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Browsing by Author "Ryti, Niilo R.I."

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  • All-cause, cardiovascular, and respiratory mortality and wildfire-related ozone: a multicountry two-stage time series analysis
    Publication . Chen, Gongbo; Guo, Yuming; Yue, Xu; Xu, Rongbin; Yu,Wenhua; Ye, Tingting; Tong, Shilu; Gasparrini, Antonio; Bell,Michelle L.; Armstrong, Ben; Schwartz, Joel; Jaakkola, Jouni J.K.; Lavigne, Eric; Saldiva, Paulo Hilario Nascimento; Kan, Haidong; Royé, Dominic; Urban, Aleš; Vicedo-Cabrera, Ana Maria; Tobias, Aurelio; Forsberg, Bertil; Sera, Francesco; Lei, Yadong; Abramson, Michael J.; Li, Shanshan; Abrutzky, Rosana; Alahmad, Barrak; Ameling, Caroline; Åström, Christofer; Breitner, Susanne; Carrasco-Escobar, Gabriel; Coêlho, Micheline de Sousa Zanotti Stagliorio; Colistro, Valentina; Correa, Patricia Matus; Dang, Tran Ngoc; de'Donato, Francesca; Dung, Do Van; Entezari, Alireza; Garcia, Samuel David Osorio; Garland, Rebecca M.; Goodman, Patrick; Guo, Yue Leon; Hashizume, Masahiro; Holobaca, Iulian-Horia; Honda, Yasushi; Houthuijs, Danny; Hurtado-Díaz, Magali; Íñiguez, Carmen; Katsouyanni, Klea; Kim, Ho; Kyselý, Jan; Lee, Whanhee; Maasikmets, Marek; Madureira, Joana; Mayvaneh, Fatemeh; Nunes, Baltazar; Orru, Hans; Ortega, Nicol´s Valdés; Overcenco, Ala; Pan, Shih-Chun; Pascal, Mathilde; Ragettli, Martina S.; Rao, Shilpa; Ryti, Niilo R.I.; Samoli, Evangelia; Schneider, Alexandra; Scovronick, Noah; Seposo, Xerxes; Stafoggia, Massimo; Valencia, César De la Cruz; Zanobetti, Antonella; Zeka, Ariana; behalf of the Multi-Country Multi-City Collaborative Research Network
    Background: Wildfire activity is an important source of tropospheric ozone (O3) pollution. However, no study to date has systematically examined the associations of wildfire-related O3 exposure with mortality globally. Methods: We did a multicountry two-stage time series analysis. From the Multi-City Multi-Country (MCC) Collaborative Research Network, data on daily all-cause, cardiovascular, and respiratory deaths were obtained from 749 locations in 43 countries or areas, representing overlapping periods from Jan 1, 2000, to Dec 31, 2016. We estimated the daily concentration of wildfire-related O3 in study locations using a chemical transport model, and then calibrated and downscaled O3 estimates to a resolution of 0·25° × 0·25° (approximately 28 km2 at the equator). Using a random-effects meta-analysis, we examined the associations of short-term wildfire-related O3 exposure (lag period of 0-2 days) with daily mortality, first at the location level and then pooled at the country, regional, and global levels. Annual excess mortality fraction in each location attributable to wildfire-related O3 was calculated with pooled effect estimates and used to obtain excess mortality fractions at country, regional, and global levels. Findings: Between 2000 and 2016, the highest maximum daily wildfire-related O3 concentrations (≥30 μg/m3) were observed in locations in South America, central America, and southeastern Asia, and the country of South Africa. Across all locations, an increase of 1 μg/m3 in the mean daily concentration of wildfire-related O3 during lag 0-2 days was associated with increases of 0·55% (95% CI 0·29 to 0·80) in daily all-cause mortality, 0·44% (-0·10 to 0·99) in daily cardiovascular mortality, and 0·82% (0·18 to 1·47) in daily respiratory mortality. The associations of daily mortality rates with wildfire-related O3 exposure showed substantial geographical heterogeneity at the country and regional levels. Across all locations, estimated annual excess mortality fractions of 0·58% (95% CI 0·31 to 0·85; 31 606 deaths [95% CI 17 038 to 46 027]) for all-cause mortality, 0·41% (-0·10 to 0·91; 5249 [-1244 to 11 620]) for cardiovascular mortality, and 0·86% (0·18 to 1·51; 4657 [999 to 8206]) for respiratory mortality were attributable to short-term exposure to wildfire-related O3. Interpretation: In this study, we observed an increase in all-cause and respiratory mortality associated with short-term wildfire-related O3 exposure. Effective risk and smoke management strategies should be implemented to protect the public from the impacts of wildfires.
