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Wen B, Wu Y, Guo Y, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Armstrong B, Forsberg B, Pan SC, Íñiguez C, Ameling C, Valencia CDLC, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de'Donato F, Rao S, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca IH, Kyselý J, Madureira J, Schwartz J, Jaakkola JJK, Katsouyanni K, Diaz MH, Ragettli MS, Hashizume M, Pascal M, Coélho MDSZS, Ortega NV, Ryti N, Scovronick N, Michelozzi P, Matus Correa P, Goodman P, Saldiva PHN, Raz R, Abrutzky R, Osorio S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Kim Y, Guo YL, Bell ML, Li S. Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study. Environ Int 2024; 187:108712. [PMID: 38714028 DOI: 10.1016/j.envint.2024.108712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/27/2024] [Accepted: 04/28/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects. OBJECTIVES We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality. METHODS We collected data on total, cardiovascular, and respiratory mortality and meteorology from 758 locations in 47 countries or regions from 1972 to 2020. We defined inter-day TV as the standard deviation (SD) of daily mean temperatures across the lag interval, and intra-day TV as the average SD of minimum and maximum temperatures on each day. In the first stage, inter-day and intra-day TVs were modelled simultaneously in the quasi-Poisson time-series model for each location. In the second stage, a multi-level analysis was used to pool the location-specific estimates. RESULTS Overall, the mortality risk due to each interquartile range [IQR] increase was higher for intra-day TV than for inter-day TV. The risk increased by 0.59% (95% confidence interval [CI]: 0.53, 0.65) for all-cause mortality, 0.64% (95% CI: 0.56, 0.73) for cardiovascular mortality, and 0.65% (95% CI: 0.49, 0.80) for respiratory mortality per IQR increase in intra-day TV0-7 (0.9 °C). An IQR increase in inter-day TV0-7 (1.6 °C) was associated with 0.22% (95% CI: 0.18, 0.26) increase in all-cause mortality, 0.44% (95% CI: 0.37, 0.50) increase in cardiovascular mortality, and 0.31% (95% CI: 0.21, 0.41) increase in respiratory mortality. The proportion of all-cause deaths attributable to intra-day TV0-7 and inter-day TV0-7 was 1.45% and 0.35%, respectively. The mortality risks varied by lag interval, climate area, season, and climate type. CONCLUSIONS Our results indicated that intra-day TV may explain the main part of the mortality risk related to TV and suggested that comprehensive evaluations should be proposed in more countries to help protect human health.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Ala Overcenco
- National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Republic of Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Ana Maria Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Ariana Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Caroline Ameling
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | | | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Dominic Royé
- CIBER of Epidemiology and Public Health, Madrid, Spain; Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | | | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Gabriel Carrasco-Escobar
- Health Innovation Lab, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Joana Madureira
- Environmental Health Department, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece; School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | | | | | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Patrick Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | | | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
| | - Rosana Abrutzky
- Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - Veronika Huber
- IBE-Chair of Epidemiology, LMU Munich, Munich, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA; Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yue Leon Guo
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Liu C, Chen R, Sera F, Vicedo-Cabrera AM, Guo Y, Tong S, Lavigne E, Correa PM, Ortega NV, Achilleos S, Roye D, Jaakkola JJ, Ryti N, Pascal M, Schneider A, Breitner S, Entezari A, Mayvaneh F, Raz R, Honda Y, Hashizume M, Ng CFS, Gaio V, Madureira J, Holobaca IH, Tobias A, Íñiguez C, Guo YL, Pan SC, Masselot P, Bell ML, Zanobetti A, Schwartz J, Gasparrini A, Kan H. Interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities: two stage time series analysis. BMJ 2023; 383:e075203. [PMID: 37793695 PMCID: PMC10548261 DOI: 10.1136/bmj-2023-075203] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To investigate potential interactive effects of fine particulate matter (PM2.5) and ozone (O3) on daily mortality at global level. DESIGN Two stage time series analysis. SETTING 372 cities across 19 countries and regions. POPULATION Daily counts of deaths from all causes, cardiovascular disease, and respiratory disease. MAIN OUTCOME MEASURE Daily mortality data during 1994-2020. Stratified analyses by co-pollutant exposures and synergy index (>1 denotes the combined effect of pollutants is greater than individual effects) were applied to explore the interaction between PM2.5 and O3 in association with mortality. RESULTS During the study period across the 372 cities, 19.3 million deaths were attributable to all causes, 5.3 million to cardiovascular disease, and 1.9 million to respiratory disease. The risk of total mortality for a 10 μg/m3 increment in PM2.5 (lag 0-1 days) ranged from 0.47% (95% confidence interval 0.26% to 0.67%) to 1.25% (1.02% to 1.48%) from the lowest to highest fourths of O3 concentration; and for a 10 μg/m3 increase in O3 ranged from 0.04% (-0.09% to 0.16%) to 0.29% (0.18% to 0.39%) from the lowest to highest fourths of PM2.5 concentration, with significant differences between strata (P for interaction <0.001). A significant synergistic interaction was also identified between PM2.5 and O3 for total mortality, with a synergy index of 1.93 (95% confidence interval 1.47 to 3.34). Subgroup analyses showed that interactions between PM2.5 and O3 on all three mortality endpoints were more prominent in high latitude regions and during cold seasons. CONCLUSION The findings of this study suggest a synergistic effect of PM2.5 and O3 on total, cardiovascular, and respiratory mortality, indicating the benefit of coordinated control strategies for both pollutants.
