TY  - JOUR
AB  - BACKGROUND: The prevalence of metabolic syndrome (MetS) has increased rapidly, with considerable variation between European countries. The study examined the relationship between air pollutants, greenspace, and MetS and its components in the Czech and Swiss populations. METHODS: Cross-sectional data from the Czech Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) (n = 4,931) and the Swiss cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) (n = 4,422) cohorts included participants aged 44-73 years. MetS was defined as abdominal obesity plus two additional components (hypertension, diabetes, low high-density lipoprotein cholesterol, and elevated triglycerides). Annual mean concentrations of PM10, PM2.5, NO2, and greenspace (defined as the annual mean of normalized difference vegetation index within 500 m) were assigned to the individual residential level. We estimated odds ratios (OR) using multivariable logistic regressions with cluster-robust standard error, controlling for multiple confounders. RESULTS: The prevalence of MetS was significantly higher in the Czech (51.1%) compared with Swiss (35.8%) population as were the concentration means of PM10 and PM2.5. In HAPIEE, a 5 μg/m3 increase in PM2.5 was associated with 14% higher odds of MetS (OR = 1.14; 95% confidence interval [CI] = 1.01, 1.28). In SAPALDIA, no evidence was found for the associations between air pollutants and MetS (e.g. OR = 1.01; 95% CI = 0.90, 1.13 for PM2.5). No protective effects of normalized difference vegetation index on MetS were observed. Upon inspection of MetS components, PM2.5 and PM10 exposures were associated with higher odds of hypertension and elevated triglycerides in HAPIEE only, while PM2.5, PM10, and NO2 were associated with higher odds of diabetes in SAPALDIA only. CONCLUSION: Individuals with higher exposures to PM2.5 may be at higher risk of MetS. The differential associations with MetS components between the cohorts deserve further investigation.
AU  - Dalecká, A.*
AU  - Jeong, A.*
AU  - Szabó, D.*
AU  - Tamasi, B.*
AU  - Imboden, M.*
AU  - Schaffner, E.*
AU  - Keidel, D.*
AU  - Shen, Y.*
AU  - Nieuwenhuijsen, M.*
AU  - Cirach, M.*
AU  - de Hoogh, K.*
AU  - Vlaanderen, J.*
AU  - Vermeulen, R.*
AU  - Peters, A.
AU  - Melén, E.*
AU  - Peasey, A.*
AU  - Bobak, M.*
AU  - Pikhart, H.*
AU  - Probst-Hensch, N.*
C1  - 74495
C2  - 57492
CY  - Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
TI  - Air pollution, greenspace, and metabolic syndrome in older Czech and Swiss populations.
JO  - Environ. Epi.
VL  - 9
IS  - 3
PB  - Lippincott Williams & Wilkins
PY  - 2025
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - An increasing proportion of the world's population lives in urban settings that have limited greenspace. Urbanization puts pressure on existing greenspace and reduces its access. Climate impacts, including increased temperature and extreme weather events, challenge the maintenance of urban vegetation, reducing its ecosystem services and benefits for human health. Although urban greenspace has been positively associated with numerous health indicators, the evidence for allergies and respiratory health is much less clear and mixed. To address these uncertainties, a workshop with 20 global participants was held in Munich, Germany, in May 2024, focusing on the impact of greenspace-related co-exposures on allergies and respiratory health. This narrative review captures key insights from the workshop, including the roles of urban greenspace in (1) climate change mitigation, (2) interactions with pollen, and (3) emissions of biogenic volatile organic compounds and their byproducts, such as ozone. Additionally, it presents research and stakeholder recommendations from the workshop. Future studies that integrate advanced greenspace exposure assessments and consider the interplay of greenspace with pollen and biogenic volatile organic compounds, along with their relevant byproducts are needed. Increased public awareness and policy actions will also be essential for developing urban greenspace that maximizes health benefits, minimizes risks, and ensures resilience amid a changing climate and rapid urbanization.
AU  - Zhao, T.*
AU  - Heinrich, J.*
AU  - Brauer, M.*
AU  - Fulman, N.*
AU  - Idrose, N.S.*
AU  - Baumbach, C.*
AU  - Buters, J.T.M.
AU  - Markevych, I.*
AU  - Ritz, B.*
AU  - Tham, R.*
AU  - Yang, B.Y.*
AU  - Zeng, X.W.*
AU  - Alashhab, S.
