Dataset Information

Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

ABSTRACT:

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 PM_2.5, 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.

SUBMITTER: Meng X

PROVIDER: S-EPMC7988454 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

Meng Xia X Liu Cong C Chen Renjie R Sera Francesco F Vicedo-Cabrera Ana Maria AM Milojevic Ai A Guo Yuming Y Tong Shilu S Coelho Micheline de Sousa Zanotti Stagliorio MSZS Saldiva Paulo Hilario Nascimento PHN Lavigne Eric E Correa Patricia Matus PM Ortega Nicolas Valdes NV Osorio Samuel S Garcia Kyselý Jan J Urban Aleš A Orru Hans H Maasikmets Marek M Jaakkola Jouni J K JJK Ryti Niilo N Huber Veronika V Schneider Alexandra A Katsouyanni Klea K Analitis Antonis A Hashizume Masahiro M Honda Yasushi Y Ng Chris Fook Sheng CFS Nunes Baltazar B Teixeira João Paulo JP Holobaca Iulian Horia IH Fratianni Simona S Kim Ho H Tobias Aurelio A Íñiguez Carmen C Forsberg Bertil B Åström Christofer C Ragettli Martina S MS Guo Yue-Liang Leon YL Pan Shih-Chun SC Li Shanshan S Bell Michelle L ML Zanobetti Antonella A Schwartz Joel J Wu Tangchun T Gasparrini Antonio A Kan Haidong H

BMJ (Clinical research ed.) 20210324

<h4>Objective</h4>To evaluate the short term associations between nitrogen dioxide (NO<sub>2</sub>) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol.<h4>Design</h4>Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis.<h4>Setting</h4>398 cities in 22 low to high income countries/regions.<h4>Main outcome measures</h4>Daily deaths from total (62.8 million), card ...[more]

PMID: 33762259

Similar Datasets

Project description:BackgroundThe systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias.MethodsWe evaluated the associations of inhalable particulate matter (PM) with an aerodynamic diameter of 10 μm or less (PM10) and fine PM with an aerodynamic diameter of 2.5 μm or less (PM2.5) with daily all-cause, cardiovascular, and respiratory mortality across multiple countries or regions. Daily data on mortality and air pollution were collected from 652 cities in 24 countries or regions. We used overdispersed generalized additive models with random-effects meta-analysis to investigate the associations. Two-pollutant models were fitted to test the robustness of the associations. Concentration-response curves from each city were pooled to allow global estimates to be derived.ResultsOn average, an increase of 10 μg per cubic meter in the 2-day moving average of PM10 concentration, which represents the average over the current and previous day, was associated with increases of 0.44% (95% confidence interval [CI], 0.39 to 0.50) in daily all-cause mortality, 0.36% (95% CI, 0.30 to 0.43) in daily cardiovascular mortality, and 0.47% (95% CI, 0.35 to 0.58) in daily respiratory mortality. The corresponding increases in daily mortality for the same change in PM2.5 concentration were 0.68% (95% CI, 0.59 to 0.77), 0.55% (95% CI, 0.45 to 0.66), and 0.74% (95% CI, 0.53 to 0.95). These associations remained significant after adjustment for gaseous pollutants. Associations were stronger in locations with lower annual mean PM concentrations and higher annual mean temperatures. The pooled concentration-response curves showed a consistent increase in daily mortality with increasing PM concentration, with steeper slopes at lower PM concentrations.ConclusionsOur data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies. (Funded by the National Natural Science Foundation of China and others.).

Dataset Information

Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

Objective

Design

Setting

Main outcome measures

Results

Conclusions

Publications

Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

Similar Datasets

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