (Bertil), Íñiguez, C. (Carmen), Garland, R. M. (Rebecca M.), Scovronick, N. (Noah), Madureira, J. (Joana), Nunes, B. (Baltazar), De la Cruz Valencia, C. (César), Hurtado Diaz, M. (Magali), Honda, Y. (Yasushi), Hashizume, M. (Masahiro), Fook Cheng Ng, C. (Chris), Samoli, E. (Evangelia), Katsouyanni, K. (Klea), Schneider, A. (Alexandra), Breitner, S. (Susanne), Ryti, N. R. (Niilo R.I.), Jaakkola, J. J. (Jouni J.K.), Maasikmets, M. (Marek), Orru, H. (Hans), Guo, Y. (Yuming), Valdés Ortega, N. (Nicolás), Matus Correa, P. (Patricia), Tong, S. (Shilu), Gasparrini, A. (Antonio), Masselot, P. (Pierre), Sera, F. (Francesco), Schneider, R. (Rochelle), Kan, H. (Haidong), Lavigne, É. (Éric), Stafoggia, M. (Massimo), Tobias, A. (Aurelio), Chen, H. (Hong), Burnett, R. T. (Richard T.), Schwartz, J. (Joel), Zanobetti, A. (Antonella), Bell, M. L. (Michelle L.), Chen, B.-Y. (Bing-Yu), Guo, Y. L. (Yue-Liang Leon), Ragettli, M. S. (Martina S.), Vicedo-Cabrera, A. M. (Ana Maria), Åström, C. (Christofer), Forsberg, B. (Bertil), Íñiguez, C. (Carmen), Garland, R. M. (Rebecca M.), Scovronick, N. (Noah), Madureira, J. (Joana), Nunes, B. (Baltazar), De la Cruz Valencia, C. (César), Hurtado Diaz, M. (Magali), Honda, Y. (Yasushi), Hashizume, M. (Masahiro), Fook Cheng Ng, C. (Chris), Samoli, E. (Evangelia), Katsouyanni, K. (Klea), Schneider, A. (Alexandra), Breitner, S. (Susanne), Ryti, N. R. (Niilo R.I.), Jaakkola, J. J. (Jouni J.K.), Maasikmets, M. (Marek), Orru, H. (Hans), Guo, Y. (Yuming), Valdés Ortega, N. (Nicolás), Matus Correa, P. (Patricia), Tong, S. (Shilu), and Gasparrini, A. (Antonio)

Abstract

Background: The association between fine particulate matter (PM2.5) and mortality widely differs between as well as within countries. Differences in PM2.5 composition can play a role in modifying the effect estimates, but there is little evidence about which components have higher impacts on mortality. Methods: We applied a 2-stage analysis on data collected from 210 locations in 16 countries. In the first stage, we estimated location-specific relative risks (RR) for mortality associated with daily total PM2.5 through time series regression analysis. We then pooled these estimates in a meta-regression model that included city-specific logratio-transformed proportions of seven PM2.5 components as well as meta-predictors derived from city-specific socio-economic and environmental indicators. Results: We found associations between RR and several PM2.5 components. Increasing the ammonium (NH₄⁺) proportion from 1% to 22%, while keeping a relative average proportion of other components, increased the RR from 1.0063 (95% confidence interval [95% CI] = 1.0030, 1.0097) to 1.0102 (95% CI = 1.0070, 1.0135). Conversely, an increase in nitrate (NO₃⁻) from 1% to 71% resulted in a reduced RR, from 1.0100 (95% CI = 1.0067, 1.0133) to 1.0037 (95% CI = 0.9998, 1.0077). Differences in composition explained a substantial part of the heterogeneity in PM2.5 risk. Conclusions: These findings contribute to the identification of more hazardous emission sources. Further work is needed to understand the health impacts of PM2.5 components and sources given the overlapping sources and correlations among many components.