AU  - Gui, Z.H.*
AU  - Lin, L.Z.*
AU  - Nowak, D.*
AU  - Sadeh, M.*
AU  - Singh, N.*
AU  - Dong, G.H.*
AU  - Fuertes, E.*
C1  - 73396
C2  - 57045
CY  - Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
TI  - Urban greenspace under a changing climate: Benefit or harm for allergies and respiratory health?
JO  - Environ. Epi.
VL  - 9
IS  - 2
PB  - Lippincott Williams & Wilkins
PY  - 2025
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - Introduction: Type 2 diabetes (T2D) is a major public health concern, and various environmental factors have been associated with the development of this disease. This study aimed to investigate the longitudinal effects of multiple environmental exposures on the risk of incident T2D in a German population-based cohort. Methods: We used data from the KORA cohort study (Augsburg, Germany) and assessed exposure to air pollutants, traffic noise, greenness, and temperature at the participants' residencies. Cox proportional hazard models were used to analyze the associations with incident T2D, adjusting for potential confounders. Results: Of 7736 participants included in the analyses, 10.5% developed T2D during follow-up (mean: 15.0 years). We found weak or no association between environmental factors and the risk of T2D, with sex and education level significantly modifying the effects of air pollutants. Conclusion: Our study contributes to the growing body of literature investigating the impact of environmental factors on T2D risks and suggests that the impact of environmental factors may be small.
AU  - Badpa, M.
AU  - Schneider, A.E.
AU  - Schwettmann, L.
AU  - Thorand, B.
AU  - Wolf, K.
AU  - Peters, A.
C1  - 70269
C2  - 55219
CY  - Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
TI  - Air pollution, traffic noise, greenness, and temperature and the risk of incident type 2 diabetes: Results from the KORA cohort study.
JO  - Environ. Epi.
VL  - 8
IS  - 2
PB  - Lippincott Williams & Wilkins
PY  - 2024
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - OBJECTIVES: While COVID-19 continues to challenge the world, meteorological variables are thought to impact COVID-19 transmission. Previous studies showed evidence of negative associations between high temperature and absolute humidity on COVID-19 transmission. Our research aims to fill the knowledge gap on the modifying effect of vaccination rates and strains on the weather-COVID-19 association. METHODS: Our study included COVID-19 data from 439 cities in 22 countries spanning 3 February 2020 - 31 August 2022 and meteorological variables (temperature, relative humidity, absolute humidity, solar radiation, and precipitation). We used a two-stage time-series design to assess the association between meteorological factors and COVID-19 incidence. For the exposure modeling, we used distributed lag nonlinear models with a lag of up to 14 days. Finally, we pooled the estimates using a random effect meta-analytic model and tested vaccination rates and dominant strains as possible effect modifiers. RESULTS: Our results showed an association between temperature and absolute humidity on COVID-19 transmission. At 5 °C, the relative risk of COVID-19 incidence is 1.22-fold higher compared to a reference level at 17 °C. Correlated with temperature, we observed an inverse association for absolute humidity. We observed a tendency of increased risk on days without precipitation, but no association for relative humidity and solar radiation. No interaction between vaccination rates or strains on the weather-COVID-19 association was observed. CONCLUSIONS: This study strengthens previous evidence of a relationship of temperature and absolute humidity with COVID-19 incidence. Furthermore, no evidence was found that vaccinations and strains significantly modify the relationship between environmental factors and COVID-19 transmission.
AU  - Feurer, D.*
AU  - Riffe, T.*
AU  - Kniffka, M.S.*
AU  - Acosta, E.*
AU  - Armstrong, B.*
AU  - Mistry, M.*
AU  - Lowe, R.*
AU  - Royé, D.*
AU  - Hashizume, M.*
AU  - Madaniyazi, L.*
AU  - Ng, C.F.S.*
AU  - Tobias, A.*
AU  - Iñiguez, C.*
AU  - Vicedo-Cabrera, A.M.*
AU  - Ragettli, M.S.*
AU  - Lavigne, E.*
AU  - Correa, P.M.*
AU  - Ortega, N.V.*
AU  - Kyselý, J.*
AU  - Urban, A.*
AU  - Orru, H.*
AU  - Indermitte, E.*
AU  - Maasikmets, M.*
AU  - Dallavalle, M.
AU  - Schneider, A.E.
