TY  - JOUR
AB  - Despite major advances in artificial intelligence (AI) research for healthcare, the deployment and adoption of AI technologies remain limited in clinical practice. This paper describes the FUTURE-AI framework, which provides guidance for the development and deployment of trustworthy AI tools in healthcare. The FUTURE-AI Consortium was founded in 2021 and comprises 117 interdisciplinary experts from 50 countries representing all continents, including AI scientists, clinical researchers, biomedical ethicists, and social scientists. Over a two year period, the FUTURE-AI guideline was established through consensus based on six guiding principles-fairness, universality, traceability, usability, robustness, and explainability. To operationalise trustworthy AI in healthcare, a set of 30 best practices were defined, addressing technical, clinical, socioethical, and legal dimensions. The recommendations cover the entire lifecycle of healthcare AI, from design, development, and validation to regulation, deployment, and monitoring.
AU  - Lekadir, K.*
AU  - Frangi, A.F.*
AU  - Porras, A.R.*
AU  - Glocker, B.*
AU  - Cintas, C.*
AU  - Langlotz, C.P.*
AU  - Weicken, E.*
AU  - Asselbergs, F.W.*
AU  - Prior, F.*
AU  - Collins, G.S.*
AU  - Kaissis, G.*
AU  - Tsakou, G.*
AU  - Buvat, I.*
AU  - Kalpathy-Cramer, J.*
AU  - Mongan, J.*
AU  - Schnabel, J.A.
AU  - Kushibar, K.*
AU  - Riklund, K.*
AU  - Marias, K.*
AU  - Amugongo, L.M.*
AU  - Fromont, L.A.*
AU  - Maier-Hein, L.*
AU  - Cerdá-Alberich, L.*
AU  - Martí-Bonmatí, L.*
AU  - Cardoso, M.J.*
AU  - Bobowicz, M.*
AU  - Shabani, M.*
AU  - Tsiknakis, M.*
AU  - Zuluaga, M.A.*
AU  - Fritzsche, M.C.*
AU  - Camacho, M.*
AU  - Linguraru, M.G.*
AU  - Wenzel, M.*
AU  - De Bruijne, M.*
AU  - Tolsgaard, M.G.*
AU  - Goisauf, M.*
AU  - Cano Abadía, M.*
AU  - Papanikolaou, N.*
AU  - Lazrak, N.*
AU  - Pujol, O.*
AU  - Osuala, R.*
AU  - Napel, S.*
AU  - Colantonio, S.*
AU  - Joshi, S.*
AU  - Klein, S.*
AU  - Aussó, S.*
AU  - Rogers, W.A.*
AU  - Salahuddin, Z.*
AU  - Starmans, M.P.A.*
C1  - 73312
C2  - 57008
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
TI  - FUTURE-AI: international consensus guideline for trustworthy and deployable artificial intelligence in healthcare.
JO  - BMJ
VL  - 388
PB  - Bmj Publishing Group
PY  - 2025
SN  - 0959-535X
ER  - 

TY  - JOUR
AB  - OBJECTIVE: To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. DESIGN: Two stage time series analysis. SETTING: 645 locations across 34 countries or regions. POPULATION: Daily mortality data, comprising a total of 109 954 744 all cause, 31 164 161 cardiovascular, and 11 817 278 respiratory deaths from 1980 to 2020. MAIN OUTCOME MEASURE: Association between daily mortality and rainfall events with return periods (the expected average time between occurrences of an extreme event of a certain magnitude) of one year, two years, and five years, with a 14 day lag period. A continuous relative intensity index was used to generate intensity-response curves to estimate mortality risks at a global scale. RESULTS: During the study period, a total of 50 913 rainfall events with a one year return period, 8362 events with a two year return period, and 3301 events with a five year return period were identified. A day of extreme rainfall with a five year return period was significantly associated with increased daily all cause, cardiovascular, and respiratory mortality, with cumulative relative risks across 0-14 lag days of 1.08 (95% confidence interval 1.05 to 1.11), 1.05 (1.02 to 1.08), and 1.29 (1.19 to 1.39), respectively. Rainfall events with a two year return period were associated with respiratory mortality only, whereas no significant associations were found for events with a one year return period. Non-linear analysis revealed protective effects (relative risk <1) with moderate-heavy rainfall events, shifting to adverse effects (relative risk >1) with extreme intensities. Additionally, mortality risks from extreme rainfall events appeared to be modified by climate type, baseline variability in rainfall, and vegetation coverage, whereas the moderating effects of population density and income level were not significant. Locations with lower variability of baseline rainfall or scarce vegetation coverage showed higher risks. CONCLUSION: Daily rainfall intensity is associated with varying health effects, with extreme events linked to an increasing relative risk for all cause, cardiovascular, and respiratory mortality. The observed associations varied with local climate and urban infrastructure.