    2024-07-03Journal article Open access Show more
  • Ambient carbon monoxide and daily mortality: a global time-series study in 337 cities
    Publication . Chen, Kai; Breitner, Susanne; Wolf, Kathrin; Stafoggia, Massimo; Sera, Francesco; Vicedo-Cabrera, Ana M.; Guo, Yuming; Tong, Shilu; Lavigne, Eric; Matus, Patricia; Valdés, Nicolás; Kan, Haidong; Jaakkola, Jouni J.K.; Ryti, Niilo R.I.; Huber, Veronika; Scortichini, Matteo; Hashizume, Masahiro; Honda, Yasushi; Nunes, Baltazar; Madureira, Joana; Holobâcă, Iulian Horia; Fratianni, Simona; Kim, Ho; Lee, Whanhee; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Ragettli, Martina S-; Guo, Yue-Liang Leon; Chen, Bing-Yu; Li, Shanshan; Milojevic, Ai; Zanobetti, Antonella; Schwartz, Joel; Bell, Michelle L-; Gasparrini, Antonio; Schneider, Alexandra
    Background: Epidemiological evidence on short-term association between ambient carbon monoxide (CO) and mortality is inconclusive and limited to single cities, regions, or countries. Generalisation of results from previous studies is hindered by potential publication bias and different modelling approaches. We therefore assessed the association between short-term exposure to ambient CO and daily mortality in a multicity, multicountry setting. Methods: We collected daily data on air pollution, meteorology, and total mortality from 337 cities in 18 countries or regions, covering various periods from 1979 to 2016. All included cities had at least 2 years of both CO and mortality data. We estimated city-specific associations using confounder-adjusted generalised additive models with a quasi-Poisson distribution, and then pooled the estimates, accounting for their statistical uncertainty, using a random-effects multilevel meta-analytical model. We also assessed the overall shape of the exposure-response curve and evaluated the possibility of a threshold below which health is not affected. Findings: Overall, a 1 mg/m3 increase in the average CO concentration of the previous day was associated with a 0·91% (95% CI 0·32-1·50) increase in daily total mortality. The pooled exposure-response curve showed a continuously elevated mortality risk with increasing CO concentrations, suggesting no threshold. The exposure-response curve was steeper at daily CO levels lower than 1 mg/m3, indicating greater risk of mortality per increment in CO exposure, and persisted at daily concentrations as low as 0·6 mg/m3 or less. The association remained similar after adjustment for ozone but was attenuated after adjustment for particulate matter or sulphur dioxide, or even reduced to null after adjustment for nitrogen dioxide. Interpretation: This international study is by far the largest epidemiological investigation on short-term CO-related mortality. We found significant associations between ambient CO and daily mortality, even at levels well below current air quality guidelines. Further studies are warranted to disentangle its independent effect from other traffic-related pollutants.
    2021-04Journal article Open access Show more
  • Ambient particulate air pollution and daily mortality in 652 cities
    Publication . 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 systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias. 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. 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. 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).