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Affiliation(s)
- Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti," University of Florence, Florence, Italy
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Centre for Disease Control and Prevention, Beijing, China
- School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China
- Centre for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | | | | | - Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jouni Jk Jaakkola
- Centre for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Niilo Ryti
- Centre for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Centre for Environmental Health, Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Centre for Environmental Health, Neuherberg, Germany
- IBE-Chair of Epidemiology, LMU Munich, Munich, Germany
| | - Alireza Entezari
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, Hebrew University of Jerusalem, Israel
| | - Yasushi Honda
- Centre for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Vânia Gaio
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal Porto, Portugal
| | | | - Aurelio Tobias
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Carmen Íñiguez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Statistics and Computational Research, University of Valencia, Valencia, Spain
| | - Yue Leon Guo
- Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
- Graduate Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Pierre Masselot
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
- Children's Hospital of Fudan University, National Centre for Children's Health, Shanghai, China
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3
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Wu Y, Li S, Zhao Q, Wen B, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Armstrong B, Forsberg B, Pan SC, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de'Donato F, Rao S, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca IH, Kyselý J, Madureira J, Schwartz J, Jaakkola JJK, Katsouyanni K, Hurtado Diaz M, Ragettli MS, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coélho M, Ortega NV, Ryti N, Scovronick N, Michelozzi P, Correa PM, Goodman P, Nascimento Saldiva PH, Abrutzky R, Osorio S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Guo YL, Bell ML, Guo Y. Global, regional, and national burden of mortality associated with short-term temperature variability from 2000-19: a three-stage modelling study. Lancet Planet Health 2022; 6:e410-e421. [PMID: 35550080 PMCID: PMC9177161 DOI: 10.1016/s2542-5196(22)00073-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 05/08/2023]
Abstract
BACKGROUND Increased mortality risk is associated with short-term temperature variability. However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000-19. METHODS In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° from 2000-19. Temperature variability was calculated as the SD of the average of the same and previous days' minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. FINDINGS An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1 753 392 deaths (95% CI 1 159 901-2 357 718) were associated with temperature variability per year, accounting for 3·4% (2·2-4·6) of all deaths. Most of Asia, Australia, and New Zealand were observed to have a higher percentage excess in mortality than the global mean. Globally, the percentage excess in mortality increased by about 4·6% (3·7-5·3) per decade. The largest increase occurred in Australia and New Zealand (7·3%, 95% CI 4·3-10·4), followed by Europe (4·4%, 2·2-5·6) and Africa (3·3, 1·9-4·6). INTERPRETATION Globally, a substantial mortality burden was associated with temperature variability, showing geographical heterogeneity and a slightly increasing temporal trend. Our findings could assist in raising public awareness and improving the understanding of the health impacts of temperature variability. FUNDING Australian Research Council, Australian National Health & Medical Research Council.
