Coarse Particulate Air Pollution and Daily Mortality: A Global Study in 205 Cities
Cong Liu, Jing Cai, Renjie Chen, Francesco Sera, Yuming Guo, Shilu Tong, Shanshan Li, Éric Lavigne, Patricia Matus Correa, Nicolás Valdés Ortega, Hans Orru, Marek Maasikmets, Jouni J. K. Jaakkola, Niilo Ryti, Susanne Breitner, Alexandra Schneider, Klea Katsouyanni, Evangelia Samoli, Masahiro Hashizume, Yasushi Honda, Chris Fook Sheng Ng, Magali Hurtado‐Díaz, César De la Cruz Valencia, Shilpa Rao, Alfonso Diz-Lois Palomares, Susana Pereira Silva, Joana Madureira, Iulian Horia Holobâc, Simona Fratianni, Noah Scovronick, Rebecca M. Garland, Aurelio Tobı́as, Carmen Íñiguez, Bertil Forsberg, Christofer Åström, Ana María Vicedo-Cabrera, Martina S. Ragettli, Yue Leon Guo, Shih‐Chun Pan, Ai Milojevic, Michelle L. Bell, Antonella Zanobetti, Joel Schwartz, Antonio Gasparrini, Haidong Kan
Abstract
Abstract Rationale The associations between ambient coarse particulate matter (PM2.5–10) and daily mortality are not fully understood on a global scale. Objectives To evaluate the short-term associations between PM2.5–10 and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide. Methods We collected daily mortality (total, cardiovascular, and respiratory) and air pollution data from 205 cities in 20 countries/regions. Concentrations of PM2.5–10 were computed as the difference between inhalable and fine PM. A two-stage time-series analytic approach was applied, with overdispersed generalized linear models and multilevel meta-analysis. We fitted two-pollutant models to test the independent effect of PM2.5–10 from copollutants (fine PM, nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide). Exposure–response relationship curves were pooled, and regional analyses were conducted. Measurements and Main Results A 10 μg/m3 increase in PM2.5–10 concentration on lag 0–1 day was associated with increments of 0.51% (95% confidence interval [CI], 0.18%–0.84%), 0.43% (95% CI, 0.15%–0.71%), and 0.41% (95% CI, 0.06%–0.77%) in total, cardiovascular, and respiratory mortality, respectively. The associations varied by country and region. These associations were robust to adjustment by all copollutants in two-pollutant models, especially for PM2.5. The exposure–response curves for total, cardiovascular, and respiratory mortality were positive, with steeper slopes at lower exposure ranges and without discernible thresholds. Conclusions This study provides novel global evidence on the robust and independent associations between short-term exposure to ambient PM2.5–10 and total, cardiovascular, and respiratory mortality, suggesting the need to establish a unique guideline or regulatory limit for daily concentrations of PM2.5–10.