    2019-08-22Journal article Restricted access Show more
  • Associations Between Extreme Temperatures and Cardiovascular Cause-Specific Mortality: Results From 27 Countries
    Publication . Alahmad, Barrak; Khraishah, Haitham; Royé, Dominic; Vicedo-Cabrera, Ana Maria; Guo, Yuming; Papatheodorou, Stefania I.; Achilleos, Souzana; Acquaotta, Fiorella; Armstrong, Ben; Bell, Michelle L.; Pan, Shih-Chun; Coelho, Micheline de Sousa Zanotti Stagliorio; Colistro, Valentina; Dang, Tran Ngoc; Dung, Do-Van; De' Donato, Francesca K.; Entezari, Alireza; Guo, Yue-Liang Leon; Hashizume, Masahiro; Honda, Yasushi; Indermitte, Ene; Íñiguez, Carmen; Jaakkola, Jouni J.K.; Kim, Ho; Lavigne, Eric; Lee, Whanhee; Li, Shanshan; Madureira, Joana; Mayvaneh, Fatemeh; Orru, Hans; Overcenco, Ala Vladimir; Ragettli, Martina S.; Ryti, Niilo R.I.; Saldiva, Paulo Hilario Nascimento; Scovronick, Noah; Seposo, Xerxes; Sera, Francesco; Silva, Susana; Stafoggia, Massimo; Tobias, Aurelio; Garshick, Eric; Bernstein, Aaron S.; Zanobetti, Antonella; Schwartz, Joel D.; Gasparrini, Antonio; Koutrakis, Petros
    Background: Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. Methods: We used unified data collection protocols within the Multi-Country Multi-City Collaborative Network to assemble a database of daily counts of specific cardiovascular causes of death from 567 cities in 27 countries across 5 continents in overlapping periods ranging from 1979 to 2019. City-specific daily ambient temperatures were obtained from weather stations and climate reanalysis models. To investigate cardiovascular mortality associations with extreme hot and cold temperatures, we fit case-crossover models in each city and then used a mixed-effects meta-analytic framework to pool individual city estimates. Extreme temperature percentiles were compared with the minimum mortality temperature in each location. Excess deaths were calculated for a range of extreme temperature days. Results: The analyses included deaths from any cardiovascular cause (32 154 935), ischemic heart disease (11 745 880), stroke (9 351 312), heart failure (3 673 723), and arrhythmia (670 859). At extreme temperature percentiles, heat (99th percentile) and cold (1st percentile) were associated with higher risk of dying from any cardiovascular cause, ischemic heart disease, stroke, and heart failure as compared to the minimum mortality temperature, which is the temperature associated with least mortality. Across a range of extreme temperatures, hot days (above 97.5th percentile) and cold days (below 2.5th percentile) accounted for 2.2 (95% empirical CI [eCI], 2.1–2.3) and 9.1 (95% eCI, 8.9–9.2) excess deaths for every 1000 cardiovascular deaths, respectively. Heart failure was associated with the highest excess deaths proportion from extreme hot and cold days with 2.6 (95% eCI, 2.4–2.8) and 12.8 (95% eCI, 12.2–13.1) for every 1000 heart failure deaths, respectively. Conclusions: Across a large, multinational sample, exposure to extreme hot and cold temperatures was associated with a greater risk of mortality from multiple common cardiovascular conditions. The intersections between extreme temperatures and cardiovascular health need to be thoroughly characterized in the present day—and especially under a changing climate.
