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Browsing by Author "Ryti, Niilo"

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  • Comparison of weather station and climate reanalysis data for modelling temperature-related mortality
    Publication . Mistry, Malcolm N.; Schneider, Rochelle; Masselot, Pierre; Royé, Dominic; Armstrong, Ben; Kyselý, Jan; Orru, Hans; Sera, Francesco; Tong, Shilu; Lavigne, Éric; Urban, Aleš; Madureira, Joana; García-León, David; Ibarreta, Dolores; Ciscar, Juan-Carlos; Feyen, Luc; de Schrijver, Evan; de Sousa Zanotti Stagliorio Coelho, Micheline; Pascal, Mathilde; Tobias, Aurelio; Alahmad, Barrak; Abrutzky, Rosana; Saldiva, Paulo Hilario Nascimento; Correa, Patricia Matus; Orteg, Nicolás Valdés; Kan, Haidong; Osorio, Samuel; Indermitte, Ene; Jaakkola, Jouni J.K.; Ryti, Niilo; Schneider, Alexandra; Huber, Veronika; Katsouyanni, Klea; Analitis, Antonis; Entezari, Alireza; Mayvaneh, Fatemeh; Michelozzi, Paola; de’Donato, Francesca; Hashizume, Masahiro; Kim, Yoonhee; Diaz, Magali Hurtado; De la Cruz Valencia, César; Overcenco, Ala; Houthuijs, Danny; Ameling, Caroline; Rao, Shilpa; Seposo, Xerxes; Nunes, Baltazar; Holobaca, Iulian-Horia; Kim, Ho; Lee, Whanhee; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Ragettli, Martina S.; Guo, Yue-Liang Leon; Chen, Bing-Yu; Colistro, Valentina; Zanobetti, Antonella; Schwartz, Joel; Dang, Tran Ngoc; Van Dung, Do; Guo, Yuming; Vicedo-Cabrera, Ana M.; Gasparrini, Antonio
    Epidemiological analyses of health risks associated with non-optimal temperature are traditionally based on ground observations from weather stations that offer limited spatial and temporal coverage. Climate reanalysis represents an alternative option that provide complete spatio-temporal exposure coverage, and yet are to be systematically explored for their suitability in assessing temperature-related health risks at a global scale. Here we provide the first comprehensive analysis over multiple regions to assess the suitability of the most recent generation of reanalysis datasets for health impact assessments and evaluate their comparative performance against traditional station-based data. Our findings show that reanalysis temperature from the last ERA5 products generally compare well to station observations, with similar non-optimal temperature-related risk estimates. However, the analysis offers some indication of lower performance in tropical regions, with a likely underestimation of heat-related excess mortality. Reanalysis data represent a valid alternative source of exposure variables in epidemiological analyses of temperature-related risk.
    2022-03-25Journal article Open access Show more
  • Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study
    Publication . Choi, Hayon Michelle; Lee, Whanhee; Roye, Dominic; Heo, Seulkee; Urban, Aleš; Entezari, Alireza; Vicedo-Cabrera, Ana Maria; Zanobetti, Antonella; Gasparrini, Antonio; Analitis, Antonis; Tobias, Aurelio; Armstrong, Ben; Forsberg, Bertil; Íñiguez, Carmen; Åström, Christofer; Indermitte, Ene; Lavigne, Eric; Mayvaneh, Fatemeh; Acquaotta, Fiorella; Sera, Francesco; Orru, Hans; Kim, Ho; Kyselý, Jan; Madueira, Joana; Schwartz, Joel; Jaakkola, Jouni J.K.; Katsouyanni, Klea; Diaz, Magali Hurtado; Ragettli, Martina S.; Pascal, Mathilde; Ryti, Niilo; Scovronick, Noah; Osorio, Samuel; Tong, Shilu; Seposo, Xerxes; Guo, Yue Leon; Guo, Yuming; Bell, Michelle L.
    Background: Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting. Methods: We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations. Findings: Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries. Interpretation: Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change.