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Affiliation(s)
- Yao Wu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bo Wen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ala Overcenco
- National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Chișinău, Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Ana Maria Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Ariana Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Barrak Alahmad
- Department of Environmental Health, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shih-Chun Pan
- NationalInstitute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Caroline Ameling
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | | | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Dominic Royé
- CIBER of Epidemiology and Public Health, Madrid, Spain; Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | | | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Gabriel Carrasco-Escobar
- Health Innovation Lab, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Joana Madureira
- Environmental Health Department, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece; School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | | | | | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Patrick Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | | | - Rosana Abrutzky
- Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - Veronika Huber
- IBE-Chair of Epidemiology, LMU Munich, Munich, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA; Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Yue Leon Guo
- NationalInstitute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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4
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Wu Y, Wen B, Li S, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Analitis A, Zeka A, Tobias A, Alahmad B, Armstrong B, Forsberg B, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de’Donato F, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca IH, Kyselý J, Madureira J, Schwartz J, Katsouyanni K, Hurtado-Diaz M, Ragettli MS, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coélho M, Scovronick N, Michelozzi P, Goodman P, Nascimento Saldiva PH, Abrutzky R, Osorio S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Bell ML, Guo Y. Fluctuating temperature modifies heat-mortality association in the globe. Innovation (N Y) 2022; 3:100225. [PMID: 35340394 PMCID: PMC8942841 DOI: 10.1016/j.xinn.2022.100225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/02/2022] [Indexed: 11/30/2022] Open
Abstract
Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days’ minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: −0.33 to 1.69), 1.34% (95% CI: −0.14 to 2.73), 1.99% (95% CI: 0.29–3.57), and 2.73% (95% CI: 0.76–4.50) of total deaths for Q1–Q4 (first quartile–fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25–9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: −0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health. Increased temperature variability (TV) poses a greater mortality risk due to heat TV has a more profound modification effect on extreme heat-mortality association Strategies against heat and TV simultaneously would benefit public health
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Affiliation(s)
- Yao Wu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Bo Wen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Corresponding author
| | - Antonio Gasparrini
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Shilu Tong
- Shanghai Children’s Medical Centre, Shanghai Jiao Tong University, Shanghai 200025, China
- School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei 230032, China
- Center for Global Health, Nanjing Medical University, Nanjing 211166, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Ala Overcenco
- National Agency for Public Health of the Ministry of Health, Labour, and Social Protection of the Republic of Moldova, Chisinau MD-2009, Republic of Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague 141 00, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague 165 00, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg 85747, Germany
| | - Alireza Entezari
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617976487, Iran
| | - Ana Maria Vicedo-Cabrera
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Institute of Social and Preventive Medicine, University of Bern, Bern 3012, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern 3012, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Ariana Zeka
- Institute for Environment, Health, and Societies, Brunel University London, London UB8 3PN, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona 08034, Spain
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8521, Japan
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Ben Armstrong
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València 46003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Caroline Ameling
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven 3720 BA, Netherlands
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos 62100, Mexico
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven 3720 BA, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 17000, Vietnam
| | - Dominic Royé
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela 15705, Spain
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu 50090, Estonia
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Air Health Science Division, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617976487, Iran
| | | | - Francesca de’Donato
- Department of Epidemiology, Lazio Regional Health Service, Rome 00147, Italy
| | - Francesco Sera
- Department of Statistics, Computer Science, and Applications “G. Parenti”, University of Florence, Florence 50121, Italy
| | - Gabriel Carrasco-Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA 92093, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu 50090, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague 141 00, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague 165 00, Czech Republic
| | - Joana Madureira
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto 4050-600, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto 4050-600, Portugal
- Environmental Health Department, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto 4000-055, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens 11527, Greece
- School of Population Health and Environmental Sciences, King’s College London, London WC2R 2LS, UK
| | - Magali Hurtado-Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos 62100, Mexico
| | - Martina S. Ragettli
- Swiss Tropical and Public Health Institute, Basel 4051, Switzerland
- University of Basel, Basel 4001, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice 94 410, France
| | | | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome 00147, Italy
| | | | | | - Rosana Abrutzky
- Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires C1053ABH, Argentina
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 17000, Vietnam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo 11200, Uruguay
| | - Veronika Huber
- IBE-Chair of Epidemiology, Ludwig Maximilian University Munich, Munich 81377, Germany
- Department of Physical, Chemical, and Natural Systems, Universidad Pablo de Olavide, Sevilla 41013, Spain
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT 06511, USA
