Associations of ambient exposure to benzene, toluene, ethylbenzene, and xylene with daily mortality: a multicountry time-series study in 757 global locations
Status Publisher Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články
PubMed
40972622
DOI
10.1016/j.lanplh.2025.101306
PII: S2542-5196(25)00184-6
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The presence of benzene, toluene, ethylbenzene, and xylene isomers (BTEX) in the environment is of increasing concern due to their toxicity and ubiquity. Although the adverse health effects of BTEX exposure have been documented, robust epidemiological evidence from large-scale, multicountry studies using advanced exposure assessment methodologies remains scarce. We aimed to assess the association of short-term ambient exposure to individual BTEX components and their mixture with daily total, cardiovascular, and respiratory mortality on a global scale. METHODS: Daily data on mortality, meteorological factors, and air pollution were collected from 757 locations across 46 countries or regions. Data on individual chemicals (ie, benzene, toluene, xylenes [summation of ethylbenzene, m-xylene, p-xylene, and o-xylene]) and the aggregate mixture (ie, BTEX) were estimated using a chemistry-climate model. We examined the short-term associations of each individual chemical as well as the BTEX mixture with daily total, cardiovascular, and respiratory mortality in a multicountry framework. Using a two-stage time-series design, we first applied generalised additive models with a quasi-Poisson distribution to obtain location-specific associations, which were subsequently pooled using random-effects meta-analysis. Two-pollutant models were used to assess the independent effects of BTEX after adjusting for co-pollutants (PM2·5, PM10, nitrogen dioxide, sulphur dioxide, ozone, and carbon monoxide). Additionally, we assessed the overall exposure-response curves with spline terms. FINDINGS: An IQR increment of BTEX concentration on lag 0-2 days (3-day moving average of the present day and the previous 2 days) was associated with increases of 0·57% (95% CI 0·49-0·65), 0·42% (0·30-0·54), and 0·68% (0·50-0·86) in total, cardiovascular, and respiratory mortality, respectively. The corresponding effect estimates for an IQR increment in individual chemicals (benzene, toluene, and xylenes) were 0·38-0·61%, 0·44-0·70%, and 0·41-0·65%, respectively. The associations remained significant after adjusting for co-pollutants, with a general decline in magnitude, except for a slight increase after adjustment for ozone. The shape of the exposure-response curves for all pollutants and causes of death was almost linear, with steeper slopes at low concentrations and no discernible thresholds. INTERPRETATION: This global study provides novel evidence linking short-term exposure to ambient BTEX, both individually and as a mixture, with increased daily total, cardiovascular, and respiratory mortality. Our findings underscore the need for comprehensive air pollution mitigation policies, including stringent controls on BTEX emissions, to protect public health. FUNDING: Noncommunicable Chronic Diseases-National Science and Technology Major Project, National Natural Science Foundation of China, Shanghai Municipal Science and Technology Major Project, Shanghai B&R Joint Laboratory Project, and Shanghai International Science and Technology Partnership Project.
Biological Mision of Galicia Madrid Spain; Ciberesp Madrid Spain
Braun School of Public Health and Community Medicine The Hebrew University of Jerusalem Israel
Center for Climate Change Adaptation National Institute for Environmental Studies Tsukuba Japan
Centro Interdisciplinario de Cambio Global Pontificia Universidad Católica de Chile Santiago Chile
Department of Civil and Environmental Engineering Wayne State University Detroit MI USA
Department of Environmental Health National Institute of Public Health Cuernavaca Morelos Mexico
Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
Department of Environmental Health University of São Paulo São Paulo Brazil
Department of Epidemiology Instituto Nacional de Saúde Dr Ricardo Jorge Lisbon Portugal
Department of Epidemiology Lazio Regional Health Service 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 Primary Care and Population Health University of Nicosia Medical School Nicosia Cyprus
Department of Public Health and Clinical Medicine Umeå University Sweden
Department of Public Health Universidad de los Andes Santiago Chile
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
Graduate School of Public Health Seoul National University Seoul South Korea
Institute for Global Health University College London London UK
Institute of Epidemiology and Social Medicine University of Münster Münster Germany
National Institute of Environmental Health Science National Health Research Institutes Zhunan Taiwan
Norwegian institute of Public Health Oslo Norway
School of the Environment Yale University New Haven CT USA
Swiss Tropical and Public Health Institute Allschwill Switzerland
Technological University Dublin Ireland
Universidad de Buenos Aires Facultad de Ciencias Sociales Instituto de Investigaciones Gino Germani
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