AU  - Honda, Y.*
AU  - Alahmad, B.*
AU  - Zanobetti, A.*
AU  - Schwartz, J.*
AU  - Carrasco, G.*
AU  - Holobâcă, I.H.*
AU  - Kim, H.*
AU  - Lee, W.*
AU  - Bell, M.L.*
AU  - Scovronick, N.*
AU  - Acquaotta, F.*
AU  - Coelho, M.S.Z.S.*
AU  - Diaz, M.H.*
AU  - Arellano, E.E.F.*
AU  - Michelozzi, P.*
AU  - Stafoggia, M.*
AU  - de'Donato, F.*
AU  - Rao, S.*
AU  - Di Ruscio, F.*
AU  - Seposo, X.*
AU  - Guo, Y.*
AU  - Tong, S.*
AU  - Masselot, P.*
AU  - Gasparrini, A.*
AU  - Sera, F.*
C1  - 72295
C2  - 56554
TI  - Meteorological factors, population immunity, and COVID-19 incidence: A global multi-city analysis.
JO  - Environ. Epi.
VL  - 8
IS  - 6
PY  - 2024
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - Research on the health risks of environmental factors and climate change requires epidemiological evidence on associated health risks at a global scale. Multi-center studies offer an excellent framework for this purpose, but they present various methodological and logistical problems. This contribution illustrates the experience of the Multi-Country Multi-City Collaborative Research Network, an international collaboration working on a global research program on the associations between environmental stressors, climate, and health in a multi-center setting. The article illustrates the collaborative scheme based on mutual contribution and data and method sharing, describes the collection of a huge multi-location database, summarizes published research findings and future plans, and discusses advantages and limitations. The Multi-Country Multi-City represents an example of a collaborative research framework that has greatly contributed to advance knowledge on the health impacts of climate change and other environmental factors and can be replicated to address other research questions across various research fields.
AU  - Gasparrini, A.*
AU  - Vicedo-Cabrera, A.M.*
AU  - Tobias, A.*
AU  - MCC Collaborative Research Network (Schneider, A.E.)
C1  - 71796
C2  - 56155
TI  - The multi-country multi-city collaborative research network: An international research consortium investigating environment, climate, and health.
JO  - Environ. Epi.
VL  - 8
IS  - 5
PY  - 2024
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - BACKGROUND: Fine particulate matter (PM2.5) occurs within a mixture of other pollutant gases that interact and impact its composition and toxicity. To characterize the local toxicity of PM2.5, it is useful to have an index that accounts for the whole pollutant mix, including gaseous pollutants. We consider a recently proposed pollutant mixture complexity index (PMCI) to evaluate to which extent it relates to PM2.5 toxicity. METHODS: The PMCI is constructed as an index spanning seven different pollutants, relative to the PM2.5 levels. We consider a standard two-stage analysis using data from 264 cities in the Northern Hemisphere. The first stage estimates the city-specific relative risks between daily PM2.5 and all-cause mortality, which are then pooled into a second-stage meta-regression model with which we estimate the effect modification from the PMCI. RESULTS: We estimate a relative excess risk of 1.0042 (95% confidence interval: 1.0023, 1.0061) for an interquartile range increase (from 1.09 to 1.95) of the PMCI. The PMCI predicts a substantial part of within-country relative risk heterogeneity with much less between-country heterogeneity explained. The Akaike information criterion and Bayesian information criterion of the main model are lower than those of alternative meta-regression models considering the oxidative capacity of PM2.5 or its composition. CONCLUSIONS: The PMCI represents an efficient and simple predictor of local PM2.5-related mortality, providing evidence that PM2.5 toxicity depends on the surrounding gaseous pollutant mix. With the advent of remote sensing for pollutants, the PMCI can provide a useful index to track air quality.
AU  - Masselot, P.*
AU  - Kan, H.*
AU  - Kharol, S.K.*
AU  - Bell, M.L.*
AU  - Sera, F.*
AU  - Lavigne, E.*
AU  - Breitner-Busch, S.
AU  - das Neves Pereira da Silva, S.*
AU  - Burnett, R.T.*
AU  - Gasparrini, A.*
AU  - Brook, J.R.*
C1  - 72221
C2  - 56491
TI  - Air pollution mixture complexity and its effect on PM2.5-related mortality: A multicountry time-series study in 264 cities.
JO  - Environ. Epi.