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul 03760, South Korea
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8521, Japan
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki 305-8506, Japan
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, CT 06511, USA
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Corresponding author
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5
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Chen G, Guo Y, Yue X, Tong S, Gasparrini A, Bell ML, Armstrong B, Schwartz J, Jaakkola JJK, Zanobetti A, Lavigne E, Nascimento Saldiva PH, Kan H, Royé D, Milojevic A, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zeka A, Tobias A, Nunes B, Alahmad B, Forsberg B, Pan SC, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Samoli E, Mayvaneh F, Sera F, Carrasco-Escobar G, Lei Y, Orru H, Kim H, Holobaca IH, Kyselý J, Teixeira JP, Madureira J, Katsouyanni K, Hurtado-Díaz M, Maasikmets M, Ragettli MS, Hashizume M, Stafoggia M, Pascal M, Scortichini M, de Sousa Zanotti Stagliorio Coêlho M, Valdés Ortega N, Ryti NRI, Scovronick N, Matus P, Goodman P, Garland RM, Abrutzky R, Garcia SO, Rao S, Fratianni S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Guo YL, Ye T, Yu W, Abramson MJ, Samet JM, Li S. Mortality risk attributable to wildfire-related PM 2·5 pollution: a global time series study in 749 locations. Lancet Planet Health 2021. [PMID: 34508679 DOI: 10.1016/s2542-5196(21)00200-x/attachment/e841c89b-3e49-4ab5-afb7-e93ea966cfb8/mmc1.pdf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2·5 and mortality across various regions of the world. METHODS For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfire-related PM2·5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM2·5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM2·5 exposure was calculated. FINDINGS 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m3 increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM2·5 exposure were 1·019 (95% CI 1·016-1·022) for all-cause mortality, 1·017 (1·012-1·021) for cardiovascular mortality, and 1·019 (1·013-1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48-0·75) of all-cause deaths, 0·55% (0·43-0·67) of cardiovascular deaths, and 0·64% (0·50-0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM2·5 exposure during the study period. INTERPRETATION Short-term exposure to wildfire-related PM2·5 was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires. FUNDING Australian Research Council, Australian National Health & Medical Research Council.
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Affiliation(s)
- Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Xu Yue
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing, China
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Joel Schwartz
- Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | | | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Dominic Royé
- Department of Geography, University of Santiago de Compostela, CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Ai Milojevic
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ala Overcenco
- National Agency for Public Health of the Ministry of Health, Chisinau, Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine and Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Ariana Zeka
- Institute of Environment, Health and Societies, Brunel University London, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Carmen Íñiguez
- Department of Statistics and Computational Research. Universitat de València, Valencia, CIBERESP, Spain
| | - Caroline Ameling
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Gabriel Carrasco-Escobar
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Yadong Lei
- Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - João Paulo Teixeira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Magali Hurtado-Díaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and occupational Health, French National Public Health Agency, Saint Maurice, France
| | | | | | | | - Niilo R I Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Patricia Matus
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | | | - Rebecca M Garland
- Council for Scientific and Industrial Research, Pretoria, South Africa; Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; Unit for Environmental Sciences and Management, North West University, South Africa
| | - Rosana Abrutzky
- Instituto de Investigaciones Gino Germani, Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Shilpa Rao
- Norwegian institute of Public Health, Oslo, Norway
| | - Simona Fratianni
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - Veronika Huber
- Potsdam Institute for Climate Impact Research, Potsdam, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Seville, Spain
| | - Whanhee Lee
- School of Environment, Yale University, New Haven, CT, USA
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yue Leon Guo
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Tingting Ye
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Wenhua Yu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jonathan M Samet
- The Colorado School of Public Health, University of Colorado, Aurora
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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6
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Chen G, Guo Y, Yue X, Tong S, Gasparrini A, Bell ML, Armstrong B, Schwartz J, Jaakkola JJK, Zanobetti A, Lavigne E, Nascimento Saldiva PH, Kan H, Royé D, Milojevic A, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zeka A, Tobias A, Nunes B, Alahmad B, Forsberg B, Pan SC, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Samoli E, Mayvaneh F, Sera F, Carrasco-Escobar G, Lei Y, Orru H, Kim H, Holobaca IH, Kyselý J, Teixeira JP, Madureira J, Katsouyanni K, Hurtado-Díaz M, Maasikmets M, Ragettli MS, Hashizume M, Stafoggia M, Pascal M, Scortichini M, de Sousa Zanotti Stagliorio Coêlho M, Valdés Ortega N, Ryti NRI, Scovronick N, Matus P, Goodman P, Garland RM, Abrutzky R, Garcia SO, Rao S, Fratianni S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Guo YL, Ye T, Yu W, Abramson MJ, Samet JM, Li S. Mortality risk attributable to wildfire-related PM 2·5 pollution: a global time series study in 749 locations. Lancet Planet Health 2021; 5:e579-e587. [PMID: 34508679 DOI: 10.1016/s2542-5196(21)00200-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2·5 and mortality across various regions of the world. METHODS For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfire-related PM2·5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM2·5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM2·5 exposure was calculated. FINDINGS 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m3 increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM2·5 exposure were 1·019 (95% CI 1·016-1·022) for all-cause mortality, 1·017 (1·012-1·021) for cardiovascular mortality, and 1·019 (1·013-1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48-0·75) of all-cause deaths, 0·55% (0·43-0·67) of cardiovascular deaths, and 0·64% (0·50-0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM2·5 exposure during the study period. INTERPRETATION Short-term exposure to wildfire-related PM2·5 was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires. FUNDING Australian Research Council, Australian National Health & Medical Research Council.
