Background: the systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias. Methods: we evaluated the associations of inhalable particulate matter (PM) with an aerodynamic diameter of 10 μm or less (PM10) and fine PM with an aerodynamic diameter of 2.5 μm or less (PM2.5) with daily all-cause, cardiovascular, and respiratory mortality across multiple countries or regions. Daily data on mortality and air pollution were collected from 652 cities in 24 countries or regions. We used overdispersed generalized additive models with random-effects meta-analysis to investigate the associations. Two-pollutant models were fitted to test the robustness of the associations. Concentration-response curves from each city were pooled to allow global estimates to be derived. Results: on average, an increase of 10 μg per cubic meter in the 2-day moving average of PM10 concentration, which represents the average over the current and previous day, was associated with increases of 0.44% (95% confidence interval [CI], 0.39 to 0.50) in daily all-cause mortality, 0.36% (95% CI, 0.30 to 0.43) in daily cardiovascular mortality, and 0.47% (95% CI, 0.35 to 0.58) in daily respiratory mortality. The corresponding increases in daily mortality for the same change in PM2.5 concentration were 0.68% (95% CI, 0.59 to 0.77), 0.55% (95% CI, 0.45 to 0.66), and 0.74% (95% CI, 0.53 to 0.95). These associations remained significant after adjustment for gaseous pollutants. Associations were stronger in locations with lower annual mean PM concentrations and higher annual mean temperatures. The pooled concentration-response curves showed a consistent increase in daily mortality with increasing PM concentration, with steeper slopes at lower PM concentrations. Conclusions: our data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies. (Funded by the National Natural Science Foundation of China and others.)
Auteur : Liu Cong, Chen Renjie, Sera Francesco, Vicedo-Cabrera Ana M., Guo Yuming, Tong Shilu, Coelho Micheline S.Z.S, Saldiva Paulo H.N, Lavigne Eric, Matus Patricia, Valdes Ortega Nicolas, Osorio Garcia Samuel, Pascal Mathilde, Stafoggia Massimo, Scortichini Matteo, Hashizume Masahiro, Honda Yasushi, Hurtado-Díaz Magali, Cruz Julio, Nunes Baltazar, Teixeira João P, Kim Ho, Tobias Aurelio, Íñiguez Carmen, Forsberg Bertil, Åström Christofer, Ragettli Martina S, Guo Yue-Leon, Chen Bing-Yu, Bell Michelle L, Wright Caradee Y, Scovronick Noah, Garland Rebecca M., Milojevic Ai, Kyselý Jan, Urban Aleš, Orru Hans, Indermitte Ene, Jaakkola Jouni J.K., Ryti Niilo R.I., Katsouyanni Klea, Analitis Antonis, Zanobetti Antonella, Schwartz Joel, Chen Jianmin, Wu Tangchun, Cohen Aaron, Gasparrini Antonio, Kan Haidong
The New England journal of medicine, 2019, vol. 381, n°. 8, p. 705-715
