TY - JOUR
T1 - Interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities
T2 - two stage time series analysis
AU - Liu, Cong
AU - Chen, Renjie
AU - Sera, Francesco
AU - Vicedo-Cabrera, Ana Maria
AU - Guo, Yuming
AU - Tong, Shilu
AU - Lavigne, Eric
AU - Correa, Patricia Matus
AU - Ortega, Nicolás Valdés
AU - Achilleos, Souzana
AU - Roye, Dominic
AU - Jaakkola, Jouni J.K.
AU - Ryti, Niilo
AU - Pascal, Mathilde
AU - Schneider, Alexandra
AU - Breitner, Susanne
AU - Entezari, Alireza
AU - Mayvaneh, Fatemeh
AU - Raz, Raanan
AU - Honda, Yasushi
AU - Hashizume, Masahiro
AU - Ng, Chris Fook Sheng
AU - Gaio, Vânia
AU - Madureira, Joana
AU - Holobaca, Iulian Horia
AU - Tobias, Aurelio
AU - Íñiguez, Carmen
AU - Guo, Yue Leon
AU - Pan, Shih Chun
AU - Masselot, Pierre
AU - Bell, Michelle L.
AU - Zanobetti, Antonella
AU - Schwartz, Joel
AU - Gasparrini, Antonio
AU - Kan, Haidong
N1 - Funding Information:
Funding: HK, RC, and CL were supported by the National Natural Science Foundation of China (92043301, 82030103, and 82103790). FS was supported by the Italian Ministry of University and Research, Department of Excellence project 2023-2027 ReDS “Rethinking Data Science” - Department of Statistics, Computer Science and Applications - University of Florence. The funders had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.
Funding Information:
Competing interests: All authors have completed the ICMJE uniform disclosure form at URL www.icmje.org/disclosure-of-interest/ and declare: support from the National Natural Science Foundation of China and the Italian Ministry of University and Research; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Publisher Copyright:
© 2019 Author(s) (or their employer(s)).
PY - 2023
Y1 - 2023
N2 - Objective: To investigate potential interactive effects of fine particulate matter (PM2.5) and ozone (O3) on daily mortality at global level. Design: Two stage time series analysis. Setting: 372 cities across 19 countries and regions. Population: Daily counts of deaths from all causes, cardiovascular disease, and respiratory disease. Main outcome measure: Daily mortality data during 1994-2020. Stratified analyses by co-pollutant exposures and synergy index (>1 denotes the combined effect of pollutants is greater than individual effects) were applied to explore the interaction between PM2.5 and O3 in association with mortality. Results: During the study period across the 372 cities, 19.3 million deaths were attributable to all causes, 5.3 million to cardiovascular disease, and 1.9 million to respiratory disease. The risk of total mortality for a 10 μg/m3 increment in PM2.5 (lag 0-1 days) ranged from 0.47% (95% confidence interval 0.26% to 0.67%) to 1.25% (1.02% to 1.48%) from the lowest to highest fourths of O3 concentration; and for a 10 μg/m3 increase in O3 ranged from 0.04% (-0.09% to 0.16%) to 0.29% (0.18% to 0.39%) from the lowest to highest fourths of PM2.5 concentration, with significant differences between strata (P for interaction <0.001). A significant synergistic interaction was also identified between PM2.5 and O3 for total mortality, with a synergy index of 1.93 (95% confidence interval 1.47 to 3.34). Subgroup analyses showed that interactions between PM2.5 and O3 on all three mortality endpoints were more prominent in high latitude regions and during cold seasons. Conclusion: The findings of this study suggest a synergistic effect of PM2.5 and O3 on total, cardiovascular, and respiratory mortality, indicating the benefit of coordinated control strategies for both pollutants.
AB - Objective: To investigate potential interactive effects of fine particulate matter (PM2.5) and ozone (O3) on daily mortality at global level. Design: Two stage time series analysis. Setting: 372 cities across 19 countries and regions. Population: Daily counts of deaths from all causes, cardiovascular disease, and respiratory disease. Main outcome measure: Daily mortality data during 1994-2020. Stratified analyses by co-pollutant exposures and synergy index (>1 denotes the combined effect of pollutants is greater than individual effects) were applied to explore the interaction between PM2.5 and O3 in association with mortality. Results: During the study period across the 372 cities, 19.3 million deaths were attributable to all causes, 5.3 million to cardiovascular disease, and 1.9 million to respiratory disease. The risk of total mortality for a 10 μg/m3 increment in PM2.5 (lag 0-1 days) ranged from 0.47% (95% confidence interval 0.26% to 0.67%) to 1.25% (1.02% to 1.48%) from the lowest to highest fourths of O3 concentration; and for a 10 μg/m3 increase in O3 ranged from 0.04% (-0.09% to 0.16%) to 0.29% (0.18% to 0.39%) from the lowest to highest fourths of PM2.5 concentration, with significant differences between strata (P for interaction <0.001). A significant synergistic interaction was also identified between PM2.5 and O3 for total mortality, with a synergy index of 1.93 (95% confidence interval 1.47 to 3.34). Subgroup analyses showed that interactions between PM2.5 and O3 on all three mortality endpoints were more prominent in high latitude regions and during cold seasons. Conclusion: The findings of this study suggest a synergistic effect of PM2.5 and O3 on total, cardiovascular, and respiratory mortality, indicating the benefit of coordinated control strategies for both pollutants.
UR - http://www.scopus.com/inward/record.url?scp=85174324211&partnerID=8YFLogxK
U2 - 10.1136/bmj-2023-075203
DO - 10.1136/bmj-2023-075203
M3 - Article
C2 - 37793695
AN - SCOPUS:85174324211
SN - 0959-8146
JO - BMJ
JF - BMJ
M1 - e075203
ER -