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Browsing INSA - Artigos em revistas internacionais by Author "Acquaotta, Fiorella"
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- Extreme Temperatures and Stroke Mortality: Evidence From a Multi-Country AnalysisPublication . Alahmad, Barrak ; Khraishah, Haitham ; Kamineni, Meghana ; Royé, Dominic ; Papatheodorou, Stefania I. ; Vicedo-Cabrera, Ana Maria ; Guo, Yuming ; Lavigne, Eric ; Armstrong, Ben ; Sera, Francesco ; Bernstein, Aaron S. ; Zanobetti, Antonella ; Garshick, Eric ; Schwartz, Joel ; Bell, Michelle L. ; Al-Mulla, Fahd; Koutrakis, Petros ; Gasparrini, Antonio ; Souzana, Achilleos ; Acquaotta, Fiorella ; Pan, Shih-Chun ; Coelho, Micheline Sousa Zanotti Stagliorio ; Colistro, Valentina ; Dang, Tran Ngoc ; Van Dung, Do ; De’ Donato, Francesca K. ; Entezari, Alireza ; Leon Guo, Yue-Liang ; Hashizume, Masahiro ; Honda, Yasushi ; Indermitte, Ene ; Íñiguez, Carmen; Jaakkola, Jouni J.K. ; Kim, Ho ; Lee, Whanhee; Li, Shanshan ; Madureira, Joana ; Mayvaneh, Fatemeh ; Orru, Hans ; Overcenco, Ala ; Ragettli, Martina S. ; Ryti, Niilo R.I. ; Saldiva, Paulo Hilario Nascimento; Scovronick, Noah ; Seposo, Xerxes ; das Neves Pereira da Silva, Susana; Stafoggia, Massimo ; Tobias, AurelioBackground: Extreme temperatures contribute significantly to global mortality. While previous studies on temperature and stroke-specific outcomes presented conflicting results, these studies were predominantly limited to single-city or single-country analyses. Their findings are difficult to synthesize due to variations in methodologies and exposure definitions. Methods: Within the Multi-Country Multi-City Network, we built a new mortality database for ischemic and hemorrhagic stroke. Applying a unified analysis protocol, we conducted a multinational case-crossover study on the relationship between extreme temperatures and stroke. In the first stage, we fitted a conditional quasi-Poisson regression for daily mortality counts with distributed lag nonlinear models for temperature exposure separately for each city. In the second stage, the cumulative risk from each city was pooled using mixed-effect meta-analyses, accounting for clustering of cities with similar features. We compared temperature-stroke associations across country-level gross domestic product per capita. We computed excess deaths in each city that are attributable to the 2.5% hottest and coldest of days based on each city's temperature distribution. Results: We collected data for a total of 3 443 969 ischemic strokes and 2 454 267 hemorrhagic stroke deaths from 522 cities in 25 countries. For every 1000 ischemic stroke deaths, we found that extreme cold and hot days contributed 9.1 (95% empirical CI, 8.6-9.4) and 2.2 (95% empirical CI, 1.9-2.4) excess deaths, respectively. For every 1000 hemorrhagic stroke deaths, extreme cold and hot days contributed 11.2 (95% empirical CI, 10.9-11.4) and 0.7 (95% empirical CI, 0.5-0.8) excess deaths, respectively. We found that countries with low gross domestic product per capita were at higher risk of heat-related hemorrhagic stroke mortality than countries with high gross domestic product per capita (P=0.02). Conclusions: Both extreme cold and hot temperatures are associated with an increased risk of dying from ischemic and hemorrhagic strokes. As climate change continues to exacerbate these extreme temperatures, interventional strategies are needed to mitigate impacts on stroke mortality, particularly in low-income countries.
