Browsing by Author "Tong, Shilu"
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- All-cause, cardiovascular, and respiratory mortality and wildfire-related ozone: a multicountry two-stage time series analysisPublication . 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 NetworkBackground: 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.
- Ambient carbon monoxide and daily mortality: a global time-series study in 337 citiesPublication . 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, AlexandraBackground: 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.
- Ambient particulate air pollution and daily mortality in 652 citiesPublication . 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, HaidongThe 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).
- Comparison of weather station and climate reanalysis data for modelling temperature-related mortalityPublication . 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, AntonioEpidemiological 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.
- Differential Mortality Risks Associated With PM2.5 Components: A Multi-Country, Multi-City StudyPublication . 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, AntonioBackground: 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.
- Effect modification of greenness on the association between heat and mortality: A multi-city multi-country studyPublication . 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.
- Fluctuating temperature modifies heat-mortality association around the globePublication . Wu, Yao; Wen, Bo; Li, Shanshan; Gasparrini, Antonio; Tong, Shilu; Overcenco, Ala; Urban, Aleš; Schneider, Alexandra; Entezari, Alireza; Vicedo-Cabrera, Ana Maria; Zanobetti, Antonella; Analitis, Antonis; Zeka, Ariana; Tobias, Aurelio; Alahmad, Barrak; Armstrong, Ben; Forsberg, Bertil; Íñiguez, Carmen; Ameling, Caroline; De la Cruz Valencia, César; Åström, Christofer; Houthuijs, Danny; Van Dung, Do; Royé, Dominic; Indermitte, Ene; Lavigne, Eric; Mayvaneh, Fatemeh; Acquaotta, Fiorella; de’Donato, Francesca; Sera, Francesco; Carrasco-Escobar, Gabriel; Kan, Haidong; Orru, Hans; Kim, Ho; Holobaca, Iulian-Horia; Kyselý, Jan; Madureira, Joana; Schwartz, Joel; Katsouyanni, Klea; Hurtado-Diaz, Magali; Ragettli, Martina S.; Hashizume, Masahiro; Pascal, Mathilde; de Sousa Zanotti Stagliorio Coélho, Micheline; Scovronick, Noah; Michelozzi, Paola; Goodman, Patrick; Nascimento Saldiva, Paulo Hilario; Abrutzky, Rosana; Osorio, Samuel; Dang, Tran Ngoc; Colistro, Valentina; Huber, Veronika; Lee, Whanhee; Seposo, Xerxes; Honda, Yasushi; Bell, Michelle L.; Guo, YumingStudies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days' minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: -0.33 to 1.69), 1.34% (95% CI: -0.14 to 2.73), 1.99% (95% CI: 0.29-3.57), and 2.73% (95% CI: 0.76-4.50) of total deaths for Q1-Q4 (first quartile-fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25-9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: -0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health.
- Geographical Variations of the Minimum Mortality Temperature at a Global ScalePublication . 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, AntonioBackground: 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.
- Global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019: a multi-country time-series studyPublication . Huang, Wenzhong; Li, Shanshan; Vogt, Thomas; Xu, Rongbin; Tong, Shilu; Molina, Tomás; Masselot, Pierre; Gasparrini, Antonio; Armstrong, Ben; Pascal, Mathilde; Royé, Dominic; Sheng Ng, Chris Fook; Vicedo-Cabrera, Ana Maria; Schwartz, Joel; Lavigne, Eric; Kan, Haidong; Goodman, Patrick; Zeka, Ariana; Hashizume, Masahiro; Diaz, Magali Hurtado; De la Cruz Valencia, César; Seposo, Xerxes; Nunes, Baltazar; Madureira, Joana; Kim, Ho; Lee, Whanhee; Tobias, Aurelio; Íñiguez, Carmen; Guo, Yue Leon; Pan, Shih-Chun; Zanobetti, Antonella; Dang, Tran Ngoc; Van Dung, Do; Geiger, Tobias; Otto, Christian; Johnson, Amanda; Hales, Simon; Yu, Pei; Yang, Zhengyu; Ritchie, Elizabeth A.; Guo, YumingBackground: The global spatiotemporal pattern of mortality risk and burden attributable to tropical cyclones is unclear. We aimed to evaluate the global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019. Methods: The wind speed associated with cyclones from 1980 to 2019 was estimated globally through a parametric wind field model at a grid resolution of 0·5° × 0·5°. A total of 341 locations with daily mortality and temperature data from 14 countries that experienced at least one tropical cyclone day (a day with maximum sustained wind speed associated with cyclones ≥17·5 m/s) during the study period were included. A conditional quasi-Poisson regression with distributed lag non-linear model was applied to assess the tropical cyclone-mortality association. A meta-regression model was fitted to evaluate potential contributing factors and estimate grid cell-specific tropical cyclone effects. Findings: Tropical cyclone exposure was associated with an overall 6% (95% CI 4-8) increase in mortality in the first 2 weeks following exposure. Globally, an estimate of 97 430 excess deaths (95% empirical CI [eCI] 71 651-126 438) per decade were observed over the 2 weeks following exposure to tropical cyclones, accounting for 20·7 (95% eCI 15·2-26·9) excess deaths per 100 000 residents (excess death rate) and 3·3 (95% eCI 2·4-4·3) excess deaths per 1000 deaths (excess death ratio) over 1980-2019. The mortality burden exhibited substantial temporal and spatial variation. East Asia and south Asia had the highest number of excess deaths during 1980-2019: 28 744 (95% eCI 16 863-42 188) and 27 267 (21 157-34 058) excess deaths per decade, respectively. In contrast, the regions with the highest excess death ratios and rates were southeast Asia and Latin America and the Caribbean. From 1980-99 to 2000-19, marked increases in tropical cyclone-related excess death numbers were observed globally, especially for Latin America and the Caribbean and south Asia. Grid cell-level and country-level results revealed further heterogeneous spatiotemporal patterns such as the high and increasing tropical cyclone-related mortality burden in Caribbean countries or regions. Interpretation: Globally, short-term exposure to tropical cyclones was associated with a significant mortality burden, with highly heterogeneous spatiotemporal patterns. In-depth exploration of tropical cyclone epidemiology for those countries and regions estimated to have the highest and increasing tropical cyclone-related mortality burdens is urgently needed to help inform the development of targeted actions against the increasing adverse health impacts of tropical cyclones under a changing climate.
