Joint effect of heat and air pollution on mortality in 620 cities of 36 countries

Stafoggia M.; Michelozzi P.; Schneider A.; Armstrong B.; Scortichini M.; Rai M.; Achilleos S.; Alahmad B.; Analitis A.; Åström C.; Bell M.L.; Calleja N.; Krage Carlsen H.; Carrasco G.; Paul Cauchi J.; DSZS Coelho M.; Correa P.M.; Diaz M.H.; Entezari A.; Forsberg B.; Garland R.M.; Leon Guo Y.; Guo Y.; Hashizume M.; Holobaca I.H.; Íñiguez C.; Jaakkola J.J.K.; Kan H.; Katsouyanni K.; Kim H.; Kyselý J.; Lavigne E.; Lee W.; Li S.; Maasikmets M.; Madureira J.; Mayvaneh F.; Fook Sheng Ng C.; Nunes B.; Orru H.; V Ortega N.; Osorio S.; Palomares A.D.L.; Pan S.-C.; Pascal M.; Ragettli M.S.; Rao S.; Raz R.; Roye D.; Ryti N.; HN Saldiva P.; Samoli E.; Schwartz J.; Scovronick N.; Sera F.; Tobias A.; Tong S.; DLC Valencia C.; Maria Vicedo-Cabrera A.; Urban A.; Gasparrini A.; Breitner S.; de' Donato F.K. · Environment International (2023) · DOI: 10.1016/j.envint.2023.108258

Resumen

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.

Instituciones: Universidad Peruana Cayetano Heredia