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Short-Term Exposure to Fine Particulate Matter and Nitrogen Dioxide and Mortality in 4 Countries.
Ma, Yiqun; Nobile, Federica; Marb, Anne; Dubrow, Robert; Stafoggia, Massimo; Breitner, Susanne; Kinney, Patrick L; Chen, Kai.
Afiliação
  • Ma Y; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut.
  • Nobile F; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut.
  • Marb A; Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy.
  • Dubrow R; Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
  • Stafoggia M; Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.
  • Breitner S; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut.
  • Kinney PL; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut.
  • Chen K; Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy.
JAMA Netw Open ; 7(3): e2354607, 2024 Mar 04.
Article em En | MEDLINE | ID: mdl-38427355
ABSTRACT
Importance The association between short-term exposure to air pollution and mortality has been widely documented worldwide; however, few studies have applied causal modeling approaches to account for unmeasured confounders that vary across time and space.

Objective:

To estimate the association between short-term changes in fine particulate matter (PM2.5) and nitrogen dioxide (NO2) concentrations and changes in daily all-cause mortality rates using a causal modeling approach. Design, Setting, and

Participants:

This cross-sectional study used air pollution and mortality data from Jiangsu, China; California; central-southern Italy; and Germany with interactive fixed-effects models to control for both measured and unmeasured spatiotemporal confounders. A total of 8 963 352 deaths in these 4 regions from January 1, 2015, to December 31, 2019, were included in the study. Data were analyzed from June 1, 2021, to October 30, 2023. Exposure Day-to-day changes in county- or municipality-level mean PM2.5 and NO2 concentrations. Main Outcomes and

Measures:

Day-to-day changes in county- or municipality-level all-cause mortality rates.

Results:

Among the 8 963 352 deaths in the 4 study regions, a 10-µg/m3 increase in daily PM2.5 concentration was associated with an increase in daily all-cause deaths per 100 000 people of 0.01 (95% CI, 0.001-0.01) in Jiangsu, 0.03 (95% CI, 0.004-0.05) in California, 0.10 (95% CI, 0.07-0.14) in central-southern Italy, and 0.04 (95% CI, 0.02- 0.05) in Germany. The corresponding increases in mortality rates for a 10-µg/m3 increase in NO2 concentration were 0.04 (95% CI, 0.03-0.05) in Jiangsu, 0.03 (95% CI, 0.01-0.04) in California, 0.10 (95% CI, 0.05-0.15) in central-southern Italy, and 0.05 (95% CI, 0.04-0.06) in Germany. Significant effect modifications by age were observed in all regions, by sex in Germany (eg, 0.05 [95% CI, 0.03-0.06] for females in the single-pollutant model of PM2.5), and by urbanicity in Jiangsu (0.07 [95% CI, 0.04-0.10] for rural counties in the 2-pollutant model of NO2). Conclusions and Relevance The findings of this cross-sectional study contribute to the growing body of evidence that increases in short-term exposures to PM2.5 and NO2 may be associated with increases in all-cause mortality rates. The interactive fixed-effects model, which controls for unmeasured spatial and temporal confounders, including unmeasured time-varying confounders in different spatial units, can be used to estimate associations between changes in short-term exposure to air pollution and changes in health outcomes.
Assuntos

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 2_ODS3 Base de dados: MEDLINE Assunto principal: Poluentes Atmosféricos / Material Particulado Limite: Female / Humans Idioma: En Revista: JAMA Netw Open Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 2_ODS3 Base de dados: MEDLINE Assunto principal: Poluentes Atmosféricos / Material Particulado Limite: Female / Humans Idioma: En Revista: JAMA Netw Open Ano de publicação: 2024 Tipo de documento: Article