- Global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019: a multi-country time-series studyPublication . Huang, Wenzhong; Li, Shanshan; Vogt, Thomas; Xu, Rongbin; Tong, Shilu; Molina, Tomás; Masselot, Pierre; Gasparrini, Antonio; Armstrong, Ben; Pascal, Mathilde; Royé, Dominic; Sheng Ng, Chris Fook; Vicedo-Cabrera, Ana Maria; Schwartz, Joel; Lavigne, Eric; Kan, Haidong; Goodman, Patrick; Zeka, Ariana; Hashizume, Masahiro; Diaz, Magali Hurtado; Valencia, César De la Cruz; Seposo, Xerxes; Nunes, Baltazar; Madureira, Joana; Kim, Ho; Lee, Whanhee; Tobias, Aurelio; Íñiguez, Carmen; Guo, Yue Leon; Pan, Shih-Chun; Zanobetti, Antonella; Dang, Tran Ngoc; Dung, Do Van; Geiger, Tobias; Otto, Christian; Johnson, Amanda; Hales, Simon; Pei Yu; Yang, Zhengyu; Ritchie, Elizabeth A.; Guo, YumingBackground: The global spatiotemporal pattern of mortality risk and burden attributable to tropical cyclones is unclear. We aimed to evaluate the global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019. Methods: The wind speed associated with cyclones from 1980 to 2019 was estimated globally through a parametric wind field model at a grid resolution of 0·5° × 0·5°. A total of 341 locations with daily mortality and temperature data from 14 countries that experienced at least one tropical cyclone day (a day with maximum sustained wind speed associated with cyclones ≥17·5 m/s) during the study period were included. A conditional quasi-Poisson regression with distributed lag non-linear model was applied to assess the tropical cyclone-mortality association. A meta-regression model was fitted to evaluate potential contributing factors and estimate grid cell-specific tropical cyclone effects. Findings: Tropical cyclone exposure was associated with an overall 6% (95% CI 4-8) increase in mortality in the first 2 weeks following exposure. Globally, an estimate of 97 430 excess deaths (95% empirical CI [eCI] 71 651-126 438) per decade were observed over the 2 weeks following exposure to tropical cyclones, accounting for 20·7 (95% eCI 15·2-26·9) excess deaths per 100 000 residents (excess death rate) and 3·3 (95% eCI 2·4-4·3) excess deaths per 1000 deaths (excess death ratio) over 1980-2019. The mortality burden exhibited substantial temporal and spatial variation. East Asia and south Asia had the highest number of excess deaths during 1980-2019: 28 744 (95% eCI 16 863-42 188) and 27 267 (21 157-34 058) excess deaths per decade, respectively. In contrast, the regions with the highest excess death ratios and rates were southeast Asia and Latin America and the Caribbean. From 1980-99 to 2000-19, marked increases in tropical cyclone-related excess death numbers were observed globally, especially for Latin America and the Caribbean and south Asia. Grid cell-level and country-level results revealed further heterogeneous spatiotemporal patterns such as the high and increasing tropical cyclone-related mortality burden in Caribbean countries or regions. Interpretation: Globally, short-term exposure to tropical cyclones was associated with a significant mortality burden, with highly heterogeneous spatiotemporal patterns. In-depth exploration of tropical cyclone epidemiology for those countries and regions estimated to have the highest and increasing tropical cyclone-related mortality burdens is urgently needed to help inform the development of targeted actions against the increasing adverse health impacts of tropical cyclones under a changing climate.
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