6533b829fe1ef96bd128a3d0
RESEARCH PRODUCT
Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities
Klea KatsouyanniKlea KatsouyanniAntonella ZanobettiHans OrruHans OrruCong LiuMasahiro HashizumePatricia Matus CorreaBaltazar NunesJan KyselýJan KyselýChris Fook Sheng NgAurelio TobiasMartina S. RagettliMartina S. RagettliYuming GuoYuming GuoTangchun WuShanshan LiAna M. Vicedo-cabreraAna M. Vicedo-cabreraChristofer ÅStrömHo KimMarek MaasikmetsAleš UrbanAleš UrbanShilu TongBertil ForsbergHaidong KanHaidong KanYasushi HondaJoão Paulo TeixeiraYueliang Leon GuoYueliang Leon GuoNiilo R.i. RytiFrancesco SeraFrancesco SeraIulian-horia HolobacaAi MilojevicXia MengAntonis AnalitisAlexandra SchneiderMicheline De Sousa Zanotti Stagliorio CoelhoMichelle L. BellEric LavigneEric LavigneVeronika HuberVeronika HuberSimona FratianniRenjie ChenJouni J. K. JaakkolaAntonio GasparriniPaulo Hilário Nascimento SaldivaShih-chun PanCarmen IñiguezSamuel OsorioNicolas Valdes OrtegaGarciaJoel Schwartzsubject
OzoneNitrogen DioxideRespiratory Tract Diseases610 Medicine & healthAir Pollutants; Air Pollution; Cardiovascular Diseases; Cities; Developed Countries; Developing Countries; Environmental Exposure; Global Health; Humans; Linear Models; Nitrogen Dioxide; Respiratory Tract Diseases; Urban HealthRespiratory MortalityHealth benefitsGlobal HealthArbetsmedicin och miljömedicinchemistry.chemical_compound360 Social problems & social servicesCardiovascular MortalityAir PollutionHumansMedicineAmbient Nitrogen DioxideNitrogen dioxideCitiesRespiratory system610 Medicine & healthDeveloping CountriesMCCAir Pollutantsbusiness.industryResearchDeveloped CountriesUrban HealthEnvironmental ExposureOccupational Health and Environmental HealthGeneral MedicineEnvironmental exposureConfidence intervalTerm (time)Increased riskchemistryambient nitrogen dioxideCardiovascular DiseasesLinear ModelsRespiratory mortalityDeterminantes da Saúde e da Doençabusiness360 Social problems & social servicesDaily MortalityDemographydescription
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 PM2.5, 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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-03-24 |