    2022-12-12Journal article Open access Show more
  • Differential Mortality Risks Associated With PM2.5 Components: A Multi-Country, Multi-City Study
    Publication . Masselot, Pierre; Sera, Francesco; Schneider, Rochelle; Kan, Haidong; Lavigne, Éric; Stafoggia, Massimo; Tobias, Aurelio; Chen, Hong; Burnett, Richard T.; Schwartz, Joel; Zanobetti, Antonella; Bell, Michelle L.; Chen, Bing-Yu; Guo, Yue-Liang Leon; Ragettli, Martina S.; Vicedo-Cabrera, Ana Maria; Åström, Christofer; Forsberg, Bertil; Íñiguez, Carmen; Garland, Rebecca M.; Scovronick, Noah; Madureira, Joana; Nunes, Baltazar; De la Cruz Valencia, César; Hurtado Diaz, Magali; Honda, Yasushi; Hashizume, Masahiro; Ng, Chris Fook Cheng; Samoli, Evangelia; Katsouyanni, Klea; Schneider, Alexandra; Breitner, Susanne; Ryti, Niilo R.I.; Jaakkola, Jouni J.K.; Maasikmets, Marek; Orru, Hans; Guo, Yuming; Valdés Ortega, Nicolás; Matus Correa, Patricia; Tong, Shilu; Gasparrini, Antonio
    Background: The association between fine particulate matter (PM2.5) and mortality widely differs between as well as within countries. Differences in PM2.5 composition can play a role in modifying the effect estimates, but there is little evidence about which components have higher impacts on mortality. Methods: We applied a 2-stage analysis on data collected from 210 locations in 16 countries. In the first stage, we estimated location-specific relative risks (RR) for mortality associated with daily total PM2.5 through time series regression analysis. We then pooled these estimates in a meta-regression model that included city-specific logratio-transformed proportions of seven PM2.5 components as well as meta-predictors derived from city-specific socio-economic and environmental indicators. Results: We found associations between RR and several PM2.5 components. Increasing the ammonium (NH4+) proportion from 1% to 22%, while keeping a relative average proportion of other components, increased the RR from 1.0063 (95% confidence interval [95% CI] = 1.0030, 1.0097) to 1.0102 (95% CI = 1.0070, 1.0135). Conversely, an increase in nitrate (NO3-) from 1% to 71% resulted in a reduced RR, from 1.0100 (95% CI = 1.0067, 1.0133) to 1.0037 (95% CI = 0.9998, 1.0077). Differences in composition explained a substantial part of the heterogeneity in PM2.5 risk. Conclusions: These findings contribute to the identification of more hazardous emission sources. Further work is needed to understand the health impacts of PM2.5 components and sources given the overlapping sources and correlations among many components.
    2021-12-07Journal article Restricted access Show more
  • Extreme Temperatures and Stroke Mortality: Evidence From a Multi-Country Analysis
    Publication . 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, Aurelio
    Background: 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.
    2024-05-22Journal article Open access Show more
  • Geographical Variations of the Minimum Mortality Temperature at a Global Scale
    Publication . Tobías, Aurelio; Hashizume, Masahiro; Honda, Yasushi; Sera, Francesco; Ng, Chris Fook Sheng; Kim, Yoonhee; Roye, Dominic; Chung, Yeonseung; Dang, Tran Ngoc; Kim, Ho; Lee, Whanhee; Íñiguez, Carmen; Vicedo-Cabrera, Ana; Abrutzky, Rosana; Guo, Yuming; Tong, Shilu; Coelho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Lavigne, Eric; Correa, Patricia Matus; Ortega, Nicolás Valdés; Kan, Haidong; Osorio, Samuel; Kyselý, Jan; Urban, Aleš; Orru, Hans; Indermitte, Ene; Jaakkola, Jouni J.K.; Ryti, Niilo R.I.; 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; De la Cruz Valencia, César; Overcenco, Ala; Houthuijs, Danny; Ameling, Caroline; Rao, Shilpa; Di Ruscio, Francesco; Carrasco, Gabriel; Seposo, Xerxes; Nunes, Baltazar; Madureira, Joana; Holobaca, Iulian-Horia; Scovronick, Noah; Acquaotta, Fiorella; Forsberg, Bertil; Åström, Christofer; Ragettli, Martina S.; Guo, Yue-Liang Leon; Chen, Bing-Yu; Li, Shanshan; Colistro, Valentina; Zanobetti, Antonella; Schwartz, Joel; Dung, Do Van; Armstrong, Ben; Gasparrini, Antonio
    Background: Minimum mortality temperature (MMT) is an important indicator to assess the temperature-mortality association, indicating long-term adaptation to local climate. Limited evidence about the geographical variability of the MMT is available at a global scale. Methods: We collected data from 658 communities in 43 countries under different climates. We estimated temperature-mortality associations to derive the MMT for each community using Poisson regression with distributed lag nonlinear models. We investigated the variation in MMT by climatic zone using a mixed-effects meta-analysis and explored the association with climatic and socioeconomic indicators. Results: The geographical distribution of MMTs varied considerably by country between 14.2 and 31.1 °C decreasing by latitude. For climatic zones, the MMTs increased from alpine (13.0 °C) to continental (19.3 °C), temperate (21.7 °C), arid (24.5 °C), and tropical (26.5 °C). The MMT percentiles (MMTPs) corresponding to the MMTs decreased from temperate (79.5th) to continental (75.4th), arid (68.0th), tropical (58.5th), and alpine (41.4th). The MMTs indreased by 0.8 °C for a 1 °C rise in a community's annual mean temperature, and by 1 °C for a 1 °C rise in its SD. While the MMTP decreased by 0.3 centile points for a 1 °C rise in a community's annual mean temperature and by 1.3 for a 1 °C rise in its SD. Conclusions: The geographical distribution of the MMTs and MMTPs is driven mainly by the mean annual temperature, which seems to be a valuable indicator of overall adaptation across populations. Our results suggest that populations have adapted to the average temperature, although there is still more room for adaptation.
