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Acute effects of fine particulate matter constituents on mortality: A systematic review and meta-regression analysis
- Source :
- Environment International, Vol 109, Iss, Pp 89-100 (2017)
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background: The link between PM2.5 exposure and adverse health outcomes is well documented from studies across the world. However, the reported effect estimates vary across studies, locations and constituents. We aimed to conduct a meta-analysis on associations between short-term exposure to PM2.5 constituents and mortality using city-specific estimates, and explore factors that may explain some of the observed heterogeneity. Methods: We systematically reviewed epidemiological studies on particle constituents and mortality using PubMed and Web of Science databases up to July 2015.We included studies that examined the association between short-term exposure to PM2.5 constituents and all-cause, cardiovascular, and respiratory mortality, in the general adult population. Each study was summarized based on pre-specified study key parameters (e.g., location, time period, population, diagnostic classification standard), and we evaluated the risk of bias using the Office of Health Assessment and Translation (OHAT) Method for each included study. We extracted city-specific mortality risk estimates for each constituent and cause of mortality. For multi-city studies, we requested the city-specific risk estimates from the authors unless reported in the article. We performed random effects meta-analyses using city-specific estimates, and examined whether the effects vary across regions and city characteristics (PM2.5 concentration levels, air temperature, elevation, vegetation, size of elderly population, population density, and baseline mortality). Results: We found a 0.89% (95% CI: 0.68, 1.10%) increase in all-cause, a 0.80% (95% CI: 0.41, 1.20%) increase in cardiovascular, and a 1.10% (95% CI: 0.59, 1.62%) increase in respiratory mortality per 10μg/m3 increase in PM2.5. Accounting for the downward bias induced by studies of single days, the all-cause mortality estimate increased to 1.01% (95% CI: 0.81, 1.20%). We found significant associations between mortality and several PM2.5 constituents. The most consistent and stronger associations were observed for elemental carbon (EC) and potassium (K). For most of the constituents, we observed high variability of effect estimates across cities. Conclusions: Our meta-analysis suggests that (a) combustion elements such as EC and K have a stronger association with mortality, (b) single lag studies underestimate effects, and (c) estimates of PM2.5 and constituents differ across regions. Accounting for PM mass in constituent's health models may lead to more stable and comparable effect estimates across different studies. Systematic review registration: PROSPERO: CRD42017055765. Keywords: Particulate matter constituents, Fine particulate matter (PM2.5), Mortality, Time series, Acute effects, Meta-analysis
- Subjects :
- Acute effects
medicine.medical_specialty
Time series
Databases, Factual
010504 meteorology & atmospheric sciences
Fine particulate
Medical Biotechnology
Population
010501 environmental sciences
Medical and Health Sciences
01 natural sciences
Population density
Article
Toxicology
Air Pollution
Epidemiology
medicine
Humans
Meta-regression
Cities
Mortality
education
lcsh:Environmental sciences
0105 earth and related environmental sciences
General Environmental Science
lcsh:GE1-350
Air Pollutants
education.field_of_study
Particulate matter constituents
business.industry
Random effects model
Fine particulate matter (PM2.5)
Meta-analysis
Regression Analysis
Particulate Matter
business
Demography
Subjects
Details
- ISSN :
- 01604120
- Volume :
- 109
- Database :
- OpenAIRE
- Journal :
- Environment International
- Accession number :
- edsair.doi.dedup.....37beab9173f0a3a678c880afb281f103