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Heat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countries

2023-02-13Journal article Open access
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dc.contributor.authorRai, Masna
dc.contributor.authorStafoggia, Massimo
dc.contributor.authorde'Donato, Francesca
dc.contributor.authorScortichini, Matteo
dc.contributor.authorZafeiratou, Sofia
dc.contributor.authorVazquez Fernandez, Liliana
dc.contributor.authorZhang, Siqi
dc.contributor.authorKatsouyanni, Klea
dc.contributor.authorSamoli, Evangelia
dc.contributor.authorRao, Shilpa
dc.contributor.authorLavigne, Eric
dc.contributor.authorGuo, Yuming
dc.contributor.authorKan, Haidong
dc.contributor.authorOsorio, 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.authorPascal, Mathilde
dc.contributor.authorHashizume, Masahiro
dc.contributor.authorFook Sheng Ng, Chris
dc.contributor.authorAlahmad, Barrak
dc.contributor.authorHurtado Diaz, Magali
dc.contributor.authorDe la Cruz Valencia, César
dc.contributor.authorNunes, Baltazar
dc.contributor.authorMadureira, Joana
dc.contributor.authorScovronick, Noah
dc.contributor.authorGarland, Rebecca M.
dc.contributor.authorKim, Ho
dc.contributor.authorLee, Whanhee
dc.contributor.authorTobias, Aurelio
dc.contributor.authorÍñiguez, Carmen
dc.contributor.authorForsberg, Bertil
dc.contributor.authorÅström, Christofer
dc.contributor.authorMaria Vicedo-Cabrera, Ana
dc.contributor.authorRagettli, Martina S.
dc.contributor.authorLeon Guo, Yue-Liang
dc.contributor.authorPan, Shih-Chun
dc.contributor.authorLi, Shanshan
dc.contributor.authorGasparrini, Antonio
dc.contributor.authorSera, Francesco
dc.contributor.authorMasselot, Pierre
dc.contributor.authorSchwartz, Joel
dc.contributor.authorZanobetti, Antonella
dc.contributor.authorBell, Michelle L.
dc.contributor.authorSchneider, Alexandra
dc.contributor.authorBreitner, Susanne
dc.date.accessioned2024-02-20T13:41:52Z
dc.date.available2024-02-20T13:41:52Z
dc.date.issued2023-02-13
dc.description.abstractHighlights: - 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.pt_PT
dc.description.abstractBackground: Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. Objectives: We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest months) in 482 locations across 24 countries. Methods: Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 µm [PM2.5]) were obtained from 2000 to 2018. We used location-specific confounder-adjusted Quasi-Poisson regression with a tensor product between air temperature and the air pollutant. We extracted heat effects at low, medium, and high levels of pollutants, defined as the 5th, 50th, and 95th percentile of the location-specific pollutant concentrations. Country-specific and overall estimates were derived using a random-effects multilevel meta-analytical model. Results: Heat was associated with increased cardiorespiratory mortality. Moreover, the heat effects were modified by elevated levels of all air pollutants in most locations, with stronger effects for respiratory than cardiovascular mortality. For example, the percent increase in respiratory mortality per increase in the 2-day average summer temperature from the 75th to the 99th percentile was 7.7% (95% Confidence Interval [CI] 7.6-7.7), 11.3% (95%CI 11.2-11.3), and 14.3% (95% CI 14.1-14.5) at low, medium, and high levels of PM2.5, respectively. Similarly, cardiovascular mortality increased by 1.6 (95%CI 1.5-1.6), 5.1 (95%CI 5.1-5.2), and 8.7 (95%CI 8.7-8.8) at low, medium, and high levels of O3, respectively. Discussion: We observed considerable modification of the heat effects on cardiovascular and respiratory mortality by elevated levels of air pollutants. Therefore, mitigation measures following the new WHO Air Quality Guidelines are crucial to enhance better health and promote sustainable development.pt_PT
dc.description.sponsorshipMasna Rai, Massimo Stafoggia, Francesca K. de’ Donato, Sofia Zafeiratou, Liliana Vazquez Fernandez, Siqi Zhang, Klea Katsouyanni, Evangelia Samoli, Shilpa Rao, Antonio Gasparrini, Pierre Masselot, and Alexandra Schneider were supported by the European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655). Joana Madureira was supported by the Fundação para a Ciência e a Tecnologia (FCT) (Grant SFRH/BPD/115112/2016).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEnviron Int. 2023 Apr:174:107825. doi: 10.1016/j.envint.2023.107825. Epub 2023 Feb 13.pt_PT
dc.identifier.doi10.1016/j.envint.2023.107825pt_PT
dc.identifier.issn0160-4120
dc.identifier.urihttp://hdl.handle.net/10400.18/9129
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relationExposure to heat and air pollution in EUrope – cardiopulmonary impacts and benefits of mitigation and adaptation
dc.relationEarly life exposure to atmospheric air pollutants and potential DNA damage: Consequences on development and childhood outcomes APPEAL
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0160412023000983pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectHeatpt_PT
dc.subjectAir Temperaturept_PT
dc.subjectAir Pollutionpt_PT
dc.subjectCardiovascular Mortalitypt_PT
dc.subjectRespiratory Mortalitypt_PT
dc.subjectEffect modificationpt_PT
dc.subjectDeterminantes da Saúde e da Doençapt_PT
dc.subjectAr e Saúde Ocupacionalpt_PT
dc.titleHeat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countriespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleExposure to heat and air pollution in EUrope – cardiopulmonary impacts and benefits of mitigation and adaptation
oaire.awardTitleEarly life exposure to atmospheric air pollutants and potential DNA damage: Consequences on development and childhood outcomes APPEAL
oaire.awardURIinfo:eu-repo/grantAgreement/EC/H2020/820655/EU
oaire.awardURIinfo:eu-repo/grantAgreement/FCT//SFRH%2FBPD%2F115112%2F2016/PT
oaire.citation.startPage107825pt_PT
oaire.citation.titleEnvironment Internationalpt_PT
oaire.citation.volume174pt_PT
oaire.fundingStreamH2020
person.familyNameNunes
person.givenNameBaltazar
person.identifier.ciencia-idAB11-AD48-A8DF
person.identifier.orcid0000-0001-6230-7209
person.identifier.scopus-author-id9133723200
project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameEuropean Commission
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.embargofctAcesso de acordo com a política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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relation.isAuthorOfPublication.latestForDiscoverybe4efa0d-49df-4a93-bfdd-b76d9f7bf492
relation.isProjectOfPublication59609b8b-2750-43e0-8fe9-155a4915a572
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