AU  - He, C.
AU  - Breitner-Busch, S.
AU  - Huber, V.
AU  - Chen, K.*
AU  - Zhang, S.*
AU  - Gasparrini, A.*
AU  - Bell, M.*
AU  - Kan, H.*
AU  - Royé, D.*
AU  - Armstrong, B.*
AU  - Schwartz, J.*
AU  - Sera, F.*
AU  - Vicedo-Cabrera, A.M.*
AU  - Honda, Y.*
AU  - Jaakkola, J.J.K.*
AU  - Ryti, N.*
AU  - Kyselý, J.*
AU  - Guo, Y.*
AU  - Tong, S.*
AU  - de'Donato, F.*
AU  - Michelozzi, P.*
AU  - Coelho, M.S.Z.S.*
AU  - Saldiva, P.H.N.*
AU  - Lavigne, E.*
AU  - Orru, H.*
AU  - Indermitte, E.*
AU  - Pascal, M.*
AU  - Goodman, P.*
AU  - Zeka, A.*
AU  - Kim, Y.*
AU  - Diaz, M.H.*
AU  - Arellano, E.E.F.*
AU  - Overcenco, A.*
AU  - Klompmaker, J.*
AU  - Rao, S.*
AU  - Palomares, A.D.*
AU  - Carrasco, G.*
AU  - Seposo, X.*
AU  - Pereira da Silva, S.D.N.*
AU  - Madureira, J.*
AU  - Holobaca, I.H.*
AU  - Scovronick, N.*
AU  - Acquaotta, F.*
AU  - Kim, H.*
AU  - Lee, W.*
AU  - Hashizume, M.*
AU  - Tobias, A.*
AU  - Iñiguez, C.*
AU  - Forsberg, B.*
AU  - Ragettli, M.S.*
AU  - Guo, Y.L.*
AU  - Pan, S.C.*
AU  - Osorio, S.*
AU  - Li, S.*
AU  - Zanobetti, A.*
AU  - Dang, T.N.*
AU  - Van Dung, D.*
AU  - Schneider, A.E.
C1  - 71965
C2  - 56389
TI  - Rainfall events and daily mortality across 645 global locations: Two stage time series analysis.
