Ambient Particulate Air Pollution and Daily Mortality in 652 Cities

Cong Liu(Children's Hospital of Fudan University), Renjie Chen(Children's Hospital of Fudan University), Francesco Sera(Royal Society of Tropical Medicine and Hygiene), Ana M. Vicedo‐Cabrera(Royal Society of Tropical Medicine and Hygiene), Yuming Guo(Binzhou Medical University), Shilu Tong(Queensland University of Technology), Micheline de Sousa Zanotti Stagliorio Coêlho(Universidade de São Paulo), Paulo Hilário Nascimento Saldiva(Universidade de São Paulo), Éric Lavigne(Health Canada), Patricia Matus Correa(Health Canada), Nicolás Valdés Ortega(Health Canada), Samuel Osorio Garcia(Universidad de Los Andes), Mathilde Pascal(Santé Publique France), Massimo Stafoggia(Universidad de Los Andes, Chile), Matteo Scortichini(Universidad de Los Andes, Chile), Masahiro Hashizume(Children's Hospital of Fudan University), Yasushi Honda(University of Tsukuba), Magali Hurtado‐Díaz(Instituto Nacional de Salud Pública), César De la Cruz Valencia(Instituto Nacional de Salud Pública), Baltazar Nunes(National Institute of Health Dr. Ricardo Jorge), João Paulo Teixeira(Universidade do Porto), Ho Kim(Seoul National University), Aurelio Tobı́as(Institute of Environmental Assessment and Water Research), Carmen Íñiguez(Children's Hospital of Fudan University), Bertil Forsberg(Children's Hospital of Fudan University), Christofer Åström(Children's Hospital of Fudan University), Martina S. Ragettli(Swiss Tropical and Public Health Institute), Yue Leon Guo(Binzhou Medical University), Bing‐Yu Chen(National Taiwan University), Michelle L. Bell(Yale University), Caradee Y. Wright(South African Medical Research Council), Noah Scovronick(Emory University), Rebecca M. Garland(Council for Scientific and Industrial Research), Ai Milojevic(Royal Society of Tropical Medicine and Hygiene), Jan Kyselý(Czech Academy of Sciences, Institute of Atmospheric Physics), Aleš Urban(Czech Academy of Sciences, Institute of Atmospheric Physics), Hans Orru(Children's Hospital of Fudan University), Ene Indermitte(Children's Hospital of Fudan University), Jouni J. K. Jaakkola(Oulu University Hospital), Niilo Ryti(Oulu University Hospital), Klea Katsouyanni(King's College London), Antonis Analitis(National and Kapodistrian University of Athens), Antonella Zanobetti(Children's Hospital of Fudan University), Joel Schwartz(Children's Hospital of Fudan University), Jianmin Chen(Children's Hospital of Fudan University), Tangchun Wu(Children's Hospital of Fudan University), Aaron Cohen(Health Effects Institute), Antonio Gasparrini(Royal Society of Tropical Medicine and Hygiene), Haidong Kan(Center for Children)
New England Journal of Medicine
August 21, 2019
Cited by 1,656Open Access
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Abstract

BACKGROUND: The systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias. METHODS: ) 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. RESULTS: 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. CONCLUSIONS: 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.).


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