    2021-09-24Journal article Open access Show more
  • Mortality risk attributable to wildfire-related PM2·5 pollution: a global time series study in 749 locations
    Publication . Chen, Gongbo; Guo, Yuming; Yue, Xu; Tong, Shilu; Gasparrini, Antonio; Bell, Michelle L.; Armstrong, Ben; Schwartz, Joel; Jaakkola, Jouni J.K.; Zanobetti, Antonella; Lavigne, Eric; Nascimento Saldiva, Paulo Hilario; Kan, Haidong; Royé, Dominic; Milojevic, Ai; Overcenco, Ala; Urban, Aleš; Schneider, Alexandra; Entezari, Alireza; Vicedo-Cabrera, Ana Maria; Zeka, Ariana; Tobias, Aurelio; Nunes, Baltazar; Alahmad, Barrak; Forsberg, Bertil; Pan, Shih-Chun; Íñiguez, Carmen; Ameling, Caroline; De la Cruz Valencia, César; Åström, Christofer; Houthuijs, Danny; Van Dung, Do; Samoli, Evangelia; Mayvaneh, Fatemeh; Sera, Francesco; Carrasco-Escobar, Gabriel; Lei, Yadong; Orru, Hans; Kim, Ho; Holobaca, Iulian-Horia; Kyselý, Jan; Teixeira, João Paulo; Madureira, Joana; Katsouyanni, Klea; Hurtado-Díaz, Magali; Maasikmets, Marek; Ragettli, Martina S.; Hashizume, Masahiro; Stafoggia, Massimo; Pascal, Mathilde; Scortichini, Matteo; de Sousa Zanotti Stagliorio Coêlho, Micheline; Valdés Ortega, Nicolás; Ryti, Niilo R.I.; Scovronick, Noah; Matus, Patricia; Goodman, Patrick; Garland, Rebecca M.; Abrutzky, Rosana; Garcia, Samuel Osorio; Rao, Shilpa; Fratianni, Simona; Dang, Tran Ngoc; Colistro, Valentina; Huber, Veronika; Lee, Whanhee; Seposo, Xerxes; Honda, Yasushi; Guo, Yue Leon; Ye, Tingting; Yu, Wenhua; Abramson, Michael J.; Samet, Jonathan M.; Li, Shanshan
    Background: Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2·5 and mortality across various regions of the world. Methods: For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfire-related PM2·5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM2·5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM2·5 exposure was calculated. Findings: 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m3 increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM2·5 exposure were 1·019 (95% CI 1·016-1·022) for all-cause mortality, 1·017 (1·012-1·021) for cardiovascular mortality, and 1·019 (1·013-1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48-0·75) of all-cause deaths, 0·55% (0·43-0·67) of cardiovascular deaths, and 0·64% (0·50-0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM2·5 exposure during the study period. Interpretation: Short-term exposure to wildfire-related PM2·5 was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires.
