Joint effect of heat and air pollution on mortality in 620 cities of 36 countries
Stafoggiaa, Massimo; Michelozzi, Paola; Schneider, Alexandra; Armstrong, Ben; Scortichini, Matteo; Rai, Masna; Achilleos, Souzana; Alahmade, Barrak; Analitisf, Antonis; Astrom, Christofer; Bell, Michelle L.; Calleja, Nebille; Krage, Hanne; Carlsenj, Hanne Krage; Carrascok, Gabriel; Cauchil, John Paul; Coelhom, Micheline DSZS; Correan, Patricia M.; Diazo, Magali H.; Entezarip, Alireza; Forsberg, Bertil; Garland, Rebecca M.; Guo, Yue Liang; Guo, Yuming; Hashizume, Masahiro; Holobaca, Iulian H.; Iniguez, Carmen; Jaakkola, Jouni J.K.; Kan, Haidong; Katsouyanni, Klea; Ho, Kim; Kysely, Jan; Lavigne, Eric; Lee, Whanhee; Li, Shanshan; Maasikmets. Marek; Madureira, Joana; Mayvanehp, Fatemeh; Sheng Ng, Chris Fook; Nunesai, Baltazar; Orruaj, Hans; Ortega, Nicolas V.; Osorio, Samuel; Palomares, Alfonso D.L.; Pan, Shih-Chun; Pascal, Mathilde; Ragettli, Martina S.; Rao, Shilpa; Raz, Raanan; Roye, Domenic; Rytiw, Niilo; Saldiva, Paulo H.N.; Samolif, Evangelia; Schwartze, Joel; Scovronickas, Noah; Sera, Francesco; Tobiasau, Aurelio; Shilu, Tong; Vicedo-Cabrera, Ana Maria; Urban, Ales; Gasparrini, Antonio; Breitner, Susanne; De’ Donato, Francesca K.
Date:
2023-11
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.
Description:
DATA AVAILABILITY : Data will be made available on request.
