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Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities

2021-03-24Journal article Open access
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dc.contributor.authorMeng, Xia
dc.contributor.authorLiu, Cong
dc.contributor.authorChen, Renjie
dc.contributor.authorSera, Francesco
dc.contributor.authorVicedo-Cabrera, Ana Maria
dc.contributor.authorMilojevic, Ai
dc.contributor.authorGuo, Yuming
dc.contributor.authorTong, Shilu
dc.contributor.authorCoelho, Micheline de Sousa Zanotti Staglior
dc.contributor.authorSaldiva, Paulo Hilario Nascimento
dc.contributor.authorLavigne, Eric
dc.contributor.authorCorrea, Patricia Matus
dc.contributor.authorOrtega, Nicolas Valdes
dc.contributor.authorOsorio Garcia, Samuel
dc.contributor.authorKyselý, Jan
dc.contributor.authorUrban, Aleš
dc.contributor.authorOrru, Hans
dc.contributor.authorMaasikmets, Marek
dc.contributor.authorJaakkola, Jouni J.K.
dc.contributor.authorRyti, Niilo
dc.contributor.authorHuber, Veronika
dc.contributor.authorSchneider, Alexandra
dc.contributor.authorKatsouyanni, Klea
dc.contributor.authorAnalitis, Antonis
dc.contributor.authorHashizume, Masahiro
dc.contributor.authorHonda, Yasushi
dc.contributor.authorNg, Chris Fook Sheng
dc.contributor.authorNunes, Baltazar
dc.contributor.authorTeixeira, João Paulo
dc.contributor.authorHolobaca, Iulian Horia
dc.contributor.authorFratianni, Simona
dc.contributor.authorKim, Ho
dc.contributor.authorTobias, Aurelio
dc.contributor.authorÍñiguez, Carmen
dc.contributor.authorForsberg, Bertil
dc.contributor.authorÅström, Christofer
dc.contributor.authorRagettli, Martina S.
dc.contributor.authorGuo, Yue-Liang Leon
dc.contributor.authorPan, Shih-Chun
dc.contributor.authorLi, Shanshan
dc.contributor.authorBell, Michelle L.
dc.contributor.authorZanobetti, Antonella
dc.contributor.authorSchwartz, Joel
dc.contributor.authorWu, Tangchun
dc.contributor.authorGasparrini, Antonio
dc.contributor.authorKan, Haidong
dc.date.accessioned2022-07-05T17:14:38Z
dc.date.available2022-07-05T17:14:38Z
dc.date.issued2021-03-24
dc.description.abstractObjective: To evaluate the short term associations between nitrogen dioxide (NO2) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. Design: Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. Setting: 398 cities in 22 low to high income countries/regions. Main outcome measures: Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018. Results: On average, a 10 μg/m3 increase in NO2 concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM10 and PM2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO2 concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities. Conclusions: This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO2 and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO2.pt_PT
dc.description.abstractWhat is already known on this topic: Evidence for the short term association between ambient nitrogen dioxide (NO2) and mortality is limited, especially for cause specific associations Previous investigations have been mostly conducted in a small number of locations that cover limited geographical areas, and use different study designs and modelling approaches that lead to heterogeneous results What this study adds: This large multilocation study in 398 cities found that each 10 μg/m3 increase in NO2 concentrations on lag 1 day (previous day) was significantly associated with increased risk of total (0.46%), cardiovascular (0.37%), and respiratory (0.47%) mortality The concentration-response curves were almost linear without discernible thresholds even below the current WHO air quality guidelines, suggesting a need to revise the currently recommended values The uniform analytical approach allows a direct comparison of estimates across global regions,pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBMJ. 2021 Mar 24;372:n534. doi: 10.1136/bmj.n534pt_PT
dc.identifier.doi10.1136/bmj.n534pt_PT
dc.identifier.issn1759-2151
dc.identifier.urihttp://hdl.handle.net/10400.18/8067
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJ Publishing Grouppt_PT
dc.relation.publisherversionhttps://www.bmj.com/content/372/bmj.n534.longpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectMCCpt_PT
dc.subjectAmbient Nitrogen Dioxidept_PT
dc.subjectDaily Mortalitypt_PT
dc.subjectCardiovascular Mortalitypt_PT
dc.subjectRespiratory Mortalitypt_PT
dc.subjectDeterminantes da Saúde e da Doençapt_PT
dc.titleShort term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 citiespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPagen534pt_PT
oaire.citation.titleBritish Medical Journal (BMJ)pt_PT
oaire.citation.volume372pt_PT
person.familyNameNunes
person.familyNamePaulo Teixeira
person.givenNameBaltazar
person.givenNameJoao
person.identifier230313
person.identifier.ciencia-idAB11-AD48-A8DF
person.identifier.ciencia-idDC1F-3ED2-2707
person.identifier.orcid0000-0001-6230-7209
person.identifier.orcid0000-0001-8693-5250
person.identifier.ridF-5445-2013
person.identifier.scopus-author-id9133723200
person.identifier.scopus-author-id36097134700
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationbe4efa0d-49df-4a93-bfdd-b76d9f7bf492
relation.isAuthorOfPublication2c7413fe-f27e-43e7-988b-5196ca407a71
relation.isAuthorOfPublication.latestForDiscovery2c7413fe-f27e-43e7-988b-5196ca407a71

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