Ambient carbon monoxide and daily mortality: a global time-series study in 337 cities (original) (raw)
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Short-Term Effects of Carbon Monoxide on Mortality: An Analysis within the APHEA Project
Environmental Health Perspectives, 2007
We investigated the short-term effects of carbon monoxide on total and cardiovascular mortality in 19 European cities participating in the APHEA-2 (Air Pollution and Health: A European Approach) project. METHODS: We examined the association using hierarchical models implemented in two stages. In the first stage, data from each city were analyzed separately, whereas in the second stage the cityspecific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity. We evaluated the sensitivity of our results by applying different degrees of smoothing for seasonality control in the city-specific analysis. RESULTS: We found significant associations of CO with total and cardiovascular mortality. A 1-mg/m 3 increase in the 2-day mean of CO levels was associated with a 1.20% [95% confidence interval (CI), 0.63-1.77%] increase in total deaths and a 1.25% (95% CI, 0.30-2.21%) increase in cardiovascular deaths. There was indication of confounding with black smoke and nitrogen dioxide, but the pollutant-adjusted effect of CO on mortality remained at least marginally statistically significant. The effect of CO on total and cardiovascular mortality was observed mainly in western and southern European cities and was larger when the standardized mortality rate was lower.
Short-term effects of daily air pollution on mortality
Atmospheric Environment, 2013
h i g h l i g h t s < We model the association of air pollution and mortality using Poisson regression. < RR for each pollutant was obtained for every IQR increase at different lag times. < O 3 , CO and PM 10 were the important pollutants associated with natural mortality. < All pollutants except SO 2 were associated with respiratory mortality. < Those who have respiratory diseases are at higher risk of mortality.
Long-Term Effects of Traffic-Related Air Pollution on Mortality in a Dutch Cohort (NLCS-AIR Study)
Environmental Health Perspectives, 2007
BACKGROUND: Several studies have found an effect on mortality of between-city contrasts in long-term exposure to air pollution. The effect of within-city contrasts is still poorly understood. OBJECTIVES: We studied the association between long-term exposure to traffic-related air pollution and mortality in a Dutch cohort. METHODS: We used data from an ongoing cohort study on diet and cancer with 120,852 subjects who were followed from 1987 to 1996. Exposure to black smoke (BS), nitrogen dioxide, sulfur dioxide, and particulate matter ≤ 2.5 µm (PM 2.5 ), as well as various exposure variables related to traffic, were estimated at the home address. We conducted Cox analyses in the full cohort adjusting for age, sex, smoking, and area-level socioeconomic status. RESULTS: Traffic intensity on the nearest road was independently associated with mortality. Relative risks (95% confidence intervals) for a 10-µg/m 3 increase in BS concentrations (difference between 5th and 95th percentile) were 1.05 (1.00-1.11) for natural cause, 1.04 (0.95-1.13) for cardiovascular, 1.22 (0.99-1.50) for respiratory, 1.03 (0.88-1.20) for lung cancer, and 1.04 (0.97-1.12) for mortality other than cardiovascular, respiratory, or lung cancer. Results were similar for NO 2 and PM 2.5 , but no associations were found for SO 2 . CONCLUSIONS: Traffic-related air pollution and several traffic exposure variables were associated with mortality in the full cohort. Relative risks were generally small. Associations between natural-cause and respiratory mortality were statistically significant for NO 2 and BS. These results add to the evidence that long-term exposure to ambient air pollution is associated with increased mortality. Mean 34.5 μg/m 3 Min 14.6 μg/m 3 Max 52.8 μg/m 3 SD 7.3 μg/m 3 Mean 36.9 μg/m 3 Min 14.6 μg/m 3 Max 66.7 μg/m 3 SD 8.2 μg/m 3 Mean 13.9 μg/m 3 Min 8.7 μg/m 3 Max 19.5 μg/m 3 SD 2.2 μg/m 3 Mean 16.5 μg/m 3 Min 8.7 μg/m 3 Max 35.8 μg/m 3 SD 3.5 μg/m 3 Mean 13.7 μg/m 3 Min 4.2 μg/m 3 Max 33.8 μg/m 3 SD 5.1 μg/m 3 Mean 28.3 μg/m 3 Min 23.0 μg/m 3 Max 36.8 μg/m 3 SD 2.1 μg/m 3 Mean 2,284 mvh/24hr Min 1 mvh/24hr Max 104,275 mvh/24hr SD 3,767 mvh/24hr Mean 140,903 mvh/24hr Min 0 mvh/24hr Max 893,722 mvh/24hr SD 116,104 mvh/24hr
2002
Chronic exposure to air pollution is associated with increased mortality rates. The impact of air pollution relative to other causes of death in a population is of public health importance and has not been well established. In this study, the rate advancement periods associated with traffic pollution exposures were estimated. Study subjects underwent pulmonary function testing at a clinic in Hamilton, Ontario, Canada, between 1985 and 1999. Cox regression was used to model mortality from all natural causes during 1992–2001 in relation to lung function, body mass index, a diagnosis of chronic pulmonary disease, chronic ischemic heart disease, or diabetes mellitus, household income, and residence within 50 m of a major urban road or within 100 m of a highway. Subjects living close to a major road had an increased risk of mortality (relative risk = 1.18, 95 % confidence interval: 1.02, 1.38). The mortality rate advancement period associated with residence near a major road was 2.5 year...