- Global, regional, and national burden of mortality associated with cold spells during 2000–19: a three-stage modelling studyPublication . Gao, Yuan; Huang, Wenzhong; Zhao, Qi; Ryti, Niilo; Armstrong, Ben; Gasparrini, Antonio; Tong, Shilu; Pascal, Mathilde; Urban, Aleš; Zeka, Ariana; Lavigne, Eric; Madureira, Joana; Goodman, Patrick; Huber, Veronika; Forsberg, Bertil; Kyselý, Jan; Sera, Francesco; Guo, Yuming; Li, Shanshan; Gao, Yuan; Huang, Wenzhong; Zhao, Qi; Ryti, Niilo; Armstrong, Ben; Gasparrini, Antonio; Tong, Shilu; Pascal, Mathilde; Urban, Aleš; Zeka, Ariana; Lavigne, Eric; Madureira, Joana; Goodman, Patrick; Huber, Veronika; Forsberg, Bertil; Kyselý, Jan; Sera, Francesco; Bell, Michelle; Simon Hales; Honda, Yasushi; Jaakkola, Jouni J.K.; Tobias, Aurelio; Vicedo-Cabrera, Ana Maria; Abrutzky, Rosana; Coelho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Correa, Patricia Matus; Ortega, Nicolás Valdés; Kan, Haidong; Osorio, Samuel; Roye, Dominic; Orru, Hans; Indermitte, Ene; Schneider, Alexandra; Katsouyanni, Klea; Analitis, Antonis; Carlsen, Hanne Krage; Mayvaneh, Fatemeh; Roradeh, Hematollah; Raz, Raanan; Michelozzi, Paola; de'Donato, Francesca; Hashizume, Masahiro; Kim, Yoonhee; Alahmad, Barrak; Cauchy, John Paul; Diaz, Magali Hurtado; Arellano, Eunice Elizabeth Félix; Valencia, César De la Cruz; Overcenco, Ala; Houthuijs, Danny; Ameling, Caroline; Rao, Shilpa; Carrasco, Gabriel; Seposo, Xerxes; Chua, Paul Lester Carlos; Silva, Susana das Neves Pereira da; Nunes, Baltazar; Holobaca, Iulian-Horia; Cvijanovic, Ivana; Mistry, Malcolm; Scovronick, Noah; Acquaotta, Fiorella; Kim, Ho; Lee, Whanhee; Íñiguez, Carmen; Åström, Christofer; Ragettli, Martina S.; Guo, Yue Leon; Pan, Shih-Chun; Colistro, Valentina; Zanobetti, Antonella; Schwartz, Joel; Dang, Tran Ngoc; Dung, Do Van; Guo, Yuming; Li, ShanshanBackground: Exposure to cold spells is associated with mortality. However, little is known about the global mortality burden of cold spells. Methods: A three-stage meta-analytical method was used to estimate the global mortality burden associated with cold spells by means of a time series dataset of 1960 locations across 59 countries (or regions). First, we fitted the location-specific, cold spell-related mortality associations using a quasi-Poisson regression with a distributed lag non-linear model with a lag period of up to 21 days. Second, we built a multivariate meta-regression model between location-specific associations and seven predictors. Finally, we predicted the global grid-specific cold spell-related mortality associations during 2000-19 using the fitted meta-regression model and the yearly grid-specific meta-predictors. We calculated the annual excess deaths, excess death ratio (excess deaths per 1000 deaths), and excess death rate (excess deaths per 100 000 population) due to cold spells for each grid across the world. Findings: Globally, 205 932 (95% empirical CI [eCI] 162 692-250 337) excess deaths, representing 3·81 (95% eCI 2·93-4·71) excess deaths per 1000 deaths (excess death ratio), and 3·03 (2·33-3·75) excess deaths per 100 000 population (excess death rate) were associated with cold spells per year between 2000 and 2019. The annual average global excess death ratio in 2016-19 increased by 0·12 percentage points and the excess death rate in 2016-19 increased by 0·18 percentage points, compared with those in 2000-03. The mortality burden varied geographically. The excess death ratio and rate were highest in Europe, whereas these indicators were lowest in Africa. Temperate climates had higher excess death ratio and rate associated with cold spells than other climate zones. Interpretation: Cold spells are associated with substantial mortality burden around the world with geographically varying patterns. Although the number of cold spells has on average been decreasing since year 2000, the public health threat of cold spells remains substantial. The findings indicate an urgency of taking local and regional measures to protect the public from the mortality burdens of cold spells. Funding: Australian Research Council, Australian National Health and Medical Research Council, EU's Horizon 2020 Project Exhaustion.