JO  - BMJ
VL  - 387
PY  - 2024
SN  - 0959-535X
ER  - 

TY  - JOUR
AB  - OBJECTIVES: To assess the short term temporal variations in suicide risk related to the day of the week and national holidays in multiple countries. DESIGN: Multicountry, two stage, time series design. SETTING: Data from 740 locations in 26 countries and territories, with overlapping periods between 1971 and 2019, collected from the Multi-city Multi-country Collaborative Research Network database. PARTICIPANTS: All suicides were registered in these locations during the study period (overall 1 701  286 cases). MAIN OUTCOME MEASURES: Daily suicide mortality. RESULTS: Mondays had peak suicide risk during weekdays (Monday-Friday) across all countries, with relative risks (reference: Wednesday) ranging from 1.02 (95% confidence interval (CI) 0.95 to 1.10) in Costa Rica to 1.17 (1.09 to 1.25) in Chile. Suicide risks were lowest on Saturdays or Sundays in many countries in North America, Asia, and Europe. However, the risk increased during weekends in South and Central American countries, Finland, and South Africa. Additionally, evidence suggested strong increases in suicide risk on New Year's day in most countries with relative risks ranging from 0.93 (95% CI 0.75 to 1.14) in Japan to 1.93 (1.31 to 2.85) in Chile, whereas the evidence on Christmas day was weak. Suicide risk was associated with a weak decrease on other national holidays, except for Central and South American countries, where the risk generally increased one or two days after these holidays. CONCLUSIONS: Suicide risk was highest on Mondays and increased on New Year's day in most countries. However, the risk of suicide on weekends and Christmas varied by country and territory. The results of this study can help to better understand the short term variations in suicide risks and define suicide prevention action plans and awareness campaigns.
AU  - Lee, W.*
AU  - Kang, C.*
AU  - Park, C.*
AU  - Bell, M.L.*
AU  - Armstrong, B.*
AU  - Royé, D.*
AU  - Hashizume, M.*
AU  - Gasparrini, A.*
AU  - Tobias, A.*
AU  - Sera, F.*
AU  - Honda, Y.*
AU  - Urban, A.*
AU  - Kyselý, J.*
AU  - Iñiguez, C.*
AU  - Ryti, N.*
AU  - Guo, Y.*
AU  - Tong, S.*
AU  - de Sousa Zanotti Stagliorio Coélho, M.*
AU  - Lavigne, E.*
AU  - de'Donato, F.*
AU  - Guo, Y.L.*
AU  - Schwartz, J.*
AU  - Schneider, A.E.
AU  - Breitner-Busch, S.
AU  - Chung, Y.*
AU  - Kim, S.*
AU  - Ha, E.E.*
AU  - Kim, H.*
AU  - Kim, Y.*
C1  - 72143
C2  - 56394
TI  - Association of holidays and the day of the week with suicide risk: Multicounty, two stage, time series study.
JO  - BMJ
VL  - 387
PY  - 2024
SN  - 0959-535X
ER  - 

TY  - JOUR
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.
AU  - Liu, C.*
AU  - Chen, R.*
AU  - Sera, F.*
AU  - Vicedo-Cabrera, A.M.*
AU  - Guo, Y.*
AU  - Tong, S.*
AU  - Lavigne, E.*
AU  - Correa, P.M.*
AU  - Ortega, N.V.*
AU  - Achilleos, S.*
AU  - Royé, D.*
AU  - Jaakkola, J.J.*
AU  - Ryti, N.*
AU  - Pascal, M.*
AU  - Schneider, A.E.
AU  - Breitner-Busch, S.
AU  - Entezari, A.*
AU  - Mayvaneh, F.*
AU  - Raz, R.*
AU  - Honda, Y.*
AU  - Hashizume, M.*
AU  - Ng, C.F.S.*
AU  - Gaio, V.*
AU  - Madureira, J.*
AU  - Holobaca, I.H.*
AU  - Tobias, A.*
AU  - Iñiguez, C.*
AU  - Guo, Y.L.*
AU  - Pan, S.C.*
AU  - Masselot, P.*
AU  - Bell, M.L.*
AU  - Zanobetti, A.*
AU  - Schwartz, J.*
AU  - Gasparrini, A.*
AU  - Kan, H.*
C1  - 68633
C2  - 54813
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
TI  - Interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities: Two stage time series analysis.