Air Quality, Atmosphere & Health, 2013
The "Air Pollution and Health: A Combined European and North American Approach" (APHENA) project is a collaborative analysis of multi-city time-series data on the association between air pollution and adverse health outcomes. The main objective of APHENA was to examine the coherence of findings of time-series studies relating short-term fluctuations in air pollution levels to mortality and morbidity in 125 cities in Europe, the US, and Canada. Multi-city time-series analysis was conducted using a twostage approach. We used Poisson regression models controlling for overdispersion with either penalized or natural splines to adjust for seasonality. Hierarchical models were used to obtain an overall estimate of excess mortality associated with ozone and to assess potential effect modification. Potential effect modifiers were city-level characteristics related to exposure to other ambient air pollutants, weather, socioeconomic status, and the vulnerability of the population. Regionally pooled risk estimates from Europe and the US were similar; those from Canada were substantially higher. The pooled estimated excess relative risk associated with a 10 μg/m 3 increase in 1 h daily maximum O 3 was 0.26 % (95 % CI, 0.15 %, 0.37 %). Across regions, there was little consistent indication of effect modification by age or other effect modifiers considered in the analysis.
BMJ
Objective To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. Design Two stage time series analysis. Setting 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. Population Deaths for all causes or for external causes only registered in each city within the study period . Main outcome measures Daily total mortality (all or non-external causes only). Results A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m 3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term e...
An association between air-pollution and mortality in 6 United-States cities
New England Journal of …, 1993
Bayesian statistical inference with a case-crossover design was used to examine the effects of air pollutants {Particulate matter ,10 mm in aerodynamic diameter (PM 10 ), sulphur dioxide (SO 2 ), and ozone (O 3 )} on mortality. We found that all air pollutants had significant short-term impacts on non-accidental mortality. An increase of 10 mg/m 3 in PM 10 , 10 ppb in O 3 , 1 ppb in SO 2 were associated with a 0.40% (95% posterior interval (PI): 0.22, 0.59%), 0.78% (95% PI: 0.20, 1.35%) and 0.34% (95% PI: 0.17, 0.50%) increase of non-accidental mortality, respectively. O 3 air pollution is significantly associated with cardiovascular mortality, while PM 10 is significantly related to respiratory mortality. In general, the effects of all pollutants on all mortality types were higher in summer and winter than those in the rainy season. This study highlights the effects of exposure to air pollution on mortality risks in Thailand. Our findings support the Thailand government in aiming to reduce high levels of air pollution. OPEN SUBJECT AREAS: RISK FACTORS EPIDEMIOLOGY
BMJ, 2021
Objective To evaluate the short term associations between nitrogen dioxide (NO 2 ) 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/m 3 increase in NO 2 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 (PM 10 and PM 2.5 , respecti...
Air Pollution and Health in Urban Areas
Reviews on Environmental Health, 2000
In this paper, recent reviews of the World Health Organization, other review papers, and more recent literature on the human health effects of current air pollution trends in urban areas are reviewed and summarized as follows: Sulphur dioxide. Some studies, but not others, found associations between sulphur dioxide (S0 2) exposure and daily mortality and morbidity. Single-pollutant correlations sometimes disappeared when other pollutants, especially suspended particulate matter (SPM), were included. Cross-sectional studies with asthmatics revealed significant, non-threshold relations between S0 2 and decrements of the forced expiratory volume in 1 second (FEVi). Nitrogen dioxide. Weak associations between short-term nitrogen dioxide (N0 2) exposure from gas cooking and respiratory symptoms and a decrement in lung function parameters were found in children, but not consistently in exposed women. With long-term exposure, children, but not adults, exhibit increased respiratory symptoms, decreased lung function, and increased incidences of chronic cough, bronchitis, and conjunctivitis. A causal relationship between N0 2 exposure and adverse health effects has not yet been established. Carbon monoxide. Binding of CO in the lungs with hemoglobin in the blood forms carboxyhemoglobin (COHb), which impairs the transport of oxygen. The health effects of CO include hypoxia, neurological deficits and neurobehavioral changes, and increases in daily mortality and hospital admissions for cardiovascular diseases. The latter persists even at very low CO levels, indicating no threshold for the onset of these effects. Whether the relation between daily mortality and exposure to CO are causal or whether CO might act as a proxy for SPM is still an open question. Ambient CO may have even more serious health consequences than does COHb formation and at lower levels than that mediated through elevated COHb levels. Ozone. Short-term acute effects of O3 include pulmonary function decrements, increased airway responsiveness and airway inflammation, aggravation of pre-existing respiratory diseases like asthma, increases in daily hospital admissions and emergency department visits for respiratory causes, and excess mortality. Exposure-response relations are non-linear for the respective associations between O3 and FEVi, inflammatory changes, and changes in hospital admissions, whereas the relation between percent change in symptom exacerbation among adults and asthmatics is linear. Single-pollutant associations between O3 exposure and daily mortality and hospital admissions for respiratory diseases is statistically significant, even in multi-pollutant models. Suspended particulate matter. Associations between SPM concentrations and mortality and morbidity rates are significant. The acute health effects of SPM, even at short-term low levels of exposure, include increased daily