- Rainfall events and daily mortality across 645 global locations: two stage time series analysisPublication . He, Cheng; Breitner-Busch, Susanne; Huber, Veronika; Chen, Kai; Zhang, Siqi; Gasparrini, Antonio; Bell, Michelle; Kan, Haidong; Royé, Dominic; Armstrong, Ben; Schwartz, Joel; Sera, Francesco; Vicedo-Cabrera, Ana Maria; Honda, Yasushi; Jaakkola, Jouni J.K.; Ryti, Niilo; Kyselý, Jan; Guo, Yuming; Tong, Shilu; de’Donato, Francesca; Michelozzi, Paola; Coelho, Micheline de Sousa Zanotti Staglior; Saldiva, Paulo Hilario Nascimento; Lavigne, Eric; Orru,Hans; Indermitte, Ene; Pascal, Mathilde; Goodman, Patrick; Zeka, Ariana; Kim, Yoonhee; Diaz, Magali Hurtado; Arellano, Eunice Elizabeth Félix; Overcenco, Ala; Klompmaker, Jochem; Rao, Shilpa; Palomares, Alfonso Diz-Lois; Carrasco, Gabriel; Seposo, Xerxes; das Neves Pereira da Silva, Susana; Joana Madureira; Holobaca, Iulian-Horia; Scovronick, Noah; Acquaotta, Fiorella; Kim, Ho; Lee, Whanhee; Hashizume, Masahiro; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Ragettli, Martina S.; Guo, Yue Leon; Pan, Shih-Chun; Osorio, Samuel; Li, Shanshan; Zanobetti, Antonella; Dang, Tran Ngoc; Dung, Do Van; Schneider. AlexandraObjective: To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. Design: Two stage time series analysis. Setting: 645 locations across 34 countries or regions. Population: Daily mortality data, comprising a total of 109 954 744 all cause, 31 164 161 cardiovascular, and 11 817 278 respiratory deaths from 1980 to 2020. Main outcome measure: Association between daily mortality and rainfall events with return periods (the expected average time between occurrences of an extreme event of a certain magnitude) of one year, two years, and five years, with a 14 day lag period. A continuous relative intensity index was used to generate intensity-response curves to estimate mortality risks at a global scale. Results: During the study period, a total of 50 913 rainfall events with a one year return period, 8362 events with a two year return period, and 3301 events with a five year return period were identified. A day of extreme rainfall with a five year return period was significantly associated with increased daily all cause, cardiovascular, and respiratory mortality, with cumulative relative risks across 0-14 lag days of 1.08 (95% confidence interval 1.05 to 1.11), 1.05 (1.02 to 1.08), and 1.29 (1.19 to 1.39), respectively. Rainfall events with a two year return period were associated with respiratory mortality only, whereas no significant associations were found for events with a one year return period. Non-linear analysis revealed protective effects (relative risk <1) with moderate-heavy rainfall events, shifting to adverse effects (relative risk >1) with extreme intensities. Additionally, mortality risks from extreme rainfall events appeared to be modified by climate type, baseline variability in rainfall, and vegetation coverage, whereas the moderating effects of population density and income level were not significant. Locations with lower variability of baseline rainfall or scarce vegetation coverage showed higher risks. Conclusion: Daily rainfall intensity is associated with varying health effects, with extreme events linked to an increasing relative risk for all cause, cardiovascular, and respiratory mortality. The observed associations varied with local climate and urban infrastructure.