JO  - BMJ
VL  - 383
PB  - Bmj Publishing Group
PY  - 2023
SN  - 0959-535X
ER  - 

TY  - JOUR
AB  - OBJECTIVE: To evaluate lag-response associations and effect modifications of exposure to floods with risks of all cause, cardiovascular, and respiratory mortality on a global scale. DESIGN: Time series study. SETTING: 761 communities in 35 countries or territories with at least one flood event during the study period. PARTICIPANTS: Multi-Country Multi-City Collaborative Research Network database, Australian Cause of Death Unit Record File, New Zealand Integrated Data Infrastructure, and the International Network for the Demographic Evaluation of Populations and their Health Network database. MAIN OUTCOME MEASURES: The main outcome was daily counts of deaths. An estimation for the lag-response association between flood and daily mortality risk was modelled, and the relative risks over the lag period were cumulated to calculate overall effects. Attributable fractions of mortality due to floods were further calculated. A quasi-Poisson model with a distributed lag non-linear function was used to examine how daily death risk was associated with flooded days in each community, and then the community specific associations were pooled using random effects multivariate meta-analyses. Flooded days were defined as days from the start date to the end date of flood events. RESULTS: A total of 47.6 million all cause deaths, 11.1 million cardiovascular deaths, and 4.9 million respiratory deaths were analysed. Over the 761 communities, mortality risks increased and persisted for up to 60 days (50 days for cardiovascular mortality) after a flooded day. The cumulative relative risks for all cause, cardiovascular, and respiratory mortality were 1.021 (95% confidence interval 1.006 to 1.036), 1.026 (1.005 to 1.047), and 1.049 (1.008 to 1.092), respectively. The associations varied across countries or territories and regions. The flood-mortality associations appeared to be modified by climate type and were stronger in low income countries and in populations with a low human development index or high proportion of older people. In communities impacted by flood, up to 0.10% of all cause deaths, 0.18% of cardiovascular deaths, and 0.41% of respiratory deaths were attributed to floods. CONCLUSIONS: This study found that the risks of all cause, cardiovascular, and respiratory mortality increased for up to 60 days after exposure to flood and the associations could vary by local climate type, socioeconomic status, and older age.
AU  - Yang, Z.*
AU  - Huang, W.*
AU  - McKenzie, J.E.*
AU  - Xu, R.*
AU  - Yu, P.*
AU  - Ye, T.*
AU  - Wen, B.*
AU  - Gasparrini, A.*
AU  - Armstrong, B.*
AU  - Tong, S.*
AU  - Lavigne, E.*
AU  - Madureira, J.*
AU  - Kyselý, J.*
AU  - Guo, Y.*
AU  - Li, S.*
AU  - MCC Collaborative Research Network (Peters, A.
AU  - Huber, V.)
C1  - 70152
C2  - 55024
TI  - Mortality risks associated with floods in 761 communities worldwide: Time series study.
JO  - BMJ
VL  - 383
PY  - 2023
SN  - 0959-535X
ER  - 

TY  - JOUR
AB  - OBJECTIVE: To evaluate the short term associations between nitrogen dioxide (NO2) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. DESIGN: Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. SETTING: 398 cities in 22 low to high income countries/regions. MAIN OUTCOME MEASURES: Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018. RESULTS: On average, a 10 μg/m3 increase in NO2 concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM10 and PM2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO2 concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities. CONCLUSIONS: This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO2 and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO2.
AU  - Meng, X.*
AU  - Liu, C.*
AU  - Chen, R.*
AU  - Sera, F.*
AU  - Vicedo-Cabrera, A.M.*
AU  - Milojevic, A.*
AU  - Guo, Y.*
AU  - Tong, S.*
AU  - Coelho, M.S.Z.S.*
AU  - Saldiva, P.H.N.*
AU  - Lavigne, E.*
AU  - Correa, P.M.*
AU  - Ortega, N.V.*
AU  - Osorio, S.*
AU  - Garcia, S.O.*
AU  - Kyselý, J.*
AU  - Urban, A.*
AU  - Orru, H.*
AU  - Maasikmets, M.*
AU  - Jaakkola, J.J.K.*
AU  - Ryti, N.*
AU  - Huber, V.*
AU  - Schneider, A.E.