    2022-10Journal article Open access Show more
  • Excess mortality attributed to heat and cold: a health impact assessment study in 854 cities in Europe
    Publication . Masselot, Pierre; Mistry, Malcolm; Vanoli, Jacopo; Schneider, Rochelle; Iungman, Tamara; Garcia-Leon, David; Ciscar, Juan-Carlos; Feyen, Luc; Orru, Hans; Urban, Aleš; Breitner, Susanne; Huber, Veronika; Schneider, Alexandra; Samoli, Evangelia; Stafoggia, Massimo; de’Donato, Francesca; Rao, Shilpa; Armstrong, Ben; Nieuwenhuijsen, Mark; Vicedo-Cabrera, Ana Maria; Gasparrini, Antonio; Achilleos, Souzana; Kyselý, Jan; Indermitte, Ene; Jaakkola, Jouni J.K.; Ryti, Niilo; Pascal, Mathilde; Katsouyanni, Klea; Analitis, Antonis; Goodman, Patrick; Zeka, Ariana; Michelozzi, Paola; Houthuijs, Danny; Ameling, Caroline; Silva, Susana; Madureira, Joana; Holobaca, Iulian-Horia; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Ragettli, Martina S.; Surname, First name; Zafeiratou, Sofia; Vazquez Fernandez, Liliana; Monteiro, Ana; Rai, Masna; Zhang, Siqi; Aunan, Kristin
    Background: Heat and cold are established environmental risk factors for human health. However, mapping the related health burden is a difficult task due to the complexity of the associations and the differences in vulnerability and demographic distributions. In this study, we did a comprehensive mortality impact assessment due to heat and cold in European urban areas, considering geographical differences and age-specific risks. Methods: We included urban areas across Europe between Jan 1, 2000, and Dec 12, 2019, using the Urban Audit dataset of Eurostat and adults aged 20 years and older living in these areas. Data were extracted from Eurostat, the Multi-country Multi-city Collaborative Research Network, Moderate Resolution Imaging Spectroradiometer, and Copernicus. We applied a three-stage method to estimate risks of temperature continuously across the age and space dimensions, identifying patterns of vulnerability on the basis of city-specific characteristics and demographic structures. These risks were used to derive minimum mortality temperatures and related percentiles and raw and standardised excess mortality rates for heat and cold aggregated at various geographical levels. Findings: Across the 854 urban areas in Europe, we estimated an annual excess of 203 620 (empirical 95% CI 180 882-224 613) deaths attributed to cold and 20 173 (17 261-22 934) attributed to heat. These corresponded to age-standardised rates of 129 (empirical 95% CI 114-142) and 13 (11-14) deaths per 100 000 person-years. Results differed across Europe and age groups, with the highest effects in eastern European cities for both cold and heat. Interpretation: Maps of mortality risks and excess deaths indicate geographical differences, such as a north-south gradient and increased vulnerability in eastern Europe, as well as local variations due to urban characteristics. The modelling framework and results are crucial for the design of national and local health and climate policies and for projecting the effects of cold and heat under future climatic and socioeconomic scenarios.
    2023-03-16Journal article Open access Show more
  • Global, regional, and national burden of heatwave-related mortality from 1990 to 2019: A three-stage modelling study
    Publication . Zhao, Qi; Li, Shanshan; Ye, Tingting; Wu, Yao; Gasparrini, Antonio; Tong, Shilu; Urban, Aleš; Vicedo-Cabrera, Ana Maria; Tobias, Aurelio; Armstrong, Ben; Royé, Dominic; Lavigne, Eric; de’Donato, Francesca; Sera, Francesco; Kan, Haidong; Schwartz, Joel; Pascal, Mathilde; Ryti, Niilo; Goodman, Patrick; Paulo Hilario Nascimento Saldiva; Bell, Michelle L.; Guo, Yuming; on behalf of the MCC Collaborative Research Network
    Background: The regional disparity of heatwave-related mortality over a long period has not been sufficiently assessed across the globe, impeding the localisation of adaptation planning and risk management towards climate change. We quantified the global mortality burden associated with heatwaves at a spatial resolution of 0.5°×0.5° and the temporal change from 1990 to 2019. Methods and findings: We collected data on daily deaths and temperature from 750 locations of 43 countries or regions, and 5 meta-predictors in 0.5°×0.5° resolution across the world. Heatwaves were defined as location-specific daily mean temperature ≥95th percentiles of year-round temperature range with duration ≥2 days. We first estimated the location-specific heatwave-mortality association. Secondly, a multivariate meta-regression was fitted between location-specific associations and 5 meta-predictors, which was in the third stage used with grid cell-specific meta-predictors to predict grid cell-specific association. Heatwave-related excess deaths were calculated for each grid and aggregated. During 1990 to 2019, 0.94% (95% CI: 0.68-1.19) of deaths [i.e., 153,078 cases (95% eCI: 109,950-194,227)] per warm season were estimated to be from heatwaves, accounting for 236 (95% eCI: 170-300) deaths per 10 million residents. The ratio between heatwave-related excess deaths and all premature deaths per warm season remained relatively unchanged over the 30 years, while the number of heatwave-related excess deaths per 10 million residents per warm season declined by 7.2% per decade in comparison to the 30-year average. Locations with the highest heatwave-related death ratio and rate were in Southern and Eastern Europe or areas had polar and alpine climates, and/or their residents had high incomes. The temporal change of heatwave-related mortality burden showed geographic disparities, such that locations with tropical climate or low incomes were observed with the greatest decline. The main limitation of this study was the lack of data from certain regions, e.g., Arabian Peninsula and South Asia. Conclusions: Heatwaves were associated with substantial mortality burden that varied spatiotemporally over the globe in the past 30 years. The findings indicate the potential benefit of governmental actions to enhance health sector adaptation and resilience, accounting for inequalities across communities.