Published
2022

2. Global, regional, and national burden of mortality associated with short-term temperature variability from 2000–19:a three-stage modelling study

Author

Wu, Y. (Yao), Li, S. (Shanshan), Zhao, Q. (Qi), Wen, B. (Bo), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), Iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), De'Donato, F. (Francesca), Rao, S. (Shilpa), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Nascimento Saldiva, P. H. (Paulo Hilario), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), Guo, Y. (Yuming), Wu, Y. (Yao), Li, S. (Shanshan), Zhao, Q. (Qi), Wen, B. (Bo), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), Iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), De'Donato, F. (Francesca), Rao, S. (Shilpa), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Nascimento Saldiva, P. H. (Paulo Hilario), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), and Guo, Y. (Yuming)

Abstract

Background: Increased mortality risk is associated with short-term temperature variability: However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000–19. Methods: In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° degrees from 2000–19. Temperature variability was calculated as the SD of the average of the same and previous days’ minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. Findings: An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1753392 deaths (95% CI 1159 901–2357 718) were associated with temperature variability per year, ac

Published
2022

3. Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality:multilocation analysis in 398 cities

Author

Meng, X. (Xia), Liu, C. (Cong), Chen, R. (Renjie), Sera, F. (Francesco), Vicedo-Cabrera, A. M. (Ana Maria), Milojevic, A. (Ai), Guo, Y. (Yuming), Tong, S. (Shilu), Coelho, M. d. (Micheline de Sousa Zanotti Stagliorio), Saldiva, P. H. (Paulo Hilario Nascimento), Lavigne, E. (Eric), Correa, P. M. (Patricia Matus), Ortega, N. V. (Nicolas Valdes), Garcia, S. O. (Samuel Osorio), Kysely, J. (Jan), Urban, A. (Ales), Orru, H. (Hans), Maasikmets, M. (Marek), Jaakkola, J. J. (Jouni J. K.), Ryti, N. (Niilo), Huber, V. (Veronika), Schneider, A. (Alexandra), Katsouyanni, K. (Klea), Analitis, A. (Antonis), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Ng, C. F. (Chris Fook Sheng), Nunes, B. (Baltazar), Teixeira, J. P. (Joao Paulo), Holobaca, I. H. (Iulian Horia), Fratianni, S. (Simona), Kim, H. (Ho), Tobias, A. (Aurelio), Iniguez, C. (Carmen), Forsberg, B. (Bertil), Astrom, C. (Christofer), Ragettli, M. S. (Martina S.), Guo, Y. L. (Yue-Liang Leon), Pan, S.-C. (Shih-Chun), Li, S. (Shanshan), Bell, M. L. (Michelle L.), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Wu, T. (Tangchun), Gasparrini, A. (Antonio), and Kan, H. (Haidong)

Abstract

Objective: To evaluate the short term associations between nitrogen dioxide (NO₂) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. Design: Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. Setting: 398 cities in 22 low to high income countries/regions. Main outcome measures: Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018. Results: On average, a 10 μg/m³ increase in NO₂ concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM₁₀ and PM2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO₂ concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities. Conclusions: This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO₂ and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO₂.

Published
2021

4. Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019:a three-stage modelling study

Author

Zhao, Q. (Qi), Guo, Y. (Yuming), Ye, T. (Tingting), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Van Dung, D. (Do), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), de'Donato, F. (Francesca), Di Ruscio, F. (Francesco), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Saldiva, P. H. (Paulo Hilario Nascimento), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Rao, S. (Shilpa), Fratianni, S. (Simona), Dang, T. N. (Tran Ngoc), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), Li, S. (Shanshan), Zhao, Q. (Qi), Guo, Y. (Yuming), Ye, T. (Tingting), Gasparrini, A. (Antonio), Tong, S. (Shilu), Overcenco, A. (Ala), Urban, A. (Ales), Schneider, A. (Alexandra), Entezari, A. (Alireza), Vicedo-Cabrera, A. M. (Ana Maria), Zanobetti, A. (Antonella), Analitis, A. (Antonis), Zeka, A. (Ariana), Tobias, A. (Aurelio), Nunes, B. (Baltazar), Alahmad, B. (Barrak), Armstrong, B. (Ben), Forsberg, B. (Bertil), Pan, S.-C. (Shih-Chun), iniguez, C. (Carmen), Ameling, C. (Caroline), De la Cruz Valencia, C. (Cesar), Astrom, C. (Christofer), Houthuijs, D. (Danny), Van Dung, D. (Do), Roye, D. (Dominic), Indermitte, E. (Ene), Lavigne, E. (Eric), Mayvaneh, F. (Fatemeh), Acquaotta, F. (Fiorella), de'Donato, F. (Francesca), Di Ruscio, F. (Francesco), Sera, F. (Francesco), Carrasco-Escobar, G. (Gabriel), Kan, H. (Haidong), Orru, H. (Hans), Kim, H. (Ho), Holobaca, I.-H. (Iulian-Horia), Kysely, J. (Jan), Madureira, J. (Joana), Schwartz, J. (Joel), Jaakkola, J. J. (Jouni J. K.), Katsouyanni, K. (Klea), Diaz, M. H. (Magali Hurtado), Ragettli, M. S. (Martina S.), Hashizume, M. (Masahiro), Pascal, M. (Mathilde), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Ortega, N. V. (Nicolas Valdes), Ryti, N. (Niilo), Scovronick, N. (Noah), Michelozzi, P. (Paola), Correa, P. M. (Patricia Matus), Goodman, P. (Patrick), Saldiva, P. H. (Paulo Hilario Nascimento), Abrutzky, R. (Rosana), Osorio, S. (Samuel), Rao, S. (Shilpa), Fratianni, S. (Simona), Dang, T. N. (Tran Ngoc), Colistro, V. (Valentina), Huber, V. (Veronika), Lee, W. (Whanhee), Seposo, X. (Xerxes), Honda, Y. (Yasushi), Guo, Y. L. (Yue Leon), Bell, M. L. (Michelle L.), and Li, S. (Shanshan)