AU  - Katsouyanni, K.*
AU  - Analitis, A.*
AU  - Hashizume, M.*
AU  - Honda, Y.*
AU  - Ng, C.F.S.*
AU  - Nunes, B.*
AU  - Teixeira, J.P.*
AU  - Holobaca, I.H.*
AU  - Fratianni, S.*
AU  - Kim, H.*
AU  - Tobias, A.*
AU  - Iñiguez, C.*
AU  - Forsberg, B.*
AU  - Åström, C.*
AU  - Ragettli, M.S.*
AU  - Guo, Y.L.*
AU  - Pan, S.C.*
AU  - Li, S.*
AU  - Bell, M.L.*
AU  - Zanobetti, A.*
AU  - Schwartz, J.*
AU  - Wu, T.*
AU  - Gasparrini, A.*
AU  - Kan, H.*
C1  - 61691
C2  - 50163
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
TI  - Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.
JO  - BMJ
VL  - 372
PB  - Bmj Publishing Group
PY  - 2021
SN  - 0959-535X
ER  - 

TY  - JOUR
AB  - OBJECTIVE: To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines. DESIGN: Pooled analysis of eight cohorts. SETTING: Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries. PARTICIPANTS: 325 367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM2.5), nitrogen dioxide, ozone, and black carbon. MAIN OUTCOME MEASURES: Deaths due to natural causes and cause specific mortality. RESULTS: Of 325 367 adults followed-up for an average of 19.5 years, 47 131 deaths were observed. Higher exposure to PM2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 µg/m3 in PM2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 µg/m3 increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 µg/m3 an increase of 5 µg/m3 in PM2.5 was associated with 29.6% (14% to 47.4%) increase in natural deaths. CONCLUSIONS: Our study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about revision of air quality limits, guidelines, and standards, and future assessments by the Global Burden of Disease.
AU  - Strak, M.*
AU  - Weinmayr, G.*
AU  - Rodopoulou, S.*
AU  - Chen, J.*
AU  - de Hoogh, K.*
AU  - Andersen, Z.J.*
AU  - Atkinson, R.*
AU  - Bauwelinck, M.*
AU  - Bekkevold, T.*
AU  - Bellander, T.*
AU  - Boutron-Ruault, M.C.*
AU  - Brandt, J.*
AU  - Cesaroni, G.*
AU  - Concin, H.*
AU  - Fecht, D.*
AU  - Forastiere, F.*
AU  - Gulliver, J.*
AU  - Hertel, O.*
AU  - Hoffmann, B.*
AU  - Hvidtfeldt, U.A.*
AU  - Janssen, N.A.H.*
AU  - Jöckel, K.H.*
AU  - Jørgensen, J.T.*
AU  - Ketzel, M.*
AU  - Klompmaker, J.O.*
AU  - Lager, A.*
AU  - Leander, K.*
AU  - Liu, S.*
AU  - Ljungman, P.*
AU  - Magnusson, P.K.E.*
AU  - Mehta, A.J.*
AU  - Nagel, G.*
AU  - Oftedal, B.*
AU  - Pershagen, G.*
AU  - Peters, A.
AU  - Raaschou-Nielsen, O.*
AU  - Renzi, M.*
AU  - Rizzuto, D.*
AU  - van der Schouw, Y.T.*
AU  - Schramm, S.*
AU  - Severi, G.*
AU  - Sigsgaard, T.*
AU  - Sørensen, M.*
AU  - Stafoggia, M.*
AU  - Tjønneland, A.*
AU  - Verschuren, W.M.M.*
AU  - Vienneau, D.*
AU  - Wolf, K.
AU  - Katsouyanni, K.*
AU  - Brunekreef, B.*
AU  - Hoek, G.*
AU  - Samoli, E.*
C1  - 62967
C2  - 51129
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
TI  - Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: Pooled analysis.