    2024-05-14Journal article Open access Show more
  • Global, regional, and national burden of mortality associated with cold spells during 2000–19: a three-stage modelling study
    Publication . 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, Shanshan
    Background: 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.
    2024-02-06Journal article Open access Show more
  • Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study
    Publication . Zhao, Qi; Guo, Yuming; Ye, Tingting; Gasparrini, Antonio; Tong, Shilu; Overcenco, Ala; Urban, Aleš; Schneider, Alexandra; Entezari, Alireza; Vicedo-Cabrera, Ana Maria; Zanobetti, Antonella; Analitis, Antonis; Zeka, Ariana; Tobias, Aurelio; Nunes, Baltazar; Alahmad, Barrak; Armstrong, Ben; Forsberg, Bertil; Pan, Shih-Chun; Íñiguez, Carmen; Ameling, Caroline; De la Cruz Valencia, César; Åström, Christofer; Houthuijs, Danny; Dung, Do Van; Royé, Dominic; Indermitte, Ene; Lavigne, Eric; Mayvaneh, Fatemeh; Acquaotta, Fiorella; de'Donato, Francesca; Di Ruscio, Francesco; Sera, Francesco; Carrasco-Escobar, Gabriel; Kan, Haidong; Orru, Hans; Kim, Ho; Holobaca, Iulian-Horia; Kyselý, Jan; Madureira, Joana; Schwartz, Joel; Jaakkola, Jouni J.K.; Katsouyanni, Klea; Hurtado Diaz, Magali; Ragettli, Martina S.; Hashizume, Masahiro; Pascal, Mathilde; de Sousa Zanotti Stagliorio Coélho, Micheline; Valdés Ortega, Nicolás; Ryti, Niilo; Scovronick, Noah; Michelozzi, Paola; Matus Correa, Patricia; Goodman, Patrick; Nascimento Saldiva, Paulo Hilario; Abrutzky, Rosana; Osorio, Samuel; Rao, Shilpa; Fratianni, Simona; Dang, Tran Ngoc; Colistro, Valentina; Huber, Veronika; Lee, Whanhee; Seposo, Xerxes; Honda, Yasushi; Guo, Yue Leon; Bell, Michelle L.; Li, Shanshan
    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.