Abstract

Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), l

Published
2021

5. Evaluation of the ERA5 reanalysis-based Universal Thermal Climate Index on mortality data in Europe

Author

Urban, A. (Aleš), Di Napoli, C. (Claudia), Cloke, H. L. (Hannah L.), Kyselý, J. (Jan), Pappenberger, F. (Florian), Sera, F. (Francesco), Schneider, R. (Rochelle), Vicedo-Cabrera, A. M. (Ana M.), Acquaotta, F. (Fiorella), Ragettli, M. S. (Martina S.), Íñiguez, C. (Carmen), Tobias, A. (Aurelio), Indermitte, E. (Ene), Orru, H. (Hans), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Huber, V. (Veronika), Schneider, A. (Alexandra), de’ Donato, F. (Francesca), Michelozzi, P. (Paola), Gasparrini, A. (Antonio), Urban, A. (Aleš), Di Napoli, C. (Claudia), Cloke, H. L. (Hannah L.), Kyselý, J. (Jan), Pappenberger, F. (Florian), Sera, F. (Francesco), Schneider, R. (Rochelle), Vicedo-Cabrera, A. M. (Ana M.), Acquaotta, F. (Fiorella), Ragettli, M. S. (Martina S.), Íñiguez, C. (Carmen), Tobias, A. (Aurelio), Indermitte, E. (Ene), Orru, H. (Hans), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Huber, V. (Veronika), Schneider, A. (Alexandra), de’ Donato, F. (Francesca), Michelozzi, P. (Paola), and Gasparrini, A. (Antonio)

Abstract

Air temperature has been the most commonly used exposure metric in assessing relationships between thermal stress and mortality. Lack of the high-quality meteorological station data necessary to adequately characterize the thermal environment has been one of the main limitations for the use of more complex thermal indices. Global climate reanalyses may provide an ideal platform to overcome this limitation and define complex heat and cold stress conditions anywhere in the world. In this study, we explored the potential of the Universal Thermal Climate Index (UTCI) based on ERA5 — the latest global climate reanalysis from the European Centre for Medium-Range Weather Forecasts (ECMWF) — as a health-related tool. Employing a novel ERA5-based thermal comfort dataset ERA5-HEAT, we investigated the relationships between the UTCI and daily mortality data in 21 cities across 9 European countries. We used distributed lag nonlinear models to assess exposure-response relationships between mortality and thermal conditions in individual cities. We then employed meta-regression models to pool the results for each city into four groups according to climate zone. To evaluate the performance of ERA5-based UTCI, we compared its effects on mortality with those for the station-based UTCI data. In order to assess the additional effect of the UTCI, the performance of ERA5-and station-based air temperature (T) was evaluated. Whilst generally similar heat- and cold-effects were observed for the ERA5-and station-based data in most locations, the important role of wind in the UTCI appeared in the results. The largest difference between any two datasets was found in the Southern European group of cities, where the relative risk of mortality at the 1st percentile of daily mean temperature distribution (1.29 and 1.30 according to the ERA5 vs station data, respectively) considerably exceeded the one for the daily mean UTCI (1.19 vs 1.22). These differences were mainly due to the effect o

