Autor(es):
Schwarz, Maximilian ; Peters, Annette ; Stafoggia, Massimo ; de'Donato, Francesca ; Sera, Francesco ; Bell, Michelle L ; Guo, Yuming ; Honda, Yasushi ; Huber, Veronika ; Jaakkola, Jouni J.K. ; Urban, Aleš ; Vicedo-Cabrera, Ana Maria ; Masselot, Pierre ; Lavigne, Eric ; Achilleos, Souzana ; Kyselý, Jan ; Samoli, Evangelia ; Hashizume, Masahiro ; Fook Sheng Ng, Chris ; Silva, Susana ; Madureira, Joana ; Garland, Rebecca M. ; Tobias, Aurelio ; Armstrong, Ben ; Schwartz, Joel ; Gasparrini, Antonio ; Schneider, Alexandra ; Breitner, Susanne ; Kan, Haidong ; Osorio, Samuel ; Orru, Hans ; Indermitte, Ene ; Maasikmets, Marek ; Ryti, Niilo ; Pascal, Mathilde ; Katsouyanni, Klea ; Analitis, Antonis ; Entezari, Alireza ; Mayvaneh, Fatemeh ; Kim, Yoonhee ; Alahmad, Barrak ; Hurtado Diaz, Magali ; Félix Arellano, Eunice Elizabeth ; Rao, Shilpa ; Diz-Lois Palomares, Alfonso ; Scovronick, Noah ; Acquaotta, Fiorella ; Kim, Ho ; Lee, Whanhee ; Íñiguez, Carmen ; Forsberg, Bertil ; Ragettli, Martina S. ; Guo, Yue Leon ; Pan, Shih-Chun ; Li, Shanshan ; Zanobetti, Antonella
Data: 2024
Identificador Persistente: http://hdl.handle.net/10400.18/10462
Origem: Repositório Científico do Instituto Nacional de Saúde
Assunto(s): Mortality; Short-Term Effects; MCC; Air Pollution; Determinantes da Saúde e da Doença; Environmental Exposure; Nitrogen Dioxide; Cardiovascular Diseases; Respiratory Tract Diseases; Europe; Avaliação do Risco
Descrição
Background: Ambient air pollution, including particulate matter (such as PM10 and PM2·5) and nitrogen dioxide (NO2), has been linked to increases in mortality. Whether populations' vulnerability to these pollutants has changed over time is unclear, and studies on this topic do not include multicountry analysis. We evaluated whether changes in exposure to air pollutants were associated with changes in mortality effect estimates over time. Methods: We extracted cause-specific mortality and air pollution data collected between 1995 and 2016 from the Multi-Country Multi-City (MCC) Collaborative Research Network database. We applied a two-stage approach to analyse the short-term effects of NO2, PM10, and PM2·5 on cause-specific mortality using city-specific time series regression analyses and multilevel random-effects meta-analysis. We assessed changes over time using a longitudinal meta-regression with time as a linear fixed term and explored potential sources of heterogeneity and two-pollutant models. Findings: Over 21·6 million cardiovascular and 7·7 million respiratory deaths in 380 cities across 24 countries over the study period were included in the analysis. All three air pollutants showed decreasing concentrations over time. The pooled results suggested no significant temporal change in the effect estimates per unit exposure of PM10, PM2·5, or NO2 and mortality. However, the risk of cardiovascular mortality increased from 0·37% (95% CI -0·05 to 0·80) in 1998 to 0·85% (0·55 to 1·16) in 2012 with a 10 μg/m3 increase in PM2·5. Two-pollutant models generally showed similar results to single-pollutant models for PM fractions and indicated temporal differences for NO2. Interpretation: Although air pollution levels decreased during the study period, the effect sizes per unit increase in air pollution concentration have not changed. This observation might be due to the composition, toxicity, and sources of air pollution, as well as other factors, such as socioeconomic determinants or changes in population distribution and susceptibility.
Questions answered in this article: - How do the findings from different countries regarding air pollution effects on mortality vary?; - What is the significance of this multicountry, multicity study in understanding air pollution effects over time?; - What exploratory secondary analyses were conducted to investigate the effects of air pollution on mortality?; - How many cities and countries were included in the analysis of air pollution effects on mortality?; - Why is it important to understand temporal trends in air pollution effects for future health estimates?
