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Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities
X. Meng, C. Liu, R. Chen, F. Sera, AM. Vicedo-Cabrera, A. Milojevic, Y. Guo, S. Tong, MSZS. Coelho, PHN. Saldiva, E. Lavigne, PM. Correa, NV. Ortega, S. Osorio, . Garcia, J. Kyselý, A. Urban, H. Orru, M. Maasikmets, JJK. Jaakkola, N. Ryti, V....
Language English Country Great Britain
Document type Journal Article, Research Support, Non-U.S. Gov't
Grant support
MR/R013349/1
Medical Research Council - United Kingdom
NLK
Europe PubMed Central
from 1981
ProQuest Central
from 1996-01-01
Nursing & Allied Health Database (ProQuest)
from 1996-01-01
Health & Medicine (ProQuest)
from 1996-01-01
PubMed
33762259
DOI
10.1136/bmj.n534
Knihovny.cz E-resources
- MeSH
- Global Health statistics & numerical data MeSH
- Cardiovascular Diseases chemically induced mortality MeSH
- Air Pollutants toxicity MeSH
- Humans MeSH
- Linear Models MeSH
- Respiratory Tract Diseases chemically induced mortality MeSH
- Nitrogen Dioxide toxicity MeSH
- Developing Countries statistics & numerical data MeSH
- Cities MeSH
- Developed Countries statistics & numerical data MeSH
- Environmental Exposure adverse effects MeSH
- Urban Health statistics & numerical data MeSH
- Air Pollution adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Cities MeSH
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.
Air Health Science Division Health Canada Ottawa ON Canada
Center for Environmental and Respiratory Health Research University of Oulu Oulu Finland
Centre for Global Health School of Public Health Nanjing Medical University Nanjing China
Centre for Statistical Methodology London School of Hygiene and Tropical Medicine London UK
Children's Hospital of Fudan University National Centre for Children's Health Shanghai China
CIBER of Epidemiology and Public Health Madrid Spain
Department of Earth Sciences University of Turin Turin Italy
Department of Environmental Health Harvard T H Chan School of Public Health Boston MA USA
Department of Environmental Health Portuguese National Institute of Health Porto Portugal
Department of Global Health Policy Graduate School of Medicine University of Tokyo Tokyo Japan
Department of Public Health and Clinical Medicine Umeå University Umeå Sweden
Department of Public Health Universidad de los Andes Santiago Chile
Department of Statistics and Operational Research Universitat de València València Spain
EPIUnit Instituto de Saúde Pública Universidade do Porto Porto Portugal
Estonian Environmental Research Centre Tallinn Estonia
Faculty of Environmental Sciences Czech University of Life Sciences Prague Czech Republic
Faculty of Geography Babes Bolay University Cluj Napoca Romania
Faculty of Health and Sport Sciences University of Tsukuba Tsukuba Japan
Faculty of Medicine University of São Paulo São Paulo Brazil
Institute of Atmospheric Physics Czech Academy of Sciences Prague Czech Republic
Institute of Family Medicine and Public Health University of Tartu Tartu Estonia
Institute of Social and Preventive Medicine University of Bern Bern Switzerland
Instituto Nacional de Salud Pública de México Cuernavaca México
National Institute of Environmental Health Sciences National Health Research Institute Miaoli Taiwan
Oeschger Centre for Climate Change Research University of Bern Bern Switzerland
Potsdam Institute for Climate Impact Research Potsdam Germany
School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada
School of Nursing and Obstetrics Universidad de los Andes Santiago Chile
School of Population Health and Environmental Sciences King's College London London UK
School of Public Health and Management Binzhou Medical University Yantai Shandong China
School of Public Health and Social Work Queensland University of Technology Brisbane QLD Australia
School of the Environment Yale University New Haven CT USA
School of Tropical Medicine and Global Health Nagasaki University Nagasaki Japan
Shanghai Children's Medical Centre Shanghai Jiao Tong University School of Medicine Shanghai China
Swiss Tropical and Public Health Institute Basel Switzerland
Universidad Pablo de Olavide Department of Physical Chemical and Natural Systems Sevilla Spain
References provided by Crossref.org
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