Published
2021

6. Ambient carbon monoxide and daily mortality:a global time-series study in 337 cities

Author

Chen, K. (Kai), Breitner, S. (Susanne), Wolf, K. (Kathrin), Stafoggia, M. (Massimo), Sera, F. (Francesco), Vicedo-Cabrera, A. M. (Ana M.), Guo, Y. (Yuming), Tong, S. (Shilu), Lavigne, E. (Eric), Matus, P. (Patricia), Valdes, N. (Nicolas), Kan, H. (Haidong), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R., I), Huber, V. (Veronika), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Nunes, B. (Baltazar), Madureira, J. (Joana), Holobaca, I. H. (Iulian Horia), Fratianni, S. (Simona), Kim, H. (Ho), Lee, W. (Whanhee), Tobias, A. (Aurelio), Iniguez, C. (Carmen), Forsberg, B. (Bertil), Astrom, C. (Christofer), Ragettli, M. S. (Martina S.), Guo, Y. L. (Yue-Liang Leon), Chen, B.-Y. (Bing-Yu), Li, S. (Shanshan), Milojevic, A. (Ai), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Bell, M. L. (Michelle L.), Gasparrini, A. (Antonio), Schneider, A. (Alexandra), Chen, K. (Kai), Breitner, S. (Susanne), Wolf, K. (Kathrin), Stafoggia, M. (Massimo), Sera, F. (Francesco), Vicedo-Cabrera, A. M. (Ana M.), Guo, Y. (Yuming), Tong, S. (Shilu), Lavigne, E. (Eric), Matus, P. (Patricia), Valdes, N. (Nicolas), Kan, H. (Haidong), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R., I), Huber, V. (Veronika), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Nunes, B. (Baltazar), Madureira, J. (Joana), Holobaca, I. H. (Iulian Horia), Fratianni, S. (Simona), Kim, H. (Ho), Lee, W. (Whanhee), Tobias, A. (Aurelio), Iniguez, C. (Carmen), Forsberg, B. (Bertil), Astrom, C. (Christofer), Ragettli, M. S. (Martina S.), Guo, Y. L. (Yue-Liang Leon), Chen, B.-Y. (Bing-Yu), Li, S. (Shanshan), Milojevic, A. (Ai), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Bell, M. L. (Michelle L.), Gasparrini, A. (Antonio), and Schneider, A. (Alexandra)

Abstract

Summary Background: Epidemiological evidence on short-term association between ambient carbon monoxide (CO) and mortality is inconclusive and limited to single cities, regions, or countries. Generalisation of results from previous studies is hindered by potential publication bias and different modelling approaches. We therefore assessed the association between short-term exposure to ambient CO and daily mortality in a multicity, multicountry setting. Methods: We collected daily data on air pollution, meteorology, and total mortality from 337 cities in 18 countries or regions, covering various periods from 1979 to 2016. All included cities had at least 2 years of both CO and mortality data. We estimated city-specific associations using confounder-adjusted generalised additive models with a quasi-Poisson distribution, and then pooled the estimates, accounting for their statistical uncertainty, using a random-effects multilevel meta-analytical model. We also assessed the overall shape of the exposure–response curve and evaluated the possibility of a threshold below which health is not affected. Findings: Overall, a 1 mg/m³ increase in the average CO concentration of the previous day was associated with a 0·91% (95% CI 0·32–1·50) increase in daily total mortality. The pooled exposure–response curve showed a continuously elevated mortality risk with increasing CO concentrations, suggesting no threshold. The exposure–response curve was steeper at daily CO levels lower than 1 mg/m³, indicating greater risk of mortality per increment in CO exposure, and persisted at daily concentrations as low as 0·6 mg/m³ or less. The association remained similar after adjustment for ozone but was attenuated after adjustment for particulate matter or sulphur dioxide, or even reduced to null after adjustment for nitrogen dioxide. Interpretation: This international study is by far the largest epidemiological investigation on short-term CO-related mortality. We found significant associations

Published
2021

7. Projections of excess mortality related to diurnal temperature range under climate change scenarios:a multi-country modelling study