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Affiliation(s)
- Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Xu Yue
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing, China
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Joel Schwartz
- Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | | | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Dominic Royé
- Department of Geography, University of Santiago de Compostela, CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Ai Milojevic
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ala Overcenco
- National Agency for Public Health of the Ministry of Health, Chisinau, Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine and Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Ariana Zeka
- Institute of Environment, Health and Societies, Brunel University London, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Carmen Íñiguez
- Department of Statistics and Computational Research. Universitat de València, Valencia, CIBERESP, Spain
| | - Caroline Ameling
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Gabriel Carrasco-Escobar
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Yadong Lei
- Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - João Paulo Teixeira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Magali Hurtado-Díaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and occupational Health, French National Public Health Agency, Saint Maurice, France
| | | | | | | | - Niilo R I Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Patricia Matus
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | | | - Rebecca M Garland
- Council for Scientific and Industrial Research, Pretoria, South Africa; Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; Unit for Environmental Sciences and Management, North West University, South Africa
| | - Rosana Abrutzky
- Instituto de Investigaciones Gino Germani, Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Shilpa Rao
- Norwegian institute of Public Health, Oslo, Norway
| | - Simona Fratianni
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - Veronika Huber
- Potsdam Institute for Climate Impact Research, Potsdam, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Seville, Spain
| | - Whanhee Lee
- School of Environment, Yale University, New Haven, CT, USA
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yue Leon Guo
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Tingting Ye
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Wenhua Yu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jonathan M Samet
- The Colorado School of Public Health, University of Colorado, Aurora
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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7
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Zhao Q, Guo Y, Ye T, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Armstrong B, Forsberg B, Pan SC, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Dung DV, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de'Donato F, Di Ruscio F, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca IH, Kyselý J, Madureira J, Schwartz J, Jaakkola JJK, Katsouyanni K, Hurtado Diaz M, Ragettli MS, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coélho M, Valdés Ortega N, Ryti N, Scovronick N, Michelozzi P, Matus Correa P, Goodman P, Nascimento Saldiva PH, Abrutzky R, Osorio S, Rao S, Fratianni S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Guo YL, Bell ML, Li S. Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study. Lancet Planet Health 2021; 5:e415-e425. [PMID: 34245712 DOI: 10.1016/s2542-5196(21)00081-4] [Citation(s) in RCA: 171] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. METHODS In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature-mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature-mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. FINDINGS Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967-5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58-11·07) of all deaths (8·52% [6·19-10·47] were cold-related and 0·91% [0·56-1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60-87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000-03 to 2016-19, the global cold-related excess death ratio changed by -0·51 percentage points (95% eCI -0·61 to -0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13-0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe. INTERPRETATION Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios. FUNDING Australian Research Council and the Australian National Health and Medical Research Council.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Tingting Ye
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ala Overcenco
- Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health, Chisinau, Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Ariana Zeka
- Institute of Environment, Health and Societies, Brunel University London, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Caroline Ameling
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | | | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Danny Houthuijs
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Dominic Royé
- CIBER of Epidemiology and Public Health, Madrid, Spain; Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | | | | | | | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK; Department of Statistics, Computer Science and Applications G. Parenti, University of Florence, Florence, Italy
| | - Gabriel Carrasco-Escobar
- Health Innovation Lab, Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California, San Diego, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research and Biocenter Oulu, University of Oulu, Oulu, Finland; Finnish Meteorological Institute, Helsinki, Finland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece; School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Martina S Ragettli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mathilde Pascal
- Department of Environmental and Occupational Health, Santé Publique France, French National Public Health Agency, Saint Maurice, France
| | | | | | - Niilo Ryti
- Center for Environmental and Respiratory Health Research and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Patrick Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | | | - Rosana Abrutzky
- Instituto de Investigaciones Gino Germani, Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Shilpa Rao
- Norwegian institute of Public Health, Oslo, Norway
| | | | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - Veronika Huber
- Potsdam Institute for Climate Impact Research, Potsdam, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yue Leon Guo
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, NTU College of Medicine and NTU Hospital, National Taiwan University, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, NTU College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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