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Heat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countries
M. Rai, M. Stafoggia, F. de'Donato, M. Scortichini, S. Zafeiratou, L. Vazquez Fernandez, S. Zhang, K. Katsouyanni, E. Samoli, S. Rao, E. Lavigne, Y. Guo, H. Kan, S. Osorio, J. Kyselý, A. Urban, H. Orru, M. Maasikmets, JJK. Jaakkola, N. Ryti, M....
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články, práce podpořená grantem
- MeSH
- kardiovaskulární nemoci * MeSH
- látky znečišťující vzduch * toxicita analýza MeSH
- látky znečišťující životní prostředí * MeSH
- lidé MeSH
- mortalita MeSH
- nemoci dýchací soustavy * MeSH
- pevné částice škodlivé účinky analýza MeSH
- velkoměsta MeSH
- vysoká teplota MeSH
- vystavení vlivu životního prostředí škodlivé účinky analýza MeSH
- znečištění ovzduší * škodlivé účinky analýza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- velkoměsta MeSH
BACKGROUND: Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. OBJECTIVES: We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest months) in 482 locations across 24 countries. METHODS: Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 μm [PM2.5]) were obtained from 2000 to 2018. We used location-specific confounder-adjusted Quasi-Poisson regression with a tensor product between air temperature and the air pollutant. We extracted heat effects at low, medium, and high levels of pollutants, defined as the 5th, 50th, and 95th percentile of the location-specific pollutant concentrations. Country-specific and overall estimates were derived using a random-effects multilevel meta-analytical model. RESULTS: Heat was associated with increased cardiorespiratory mortality. Moreover, the heat effects were modified by elevated levels of all air pollutants in most locations, with stronger effects for respiratory than cardiovascular mortality. For example, the percent increase in respiratory mortality per increase in the 2-day average summer temperature from the 75th to the 99th percentile was 7.7% (95% Confidence Interval [CI] 7.6-7.7), 11.3% (95%CI 11.2-11.3), and 14.3% (95% CI 14.1-14.5) at low, medium, and high levels of PM2.5, respectively. Similarly, cardiovascular mortality increased by 1.6 (95%CI 1.5-1.6), 5.1 (95%CI 5.1-5.2), and 8.7 (95%CI 8.7-8.8) at low, medium, and high levels of O3, respectively. DISCUSSION: We observed considerable modification of the heat effects on cardiovascular and respiratory mortality by elevated levels of air pollutants. Therefore, mitigation measures following the new WHO Air Quality Guidelines are crucial to enhance better health and promote sustainable development.
Center for Environmental and Respiratory Health Research University of Oulu Oulu Finland
Department of Air Pollution and Noise Norwegian Institute of Public Health Oslo Norway
Department of Environmental Health Harvard T H Chan School of Public Health Boston MA USA
Department of Environmental Health Instituto Nacional de Saúde Dr Ricardo Jorge Porto Portugal
Department of Environmental Health National Institute of Public Health Cuernavaca Morelos Mexico
Department of Environmental Health Rollins School of Public Health Emory University Atlanta USA
Department of Environmental Health School of Public Health Fudan University Shanghai China
Department of Environmental Health University of São Paulo São Paulo Brazil
Department of Epidemiology Lazio Regional Health Service ASL Roma 1 Rome Italy
Department of Family Medicine and Public Health University of Tartu Tartu Estonia
Department of Geography Geoinformatics and Meteorology University of Pretoria Pretoria South Africa
Department of Global Health Policy Graduate School of Medicine The University of Tokyo Tokyo Japan
Department of Public Health and Clinical Medicine Umeå University Sweden
Department of Statistics and Computational Research Universitat de València València Spain
Estonian Environmental Research Centre Tallinn Estonia
Graduate School of Public Health Seoul National University Seoul Republic of Korea
Institute of Environmental Assessment and Water Research Barcelona Spain
Institute of Social and Preventive Medicine University of Bern Bern Switzerland
National Institute of Environmental Health Science National Health Research Institutes Zhunan Taiwan
School of Biomedical Convergence Engineering Pusan National University Yangsan South Korea
School of Forestry and Environmental Studies Yale University New Haven CT USA
School of Tropical Medicine and Global Health Nagasaki University Nagasaki Japan
Swiss Tropical and Public Health Institute Basel Switzerland
Citace poskytuje Crossref.org
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- $a Rai, Masna $u Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany. Electronic address: masna.rai@campus.lmu.de
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