Author

Lee, W. (Whanhee), Kim, Y. (Yoonhee), Sera, F. (Francesco), Gasparrini, A. (Antonio), Park, R. (Rokjin), Choi, H. M. (Hayon Michelle), Prifti, K. (Kristi), Bell, M. L. (Michelle L.), Abrutzky, R. (Rosana), Guo, Y. (Yuming), Tong, S. (Shilu), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. (Patrick), Zeka, A. (Ariana), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Diaz, M. H. (Magali Hurtado), Cruz, J. C. (Julio Cesar), Overcenco, A. (Ala), Nunes, B. (Baltazar), Madureira, J. (Joana), Scovronick, N. (Noah), Acquaotta, F. (Fiorella), Tobias, A. (Aurelio), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Guo, Y. L. (Yue-Liang Leon), Chen, B.-Y. (Bing-Yu), Li, S. (Shanshan), Armstrong, B. (Ben), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Kim, H. (Ho), Lee, W. (Whanhee), Kim, Y. (Yoonhee), Sera, F. (Francesco), Gasparrini, A. (Antonio), Park, R. (Rokjin), Choi, H. M. (Hayon Michelle), Prifti, K. (Kristi), Bell, M. L. (Michelle L.), Abrutzky, R. (Rosana), Guo, Y. (Yuming), Tong, S. (Shilu), Zanotti Stagliorio Coelho, M. d. (Micheline de Sousa), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. (Patrick), Zeka, A. (Ariana), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Diaz, M. H. (Magali Hurtado), Cruz, J. C. (Julio Cesar), Overcenco, A. (Ala), Nunes, B. (Baltazar), Madureira, J. (Joana), Scovronick, N. (Noah), Acquaotta, F. (Fiorella), Tobias, A. (Aurelio), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Guo, Y. L. (Yue-Liang Leon), Chen, B.-Y. (Bing-Yu), Li, S. (Shanshan), Armstrong, B. (Ben), Zanobetti, A. (Antonella), Schwartz, J. (Joel), and Kim, H. (Ho)

Abstract

Background: Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions. Methods: DTR-related mortality risk was estimated on the basis of the historical daily time-series of mortality and weather factors from Jan 1, 1985, to Dec 31, 2015, with data for 445 communities across 20 countries and regions, from the Multi-Country Multi-City Collaborative Research Network. We obtained daily projected temperature series associated with four climate change scenarios, using the four representative concentration pathways (RCPs) described by the Intergovernmental Panel on Climate Change, from the lowest to the highest emission scenarios (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). Excess deaths attributable to the DTR during the current (1985–2015) and future (2020–99) periods were projected using daily DTR series under the four scenarios. Future excess deaths were calculated on the basis of assumptions that warmer long-term average temperatures affect or do not affect the DTR-related mortality risk. Findings: The time-series analyses results showed that DTR was associated with excess mortality. Under the unmitigated climate change scenario (RCP 8.5), the future average DTR is projected to increase in most countries and regions (by −0·4 to 1·6°C), particularly in the USA, south-central Europe, Mexico, and South Africa. The excess deaths currently attributable to DTR were estimated to be 0·2–7·4%. Furthermore, the DTR-related mortality risk increased as the long-term average temperature increased; in the linear mixed model with the assumption of an interactive effect with long-term average temperature, we estimated 0·05% additional DTR mortality risk per 1°C increase in average temperature. Based on the interaction with long-term average temperature, the DTR-related excess deaths are projected to incre

