Coarse Particulate Air Pollution and Daily Mortality: A Global Study in 205 Cities.

Cong Liu ; Jing Cai ; Renjie Chen ; Francesco Sera ORCID logo ; Yuming Guo ; Shilu Tong ; Shanshan Li ; Eric Lavigne ; Patricia Matus Correa ; Nicolas Valdes Ortega ; +35 more... Hans Orru ; Marek Maasikmets ; Jouni JK Jaakkola ; Niilo Ryti ; Susanne Breitner ; Alexandra Schneider ; Klea Katsouyanni ; Evangelia Samoli ; Masahiro Hashizume ; Yasushi Honda ; Chris Fook Sheng Ng ; Magali Hurtado Diaz ; César De la Cruz Valencia ; Shilpa Rao ; Alfonso Diz-Lois Palomares ; Susana Pereira da Silva ; Joana Madureira ; Iulian Horia Holobâc ; Simona Fratianni ; Noah Scovronick ; Rebecca M Garland ; Aurelio Tobias ; Carmen Íñiguez ; Bertil Forsberg ; Christofer Åström ; Ana Maria Vicedo-Cabrera ; Martina S Ragettli ; Yue-Liang Leon Guo ; Shih-Chun Pan ; Ai Milojevic ORCID logo ; Michelle L Bell ; Antonella Zanobetti ; Joel Schwartz ; Antonio Gasparrini ORCID logo ; Haidong Kan ORCID logo ; (2022) Coarse Particulate Air Pollution and Daily Mortality: A Global Study in 205 Cities. American Journal of Respiratory and Critical Care Medicine, 206 (8). pp. 999-1007. ISSN 1073-449X DOI: 10.1164/rccm.202111-2657OC
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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.


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