- Regional variation in the role of humidity on city-level heat-related mortalityPublication . Guo, Qiang; Mistry, Malcolm N.; Zhou, Xudong; Zhao, Gang; Kino, Kanon; Wen, Bo; Yoshimura, Kei; Satoh, Yusuke; Cvijanovic, Ivana; Kim, Yoonhee; Ng, Chris Fook Sheng; Vicedo-Cabrera, Ana M.; Armstrong, Ben; Urban, Aleš; Katsouyanni, Klea; Masselot, Pierre; Tong, Shilu; Sera, Francesco; Huber, Veronika; Bell, Michelle L.; Kyselý, Jan; Gasparrini, Antonio; Hashizume, Masahiro; Oki, Taikan; Abrutzky, Rosana; Guo, Yuming; de Sousa Zanotti Stagliorio Coelho, Micheline; Nascimento Saldiva, Paulo Hilario; Lavigne, Eric; Ortega, Nicolás Valdés; Correa, Patricia Matus; Kan, Haidong; Osorio, Samuel; Roye, Dominic; Indermitte, Ene; Orru, Hans; Jaakkola, Jouni J K.; Ryti, Niilo; Pascal, Mathilde; Schneider, Alexandra; Analitis, Antonis; Entezari, Alireza; Mayvaneh, Fatemeh; Zeka, Ariana; Goodman, Patrick; de'Donato, Francesca; Michelozzi, Paola; Alahmad, Barrak; De la Cruz Valencia, César; Hurtado Diaz, Magali; Overcenco, Ala; Ameling, Caroline; Houthuijs, Danny; Rao, Shilpa; Carrasco, Gabriel; Seposo, Xerxes; Madureira, Joana; Silva, Susana; Holobaca, Iulian-Horia; Acquaotta, Fiorella; Scovronick, Noah; Kim, Ho; Lee, Whanhee; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Ragettli, Martina S.; Pan, Shih-Chun; Guo, Yue Leon; Li, Shanshan; Schneider, Rochelle; Colistro, Valentina; Zanobetti, Antonella; Schwartz, Joel; Van Dung, Do; Ngoc Dang, Tran; Honda, YasushiThe rising humid heat is regarded as a severe threat to human survivability, but the proper integration of humid heat into heat-health alerts is still being explored. Using state-of-the-art epidemiological and climatological datasets, we examined the association between multiple heat stress indicators (HSIs) and daily human mortality in 739 cities worldwide. Notable differences were observed in the long-term trends and timing of heat events detected by HSIs. Air temperature (Tair) predicts heat-related mortality well in cities with a robust negative Tair-relative humidity correlation (CT-RH). However, in cities with near-zero or weak positive CT-RH, HSIs considering humidity provide enhanced predictive power compared to Tair. Furthermore, the magnitude and timing of heat-related mortality measured by HSIs could differ largely from those associated with Tair in many cities. Our findings provide important insights into specific regions where humans are vulnerable to humid heat and can facilitate the further enhancement of heat-health alert systems.
- Temperature frequency and mortality: Assessing adaptation to local temperaturePublication . Wu, Yao; Wen, Bo; Gasparrini, Antonio; Armstrong, Ben; Sera, Francesco; Lavigne, Eric; Li, Shanshan; Guo, Yuming; Overcenco, Ala; Urban, Aleš; Schneider, Alexandra; Entezari, Alireza; Vicedo-Cabrera, Ana Maria; Zanobetti, Antonella; Analitis, Antonis; Zeka, Ariana; Tobias, Aurelio; Nunes, Baltazar; Alahmad, Barrak; Forsberg, Bertil; Íñiguez, Carmen; Ameling, Caroline; Cruz Valencia, César De la; Houthuijs, Danny; Dung, Do Van; Roye, Dominic; Indermitte, Ene; Mayvaneh, Fatemeh; Acquaotta, Fiorella; de'Donato, Francesca; Carrasco-Escobar, Gabriel; Kan, Haidong; Carlsen, Hanne Krage; Orru, Hans; Kim, Ho; Holobaca, Iulian-Horia; Kyselý, Jan; Madureira, Joana; Schwartz, Joel; Jaakkola, Jouni J.K.; Katsouyanni, Klea; Diaz, Magali Hurtado; Ragettli, Martina S.; Hashizume, Masahiro; Pascal, Mathilde; Coelho, Micheline de Sousa Zanotti Stagliorio; Ortega, Nicolás Valdés; Ryti, Niilo; Scovronick, Noah; Michelozzi, Paola; Correa, Patricia Matus; Goodman, Patrick; Saldiva, Paulo Hilario Nascimento; Raz, Raanan; Abrutzky, Rosana; Osorio, Samuel; Pan, Shih-Chun; Rao, Shilpa; Tong, Shilu; Achilleos, Souzana; Dang, Tran Ngoc; Colistro, Valentina; Huber, Veronika; Lee, Whanhee; Seposo, Xerxes; Honda, Yasushi; Kim, Yoonhee; Guo, Yue Leon; Li, Shanshan; Guo, YumingAssessing the association between temperature frequency and mortality can provide insights into human adaptation to local ambient temperatures. We collected daily time-series data on mortality and temperature from 757 locations in 47 countries/regions during 1979–2020. We used a two-stage time series design to assess the association between temperature frequency and all-cause mortality. The results were pooled at the national, regional, and global levels. We observed a consistent decrease in the risk of mortality as the normalized frequency of temperature increases across the globe. The average increase in mortality risk comparing the 10th to 100th percentile of normalized frequency was 13.03% (95% CI: 12.17–13.91), with substantial regional differences (from 4.56% in Australia and New Zealand to 33.06% in South Europe). The highest increase in mortality was observed for high-income countries (13.58%, 95% CI: 12.56–14.61), followed by lower-middle-income countries (12.34%, 95% CI: 9.27–15.51). This study observed a declining risk of mortality associated with higher temperature frequency. Our findings suggest that populations can adapt to their local climate with frequent exposure, with the adapting ability varying geographically due to differences in climatic and socioeconomic characteristics.
- Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986-2015Publication . Yang, Daewon; Hashizume, Masahiro; Tobías, Aurelio; Honda, Yasushi; Roye, Dominic; Oh, Jaemin; Dang, Tran Ngoc; Kim, Yoonhee; Abrutzky, Rosana; Guo, Yuming; Tong, Shilu; Coelho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Lavigne, Eric; Correa, Patricia Matus; Ortega, Nicolás Valdés; Osorio, Samuel; Kyselý, Jan; Urban, Aleš; Orru, Hans; Indermitte, Ene; Jaakkola, Jouni; Ryti, Niilo; Pascal, Mathilde; Huber, Veronika; Schneider, Alexandra; Katsouyanni, Klea; Analitis, Antonis; Entezari, Alireza; Mayvaneh, Fatemeh; Goodman, Patrick; Zeka, Ariana; Michelozzi, Paola; de'Donato, Francesca; Alahmad, Barrak; Diaz, Magali Hurtado; la Cruz Valencia, César De; Overcenco, Ala; Houthuijs, Danny; Ameling, Caroline; Rao, Shilpa; Nunes, Baltazar; Madureira, Joana; Holo-Bâc, Iulian Horia; Scovronick, Noah; Acquaotta, Fiorella; Kim, Ho; Lee, Whanhee; Íñiguez, Carmen; Forsberg, Bertil; Vicedo-Cabrera, Ana Maria; Ragettli, Martina S; Guo, Yue-Liang Leon; Pan, Shih Chun; Li, Shanshan; Sera, Francesco; Zanobetti, Antonella; Schwartz, Joel; Armstrong, Ben; Gasparrini, Antonio; Chung, YeonseungBackground: The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in multiple countries. Methods: Daily time-series data for mortality and ambient mean temperature for 699 communities in 34 countries spanning 1986-2015 were analyzed using a two-stage meta-analysis. First, a quasi-Poisson regression was employed to estimate MMT and MMTP for each community during the designated subperiods. Second, we pooled the community-specific temporally varying estimates using mixed-effects meta-regressions to examine temporal changes in MMT and MMTP in the entire study population, as well as by climate zone, geographical region, and country. Results: Temporal increases in MMT and MMTP from 19.5 °C (17.9, 21.1) to 20.3 °C (18.5, 22.0) and from the 74.5 (68.3, 80.6) to 75.0 (71.0, 78.9) percentiles in the entire population were found, respectively. Temporal change was significantly heterogeneous across geographical regions (P < 0.001). Temporal increases in MMT were observed in East Asia (linear slope [LS] = 0.91, P = 0.02) and South-East Asia (LS = 0.62, P = 0.05), whereas a temporal decrease in MMT was observed in South Europe (LS = -0.46, P = 0.05). MMTP decreased temporally in North Europe (LS = -3.45, P = 0.02) and South Europe (LS = -2.86, P = 0.05). Conclusions: The temporal change in MMT or MMTP was largely heterogeneous. Population susceptibility in terms of optimum temperature may have changed under a warming climate, albeit with large region-dependent variations.
- Temporal variations in the short-term effects of ambient air pollution on cardiovascular and respiratory mortality: a pooled analysis of 380 urban areas over a 22-year periodPublication . 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, AntonellaBackground: 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.