Published
2020

8. Predicted temperature-increase-induced global health burden and its regional variability

Author

Young Lee, J. (Jae), Kim, H. (Ho), Gasparrini, A. (Antonio), Armstrong, B. (Ben), Bell, M. L. (Michelle L.), Sera, F. (Francesco), Lavigne, E. (Eric), Abrutzky, R. (Rosana), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio Garcia, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G.), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado, M. (Magali), Cruz, J. (Julio), Seposo, X. (Xerxes), Nunes, B. (Baltazar), Paulo Teixeira, J. (João), Tobias, A. (Aurelio), Íñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, C. (Christofer), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Leon Guo, Y.-L. (Yue-Liang), Chen, B.-Y. (Bing-Yu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Ngoc Dang, T. (Tran), Van, D. D. (Dung Do), Mayvaneh, F. (Fetemeh), Overcenco, A. (Ala), Li, S. (Shanshan), Guo, Y. (Yuming), Young Lee, J. (Jae), Kim, H. (Ho), Gasparrini, A. (Antonio), Armstrong, B. (Ben), Bell, M. L. (Michelle L.), Sera, F. (Francesco), Lavigne, E. (Eric), Abrutzky, R. (Rosana), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio Garcia, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Orru, H. (Hans), Indermitte, E. (Ene), Jaakkola, J. J. (Jouni J. K.), Ryti, N. R. (Niilo R. I.), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G.), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado, M. (Magali), Cruz, J. (Julio), Seposo, X. (Xerxes), Nunes, B. (Baltazar), Paulo Teixeira, J. (João), Tobias, A. (Aurelio), Íñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, C. (Christofer), Vicedo-Cabrera, A. M. (Ana Maria), Ragettli, M. S. (Martina S.), Leon Guo, Y.-L. (Yue-Liang), Chen, B.-Y. (Bing-Yu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Ngoc Dang, T. (Tran), Van, D. D. (Dung Do), Mayvaneh, F. (Fetemeh), Overcenco, A. (Ala), Li, S. (Shanshan), and Guo, Y. (Yuming)

Abstract

An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010–2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (−0.92%p/°C) and Australia (−0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population.

Published
2019

9. Projections of temperature-related excess mortality under climate change scenarios

Author

Gasparrini, A. (Antonio), Guo, Y. (Yuming), Sera, F. (Francesco), Vicedo-Cabrera, A. M. (Ana Maria), Huber, V. (Veronika), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Jaakkola, J. J. (Jouni J K), Ryti, N. R. (Niilo R I), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado-Diaz, M. (Magali), Cesar Cruz, J. (Julio), Seposo, X. (Xerxes), Kim, H. (Ho), Tobias, A. (Aurelio), Iñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, D. O. (Daniel Oudin), Ragettli, M. S. (Martina S), Guo, Y. L. (Yue Leon), Wu, C.-f. (Chang-fu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Bell, M. L. (Michelle L), Dang, T. N. (Tran Ngoc), Van, D. D. (Dung Do), Heaviside, C. (Clare), Vardoulakis, S. (Sotiris), Hajat, S. (Shakoor), Haines, A. (Andy), Armstrong, B. (Ben), Gasparrini, A. (Antonio), Guo, Y. (Yuming), Sera, F. (Francesco), Vicedo-Cabrera, A. M. (Ana Maria), Huber, V. (Veronika), Tong, S. (Shilu), de Sousa Zanotti Stagliorio Coelho, M. (Micheline), Nascimento Saldiva, P. H. (Paulo Hilario), Lavigne, E. (Eric), Matus Correa, P. (Patricia), Valdes Ortega, N. (Nicolas), Kan, H. (Haidong), Osorio, S. (Samuel), Kyselý, J. (Jan), Urban, A. (Aleš), Jaakkola, J. J. (Jouni J K), Ryti, N. R. (Niilo R I), Pascal, M. (Mathilde), Goodman, P. G. (Patrick G), Zeka, A. (Ariana), Michelozzi, P. (Paola), Scortichini, M. (Matteo), Hashizume, M. (Masahiro), Honda, Y. (Yasushi), Hurtado-Diaz, M. (Magali), Cesar Cruz, J. (Julio), Seposo, X. (Xerxes), Kim, H. (Ho), Tobias, A. (Aurelio), Iñiguez, C. (Carmen), Forsberg, B. (Bertil), Åström, D. O. (Daniel Oudin), Ragettli, M. S. (Martina S), Guo, Y. L. (Yue Leon), Wu, C.-f. (Chang-fu), Zanobetti, A. (Antonella), Schwartz, J. (Joel), Bell, M. L. (Michelle L), Dang, T. N. (Tran Ngoc), Van, D. D. (Dung Do), Heaviside, C. (Clare), Vardoulakis, S. (Sotiris), Hajat, S. (Shakoor), Haines, A. (Andy), and Armstrong, B. (Ben)

Abstract

Background: Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates. Methods: We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature–mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990–2099 under each scenario of climate change, assuming no adaptation or population changes. Findings: Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090–99 compared with 2010–19 ranging from −1·2% (empirical 95% CI −3·6 to 1·4) in Australia to −0·1% (−2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sh

Published
2017

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