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


Journal

Environment international
ISSN: 1873-6750
Titre abrégé: Environ Int
Pays: Netherlands
ID NLM: 7807270

Informations de publication

Date de publication:
04 2023
Historique:
received: 31 08 2022
revised: 11 01 2023
accepted: 12 02 2023
medline: 28 4 2023
pubmed: 20 3 2023
entrez: 19 3 2023
Statut: ppublish

Résumé

Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. 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. Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 µm [PM 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 PM 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.

Sections du résumé

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 [PM
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 PM
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.

Identifiants

pubmed: 36934570
pii: S0160-4120(23)00098-3
doi: 10.1016/j.envint.2023.107825
pii:
doi:

Substances chimiques

Air Pollutants 0
Environmental Pollutants 0
Particulate Matter 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

107825

Informations de copyright

Copyright © 2023. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Masna Rai (M)

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, Germany. Electronic address: masna.rai@campus.lmu.de.

Massimo Stafoggia (M)

Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy.

Francesca de'Donato (F)

Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy.

Matteo Scortichini (M)

Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy.

Sofia Zafeiratou (S)

Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece.

Liliana Vazquez Fernandez (L)

Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway.

Siqi Zhang (S)

Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany.

Klea Katsouyanni (K)

Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece.

Evangelia Samoli (E)

Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece.

Shilpa Rao (S)

Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway.

Eric Lavigne (E)

School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada and Environmental Health Science & Research Bureau, Health Canada, Ottawa, Canada.

Yuming Guo (Y)

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Haidong Kan (H)

Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China.

Samuel Osorio (S)

Department of Environmental Health, University of São Paulo, São Paulo, Brazil.

Jan Kyselý (J)

Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.

Aleš Urban (A)

Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.

Hans Orru (H)

Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.

Marek Maasikmets (M)

Estonian Environmental Research Centre, Tallinn, Estonia.

Jouni J K Jaakkola (JJK)

Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland.

Niilo Ryti (N)

Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland.

Mathilde Pascal (M)

Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France.

Masahiro Hashizume (M)

Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Chris Fook Sheng Ng (C)

School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.

Barrak Alahmad (B)

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Magali Hurtado Diaz (M)

Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.

César De la Cruz Valencia (C)

Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.

Baltazar Nunes (B)

Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal.

Joana Madureira (J)

Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal.

Noah Scovronick (N)

Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, USA.

Rebecca M Garland (RM)

Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa.

Ho Kim (H)

Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

Whanhee Lee (W)

School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea.

Aurelio Tobias (A)

Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain.

Carmen Íñiguez (C)

Department of Statistics and Computational Research. Universitat de València, València, Spain.

Bertil Forsberg (B)

Department of Public Health and Clinical Medicine, Umeå University, Sweden.

Christofer Åström (C)

Department of Public Health and Clinical Medicine, Umeå University, Sweden.

Ana Maria Vicedo-Cabrera (A)

Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

Martina S Ragettli (MS)

Swiss Tropical and Public Health Institute, Basel, Switzerland.

Yue-Liang Leon Guo (YL)

Environmental and Occupational Medicine, and Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan.

Shih-Chun Pan (SC)

National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.

Shanshan Li (S)

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Antonio Gasparrini (A)

Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Francesco Sera (F)

Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy.

Pierre Masselot (P)

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Joel Schwartz (J)

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Antonella Zanobetti (A)

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Michelle L Bell (ML)

School of Forestry and Environmental Studies, Yale University, New Haven CT, USA.

Alexandra Schneider (A)

Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany.

Susanne Breitner (S)

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, Germany.

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