JO  - BMJ
VL  - 374
PB  - Bmj Publishing Group
PY  - 2021
SN  - 0959-535X
ER  - 

TY  - JOUR
AB  - Objective To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. Design Two stage time series analysis. Setting 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. Population Deaths for all causes or for external causes only registered in each city within the study period. Main outcome measures Daily total mortality (all or non-external causes only). Results A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 μg/m 3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 μg/m 3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 μg/m 3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively. Conclusions Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.
AU  - Vicedo-Cabrera, A.M.*
AU  - Sera, F.*
AU  - Liu, C.*
AU  - Armstrong, B.*
AU  - Milojevic, A.*
AU  - Guo, Y.*
AU  - Tong, S.*
AU  - Lavigne, E.*
AU  - Kyselý, J.*
AU  - Urban, A.*
AU  - Orru, H.*
AU  - Indermitte, E.*
AU  - Pascal, M.*
AU  - Huber, V.*
AU  - Schneider, A.E.
AU  - Katsouyanni, K.*
AU  - Samoli, E.*
AU  - Stafoggia, M.*
AU  - Scortichini, M.*
AU  - Hashizume, M.*
AU  - Honda, Y.*
AU  - Ng, C.F.S.*
AU  - Hurtado-Diaz, M.*
AU  - Cruz, J.*
AU  - Silva, S.*
AU  - Madureira, J.*
AU  - Scovronick, N.*
AU  - Garland, R.M.*
AU  - Kim, H.*
AU  - Tobias, A.*
AU  - Iñiguez, C.*
AU  - Forsberg, B.*
AU  - Åström, C.*
AU  - Ragettli, M.S.*
AU  - Röösli, M.*
AU  - Guo, Y.L.L.*
AU  - Chen, B.Y.*
AU  - Zanobetti, A.*
AU  - Schwartz, J.*
AU  - Bell, M.L.*
AU  - Kan, H.*
AU  - Gasparrini, A.*
C1  - 58891
C2  - 48417
TI  - Short term association between ozone and mortality: Global two stage time series study in 406 locations in 20 countries.
JO  - BMJ
VL  - 368
PY  - 2020
SN  - 0959-535X
ER  - 

TY  - JOUR
AB  - OBJECTIVE: To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological relative risk measures. DESIGN: Individual participant meta-analysis using data from 25 cohorts participating in the CHANCES consortium. Data were harmonised, analysed separately employing Cox proportional hazard regression models, and combined by meta-analysis. RESULTS: Overall, 503 905 participants aged 60 and older were included in this study, of whom 37 952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1.49) for former smokers compared with never smokers. Corresponding summary estimates for risk advancement periods were 5.50 years (4.25 to 6.75) for current smokers and 2.16 years (1.38 to 2.39) for former smokers. The excess risk in smokers increased with cigarette consumption in a dose-response manner, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar. CONCLUSIONS: Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk.
AU  - Mons, U.*
AU  - Müezzinler, A.*
AU  - Gellert, C.*
AU  - Schöttker, B.*
AU  - Abnet, C.C.*
AU  - Bobak, M.*
AU  - de Groot, L.*
AU  - Freedman, N.D.*
AU  - Jansen, E.*
AU  - Kee, F.*
AU  - Kromhout, D.*
AU  - Kuulasmaa, K.*
AU  - Laatikainen, T.*
AU  - O'Doherty, M.G.*
AU  - Bueno-de-Mesquita, H.B.*
AU  - Orfanos, P.*
AU  - Peters, A.
AU  - van der Schouw, Y.T.*
AU  - Wilsgaard, T.*
AU  - Wolk, A.*
AU  - Trichopoulou, A.*
AU  - Boffetta, P.*
AU  - Brenner, H.*
AU  - CHANCES Consortium (*)
C1  - 44458
C2  - 36867
CY  - London
TI  - Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: Meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium.
JO  - BMJ
VL  - 350
PB  - Bmj Publishing Group
PY  - 2015
SN  - 0959-535X
ER  -