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  • Rai, MasnaInstitute 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 (author)

Heat-related cardiorespiratory mortality : effect modification by air pollution across 482 cities from 24 countries

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • Elsevier,2023
  • electronicrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:umu-206020
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-206020URI
  • https://doi.org/10.1016/j.envint.2023.107825DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

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  • Stafoggia, MassimoDepartment of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy (author)
  • de'Donato, FrancescaDepartment of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy (author)
  • Scortichini, MatteoDepartment of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy (author)
  • Zafeiratou, Sofiaepartment of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece (author)
  • Vazquez Fernandez, LilianaDepartment of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway (author)
  • Zhang, SiqiInstitute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany (author)
  • Katsouyanni, Kleaepartment of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece (author)
  • Samoli, Evangeliaepartment of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Greece (author)
  • Rao, ShilpaDepartment of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway (author)
  • Lavigne, EricSchool of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada and Environmental Health Science & Research Bureau, Health Canada, Ottawa, Canada (author)
  • Guo, YumingDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (author)
  • Kan, HaidongDepartment of Environmental Health, School of Public Health, Fudan University, Shanghai, China (author)
  • Osorio, SamuelDepartment of Environmental Health, University of São Paulo, São Paulo, Brazil (author)
  • Kyselý, JanInstitute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic (author)
  • Urban, AlešInstitute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic (author)
  • Orru, HansDepartment of Family Medicine and Public Health, University of Tartu, Tartu, Estonia (author)
  • Maasikmets, MarekEstonian Environmental Research Centre, Tallinn, Estonia (author)
  • Jaakkola, Jouni J.K.Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland (author)
  • Ryti, NiiloCenter for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland (author)
  • Pascal, MathildeSanté Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France (author)
  • Hashizume, MasahiroDepartment of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (author)
  • Fook Sheng Ng, ChrisSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan (author)
  • Alahmad, BarrakDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, MA, Boston, United States (author)
  • Hurtado Diaz, MagaliDepartment of Environmental Health, National Institute of Public Health, Morelos, Cuernavaca, Mexico (author)
  • De la Cruz Valencia, CésarDepartment of Environmental Health, National Institute of Public Health, Morelos, Cuernavaca, Mexico (author)
  • Nunes, BaltazarDepartment of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal (author)
  • Madureira, JoanaDepartment of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal (author)
  • Scovronick, NoahDepartment of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, United States (author)
  • Garland, Rebecca M.Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa (author)
  • Kim, HoGraduate School of Public Health, Seoul National University, Seoul, South Korea (author)
  • Lee, WhanheeSchool of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea (author)
  • Tobias, AurelioInstitute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain (author)
  • Íñiguez, CarmenDepartment of Statistics and Computational Research, Universitat de València, València, Spain (author)
  • Forsberg, Bertil,professor,1956-Umeå universitet,Institutionen för folkhälsa och klinisk medicin(Swepub:umu)befo0001 (author)
  • Åström, Christofer,1983-Umeå universitet,Institutionen för folkhälsa och klinisk medicin(Swepub:umu)chas0002 (author)
  • Maria Vicedo-Cabrera, AnaInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (author)
  • Ragettli, Martina S.Swiss Tropical and Public Health Institute, Basel, Switzerland (author)
  • Leon Guo, Yue-LiangEnvironmental and Occupational Medicine, Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan (author)
  • Pan, Shih-ChunNational Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan (author)
  • Li, ShanshanDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (author)
  • Gasparrini, AntonioDepartment of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom (author)
  • Sera, FrancescoDepartment of Statistics, Computer Science and Applications “G. Parenti”, University of Florence, Florence, Italy (author)
  • Masselot, PierreDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (author)
  • Schwartz, JoelDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, MA, Boston, United States (author)
  • Zanobetti, AntonellaDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, MA, Boston, United States (author)
  • Bell, Michelle L.School of Forestry and Environmental Studies, Yale University, CT, New Haven, United States (author)
  • Schneider, AlexandraInstitute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany (author)
  • Breitner, SusanneInstitute 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 (author)
  • 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, GermanyDepartment of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy (creator_code:org_t)

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  • In:Environment International: Elsevier1740160-41201873-6750

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