Dataset Information

Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries.

ABSTRACT:

Objective

To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide.

Design

Two stage time series analysis.

Setting

406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network.

Population

Deaths for all causes or for external causes only registered in each city within the study period. MAIN OUTCOME MEASURES: Daily total mortality (all or non-external causes only).

Results

A total of 45?165?171 deaths were analysed in the 406 cities. On average, a 10 µg/m³ increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m³) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12?840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 µg/m³), corresponding to 6262 annual excess deaths (1413 to 11?065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively.

Conclusions

Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.

SUBMITTER: Vicedo-Cabrera AM

PROVIDER: S-EPMC7190035 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries.

Vicedo-Cabrera Ana M AM Sera Francesco F Liu Cong C Armstrong Ben B Milojevic Ai A Guo Yuming Y Tong Shilu S Lavigne Eric E Kyselý Jan J Urban Aleš A Orru Hans H Indermitte Ene E Pascal Mathilde M Huber Veronika V Schneider Alexandra A Katsouyanni Klea K Samoli Evangelia E Stafoggia Massimo M Scortichini Matteo M Hashizume Masahiro M Honda Yasushi Y Ng Chris Fook Sheng CFS Hurtado-Diaz Magali M Cruz Julio J Silva Susana S Madureira Joana J Scovronick Noah N Garland Rebecca M RM Kim Ho H Tobias Aurelio A Íñiguez Carmen C Forsberg Bertil B Åström Christofer C Ragettli Martina S MS Röösli Martin M Guo Yue-Liang Leon YL Chen Bing-Yu BY Zanobetti Antonella A Schwartz Joel J Bell Michelle L ML Kan Haidong H Gasparrini Antonio A

BMJ (Clinical research ed.) 20200210

<h4>Objective</h4>To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide.<h4>Design</h4>Two stage time series analysis.<h4>Setting</h4>406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network.<h4>Population</h4>Deaths for all causes or for external causes only registered in each city within the study period<b>.</b> MAIN OUTCOME ...[more]

PMID: 32041707

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Project description:BackgroundIncreased 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.MethodsIn 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.FindingsAn 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).InterpretationGlobally, 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.FundingAustralian Research Council, Australian National Health & Medical Research Council.

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Dataset Information

Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries.

Objective

Design

Setting

Population

Results

Conclusions

Publications

Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries.

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