    2021-09Journal article Open access Show more
  • Predicted temperature-increase-induced global health burden and its regional variability
    Publication . Lee, Jae Young; Kim, Ho; Gasparrini, Antonio; Armstrong, Ben; Bell, Michelle L.; Sera, Francesco; Lavigne, Eric; Abrutzky, Rosana; Tong, Shilu; Coelho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Correa, Patricia Matus; Ortega, Nicolas Valdes; Kan, Haidong; Garcia, Samuel Osorio; Kyselý, Jan; Urban, Aleš; Orru, Hans; Indermitte, Ene; Jaakkola, Jouni J.K.; Ryti, Niilo R.I.; Pascal, Mathilde; Goodman, Patrick G.; Zeka, Ariana; Michelozzi, Paola; Scortichini, Matteo; Hashizume, Masahiro; Honda, Yasushi; Hurtado, Magali; Cruz, Julio; Seposo, Xerxes; Nunes, Baltazar; Teixeira, João Paulo; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Vicedo-Cabrera, Ana Maria; Ragettli, Martina S.; Guo, Yue-Liang Leon; Chen, Bing-Yu; Zanobetti, Antonella; Schwartz, Joel; Dang, Tran Ngoc; Do Van, Dung; Mayvaneh, Fetemeh; Overcenco, Ala; Li, Shanshan; Guo, Yuming
    An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010-2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (-0.92%p/°C) and Australia (-0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population.
    2019-10Journal article Open access Show more
  • Projections of excess mortality related to diurnal temperature range under climate change scenarios: a multi-country modelling study
    Publication . Lee, Whanhee; Kim, Yoonhee; Sera, Francesco; Gasparrini, Antonio; Park, Rokjin; Michelle Choi, Hayon; Prifti, Kristi; Bell, Michelle L.; Abrutzky, Rosana; Guo, Yuming; Tong, Shilu; de Sousa Zanotti Stagliorio Coelho, Micheline; Nascimento Saldiva, Paulo Hilario; Lavigne, Eric; Orru, Hans; Indermitte, Ene; Jaakkola, Jouni J.K.; Ryti, Niilo R.I.; Pascal, Mathilde; Goodman, Patrick; Zeka, Ariana; Hashizume, Masahiro; Honda, Yasushi; Hurtado Diaz, Magali; César Cruz, Julio; Overcenco, Ala; Nunes, Baltazar; Madureira, Joana; Scovronick, Noah; Acquaotta, Fiorella; Tobias, Aurelio; Vicedo-Cabrera, Ana Maria; Ragettli, Martina S.; Guo, Yue-Liang Leon; Chen, Bing-Yu; Li, Shanshan; Armstrong, Ben; Zanobetti, Antonella; Schwartz, Joel; Kim, Ho
    Background: Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions. Methods: DTR-related mortality risk was estimated on the basis of the historical daily time-series of mortality and weather factors from Jan 1, 1985, to Dec 31, 2015, with data for 445 communities across 20 countries and regions, from the Multi-Country Multi-City Collaborative Research Network. We obtained daily projected temperature series associated with four climate change scenarios, using the four representative concentration pathways (RCPs) described by the Intergovernmental Panel on Climate Change, from the lowest to the highest emission scenarios (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). Excess deaths attributable to the DTR during the current (1985-2015) and future (2020-99) periods were projected using daily DTR series under the four scenarios. Future excess deaths were calculated on the basis of assumptions that warmer long-term average temperatures affect or do not affect the DTR-related mortality risk. Findings: The time-series analyses results showed that DTR was associated with excess mortality. Under the unmitigated climate change scenario (RCP 8.5), the future average DTR is projected to increase in most countries and regions (by -0·4 to 1·6°C), particularly in the USA, south-central Europe, Mexico, and South Africa. The excess deaths currently attributable to DTR were estimated to be 0·2-7·4%. Furthermore, the DTR-related mortality risk increased as the long-term average temperature increased; in the linear mixed model with the assumption of an interactive effect with long-term average temperature, we estimated 0·05% additional DTR mortality risk per 1°C increase in average temperature. Based on the interaction with long-term average temperature, the DTR-related excess deaths are projected to increase in all countries or regions by 1·4-10·3% in 2090-99. Interpretation: This study suggests that globally, DTR-related excess mortality might increase under climate change, and this increasing pattern is likely to vary between countries and regions. Considering climatic changes, our findings could contribute to public health interventions aimed at reducing the impact of DTR on human health.
    2020-11Journal article Open access Show more