    2021-07Journal article Open access Show more
  • Heat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countries
    Publication . Rai, Masna; Stafoggia, Massimo; de'Donato, Francesca; Scortichini, Matteo; Zafeiratou, Sofia; Vazquez Fernandez, Liliana; Zhang, Siqi; Katsouyanni, Klea; Samoli, Evangelia; Rao, Shilpa; Lavigne, Eric; Guo, Yuming; Kan, Haidong; Osorio, Samuel; Kyselý, Jan; Urban, Aleš; Orru, Hans; Maasikmets, Marek; Jaakkola, Jouni J.K.; Ryti, Niilo; Pascal, Mathilde; Hashizume, Masahiro; Fook Sheng Ng, Chris; Alahmad, Barrak; Hurtado Diaz, Magali; De la Cruz Valencia, César; Nunes, Baltazar; Madureira, Joana; Scovronick, Noah; Garland, Rebecca M.; Kim, Ho; Lee, Whanhee; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Maria Vicedo-Cabrera, Ana; Ragettli, Martina S.; Leon Guo, Yue-Liang; Pan, Shih-Chun; Li, Shanshan; Gasparrini, Antonio; Sera, Francesco; Masselot, Pierre; Schwartz, Joel; Zanobetti, Antonella; Bell, Michelle L.; Schneider, Alexandra; Breitner, Susanne
    Highlights: - Heat effect modification by air pollution on cardiovascular and respiratory mortality was investigated across 482 cities.- Heat effect was seen to be significantly modified by air pollutants PM10, PM2.5, O3, and NO2. -This study is the most extensive research to date investigating the heat effect modification on cardiovascular and respiratory mortality. - This is the first-ever study to deeply investigate effect modifications by air pollutants such as PM2.5 and NO2.
    2023-02-13Journal article Open access Show more
  • Interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities: two stage time series analysis
    Publication . Liu, Cong; Chen, Renjie; Sera, Francesco; Vicedo-Cabrera, Ana Maria; Guo, Yuming; Tong, Shilu; Lavigne, Eric; Correa, Patricia Matus; Ortega, Nicolás Valdés; Achilleos, Souzana; Roye, Dominic; Jaakkola, Jouni J.K.; Ryti, Niilo; Pascal, Mathilde; Schneider, Alexandra; Breitner, Susanne; Entezari, Alireza; Mayvaneh, Fatemeh; Raz, Raanan; Honda, Yasushi; Hashizume, Masahiro; Ng, Chris Fook Sheng; Gaio, Vânia; Madureira, Joana; Holobaca, Iulian-Horia; Tobias, Aurelio; Íñiguez, Carmen; Guo, Yue Leon; Pan, Shih-Chun; Masselot, Pierre; Bell, Michelle L.; Zanobetti, Antonella; Schwartz, Joel; Gasparrini, Antonio; Kan, Haidong
    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.
    2023-10-04Journal article Restricted access Show more
  • Joint effect of heat and air pollution on mortality in 620 cities of 36 countries
    Publication . Stafoggia, Massimo; Michelozzi, Paola; Schneider, Alexandra; Armstrong, Ben; Scortichini, Matteo; Rai, Masna; Achilleos, Souzana; Alahmad, Barrak; Analitis, Antonis; Åström, Christofer; Bell, Michelle L.; Calleja, Neville; Krage Carlsen, Hanne; Carrasco, Gabriel; Paul Cauchi, John; DSZS Coelho, Micheline; Correa, Patricia M.; Diaz, Magali H.; Entezari, Alireza; Forsberg, Bertil; Garland, Rebecca M.; Leon Guo, Yue; Guo, Yuming; Hashizume, Masahiro; Holobaca, Iulian H.; Íñiguez, Carmen; Jaakkola, Jouni J.K.; Kan, Haidong; Katsouyanni, Klea; Kim, Ho; Kyselý, Jan; Lavigne, Eric; Lee, Whanhee; Li, Shanshan; Maasikmets, Marek; Madureira, Joana; Mayvaneh, Fatemeh; Fook Sheng Ng, Chris; Nunes, Baltazar; Orru, Hans; V Ortega, Nicolás; Osorio, Samuel; Palomares, Alfonso D.L.; Pan, Shih-Chun; Pascal, Mathilde; Ragettli, Martina S; Rao, Shilpa; Raz, Raanan; Roye, Dominic; Ryti, Niilo; HN Saldiva, Paulo; Samoli, Evangelia; Schwartz, Joel; Scovronick, Noah; Sera, Francesco; Tobias, Aurelio; Tong, Shilu; DLC Valencia, César; Maria Vicedo-Cabrera, Ana; Urban, Aleš; Gasparrini, Antonio; Breitner, Susanne; de' Donato, Francesca K.
    Background: The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. Objectives: To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. Methods: We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. Results: We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. Conclusions: Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
    2023-10-10Journal article Open access Show more
  • Rainfall events and daily mortality across 645 global locations: two stage time series analysis
    Publication . 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. Alexandra
    Objective: 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.
    2024-10-09Journal article Open access Show more