The association between gaseous pollutants and non-accidental mortality: a time series study

Effect of short-term exposure to ambient air pollutants on non-accidental mortality in emergency department visits: a time-series study

Objectives

Exposure to air pollution has been linked to an increased risk of premature mortality. However, the acute effects of air pollution on the risk of non-accidental mortality have not been extensively researched in developing countries, and the findings thus far have been inconsistent. Therefore, this study aimed to examine the association between short-term exposure to six pollutants (PM_2.5, PM₁₀, SO₂, NO₂, O₃, and CO) and non-accidental mortality in Beijing, China.

Methods

Daily data on non-accidental deaths were gathered from 1 January 2017 to 31 December 2018. Air pollution data for the same period were collected from 35 fixed-site air quality monitoring stations in Beijing. Generalized additive models (GAM) based on Poisson regression were used to investigate the association between non-accidental mortality in emergency department visits and the daily average levels of air pollutants.

Results

There were 8,676 non-accidental deaths recorded during 2017-2018. After sensitivity analysis, short-term exposure to air pollutants, particularly gaseous pollutants, was linked to non-accidental mortality. Specifically, for every 10 μg/m³ increase (5 μg/m³ in SO₂, 0.5 mg/m³ in CO) of SO₂ (lag 04), NO₂ (lag 04), O₃ (lag 05), and CO (lag 04), the relative risk (RR) values were 1.054 (95% CI: 1.009, 1.100), 1.038 (95% CI: 1.013, 1.063), 1.032 (95% CI: 1.011, 1.054), and 1.034 (95% CI: 1.004, 1.066), respectively. In terms of causes of death, short-term exposure to NO₂, SO₂, and O₃ increased the risk of circulatory mortality. Further stratified analysis revealed that the stronger associations were presented in females for O₃ while in males for CO. People aged 65 and over were strongly associated with ambient air pollution.

Conclusions

Our study showed that ambient air pollutants were associated with non-accidental mortality. Our findings suggested that efforts to control gaseous pollution should be stepped up, and vulnerable groups should be the focus of health protection education.

Environmental gaseous pollutants are related to increase of acute coronary syndrome in Valencia region

INTRODUCTION AND AIMS

Environmental pollution are one of the most relevant risk factors to atherosclerosis. To know awareness about the importance of urban air pollution as a trigger for hospital admission due to acute coronary syndrome (ACS), this study analyzed levels of different gaseous air pollutants in the air and its correlation with number of ACS.

METHODS

Epidemiological data of patients admitted for ACS in five towns during the years 2006-2008 were recovered. Clinical data regarding admissions for ACS were obtained from the hospital admission services. Measures of seven air contaminants were recovered from the environmental stations. Mixed model including sex, age, location, and the average levels of air pollutants contaminants as fixed effects and its interaction were performed.

RESULTS

The incidence rate of ACS is higher in man than woman, and higher in older people than young. The maximum ACS were in the last trimester of the year, was the most elevated levels of gaseous pollutants have been found. Levels of NO₂, NO, and CO are positively correlated between them, and negatively correlated with O₃ levels. All air pollutants analyzed increase the number of ACS hospital admission in the five locations evaluated.

CONCLUSIONS

Levels of gaseous pollutants are related between them, being the levels of NO₂, NO, and CO, positively correlated, and negatively correlated with levels of O₃. Number of ACS hospital admission increases with levels of five air gaseous pollutants studied.

Ambient gaseous pollutants and emergency ambulance calls for all-cause and cause-specific diseases in China: a multicity time-series study

Much attention has been paid to the health effects of ambient particulate matter pollution; the effects of gaseous air pollutants have not been well studied. Emergency ambulance calls (EACs) may provide a better indicator of the acute health effects than the widely used health indicators, such as mortality and hospital admission. We estimated the short-term associations between gaseous air pollutants [nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and ozone (O₃)] and EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and pooled associations. Stratified analyses were conducted by age, sex, and season. A total of 1,626,017 EACs were observed for all-cause EACs, including 230,537 from cardiovascular diseases, and 96,483 from respiratory diseases. Statistically significant associations were observed between NO₂ and EACs for all-cause diseases, while the effects of SO₂ were positive, but not statistically significant in most models. No significant relationship was found between O₃ and EACs. Specifically, each 10 μg/m³ increase in the 2-day moving average concentration of NO₂ was associated with a 1.07% [95% confidence interval (CI): 0.40%, 1.76%], 0.76% (95% CI: 0.19%, 1.34%) and 0.06% (95% CI: -1.57%, 1.73%) increase in EACs due to all-cause, cardiovascular and respiratory diseases, respectively. Stratified analysis showed a larger effect of NO₂ on all-cause EACs in the cold season [excess relative risk (ERR): 0.33% (95% CI: 0.05%, 0.60%) for warm season, ERR: 0.77% (95% CI: 0.31%, 1.23%) for cold season]. Our study indicates that acute exposures to NO₂ might be an important trigger of the emergent occurrence of all-cause, cardiovascular and respiratory diseases, and this effect should be of particular concern in the cold season. Further policy development for controlling gaseous air pollution is warranted to reduce the emergent occurrence of cardiopulmonary diseases.

Short-term exposure to nitrogen dioxide and mortality: A systematic review and meta-analysis

BACKGROUND

Ambient air pollution has been characterized as a leading cause of mortality worldwide and has been associated with cardiovascular and respiratory diseases. There is increasing evidence that short-term exposure to nitrogen dioxide (NO₂), is related to adverse health effects and mortality.

METHODS

We conducted a systematic review of short-term NO₂ and daily mortality, which were indexed in PubMed and Embase up to June 2021. We calculated random-effects estimates by different continents and globally, and tested for heterogeneity and publication bias.

RESULTS

We included 87 articles in our quantitative analysis. NO₂ and all-cause as well as cause-specific mortality were positively associated in the main analysis. For all-cause mortality, a 10 ppb increase in NO₂ was associated with a 1.58% (95%CI 1.28%-1.88%, I² = 96.3%, Eggers' test p < 0.01, N = 57) increase in the risk of death. For cause-specific mortality, a 10 ppb increase in NO₂ was associated with a 1.72% (95%CI 1.41%-2.04%, I² = 87.4%, Eggers' test p < 0.01, N = 42) increase in cardiovascular mortality and a 2.05% (95%CI 1.52%-2.59%, I² = 78.5%, Eggers' test p < 0.01, N = 38) increase in respiratory mortality. In the sensitivity analysis, the meta-estimates for all-cause mortality, cardiovascular and respiratory mortality were nearly identical. The heterogeneity would decline to varying degrees through regional and study-design stratification.

CONCLUSIONS

This study provides evidence of an association between short-term exposure to NO₂, a proxy for traffic-sourced air pollutants, and all-cause, cardiovascular and respiratory mortality.