VL  - 8
IS  - 6
PY  - 2024
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - Background: The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in multiple countries. Methods: Daily time-series data for mortality and ambient mean temperature for 699 communities in 34 countries spanning 1986–2015 were analyzed using a two-stage meta-analysis. First, a quasi-Poisson regression was employed to estimate MMT and MMTP for each community during the designated subperiods. Second, we pooled the community-specific temporally varying estimates using mixed-effects meta-regressions to examine temporal changes in MMT and MMTP in the entire study population, as well as by climate zone, geographical region, and country. Results: Temporal increases in MMT and MMTP from 19.5 °C (17.9, 21.1) to 20.3 °C (18.5, 22.0) and from the 74.5 (68.3, 80.6) to 75.0 (71.0, 78.9) percentiles in the entire population were found, respectively. Temporal change was significantly heterogeneous across geographical regions (P < 0.001). Temporal increases in MMT were observed in East Asia (linear slope [LS] = 0.91, P = 0.02) and South-East Asia (LS = 0.62, P = 0.05), whereas a temporal decrease in MMT was observed in South Europe (LS = −0.46, P = 0.05). MMTP decreased temporally in North Europe (LS = −3.45, P = 0.02) and South Europe (LS = −2.86, P = 0.05). Conclusions: The temporal change in MMT or MMTP was largely heterogeneous. Population susceptibility in terms of optimum temperature may have changed under a warming climate, albeit with large region-dependent variations.
AU  - Yang, D.*
AU  - Hashizume, M.*
AU  - Tobias, A.*
AU  - Honda, Y.*
AU  - Royé, D.*
AU  - Oh, J.*
AU  - Dang, T.N.*
AU  - Kim, Y.*
AU  - Abrutzky, R.*
AU  - Guo, Y.*
AU  - Tong, S.*
AU  - Coelho, M.d.S.Z.S.*
AU  - Saldiva, P.H.N.*
AU  - Lavigne, E.*
AU  - Correa, P.M.*
AU  - Ortega, N.V.*
AU  - Osorio, S.*
AU  - Kyselý, J.*
AU  - Urban, A.*
AU  - Orru, H.*
AU  - Indermitte, E.*
AU  - Jaakkola, J.*
AU  - Ryti, N.*
AU  - Pascal, M.*
AU  - Huber, V.
AU  - Schneider, A.E.
AU  - Katsouyanni, K.*
AU  - Analitis, A.*
AU  - Entezari, A.*
AU  - Mayvaneh, F.*
AU  - Goodman, P.*
AU  - Zeka, A.*
AU  - Michelozzi, P.*
AU  - de’Donato, F.*
AU  - Alahmad, B.*
AU  - Diaz, M.H.*
AU  - Valencia, C.D.L.C.*
AU  - Overcenco, A.*
AU  - Houthuijs, D.*
AU  - Ameling, C.*
AU  - Rao, S.*
AU  - Nunes, B.*
AU  - Madureira, J.*
AU  - Holo-Bâc, I.H.*
AU  - Scovronick, N.*
AU  - Acquaotta, F.*
AU  - Kim, H.*
AU  - Lee, W.*
AU  - Iñiguez, C.*
AU  - Forsberg, B.*
AU  - Vicedo-Cabrera, A.M.*
AU  - Ragettli, M.S.*
AU  - Guo, Y.L.L.*
AU  - Pan, S.C.*
AU  - Li, S.*
AU  - Sera, F.*
AU  - Zanobetti, A.*
AU  - Schwartz, J.*
AU  - Armstrong, B.*
AU  - Gasparrini, A.*
AU  - Chung, Y.*
C1  - 72138
C2  - 56387
CY  - Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
TI  - Temporal change in minimum mortality temperature under changing climate A multicountry multicommunity observational study spanning 1986–2015.
JO  - Environ. Epi.
VL  - 8
IS  - 5
PB  - Lippincott Williams & Wilkins
PY  - 2024
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - Background: Heat effects on respiratory mortality are known, mostly from time-series studies of city-wide data. A limited number of studies have been conducted at the national level or covering non-urban areas. Effect modification by area-level factors has not been extensively investigated. Our study assessed the heat effects on respiratory mortality at a small administrative area level in Norway, Germany, and England and Wales, in the warm period (May-September) within 1996-2018. Also, we examined possible effect modification by several area-level characteristics in the framework of the EU-Horizon2020 EXHAUSTION project. Methods: Daily respiratory mortality counts and modeled air temperature data were collected for Norway, Germany, and England and Wales at a small administrative area level. The temperature-mortality association was assessed by small area-specific Poisson regression allowing for overdispersion, using distributed lag non-linear models. Estimates were pooled at the national level and overall using a random-effect meta-analysis. Age- and sex-specific models were also applied. A multilevel random-effects model was applied to investigate the modification of the heat effects by area-level factors. Results: A rise in temperature from the 75th to 99th percentile was associated with a 27% (95% confidence interval [CI] = 19%, 34%) increase in respiratory mortality, with higher effects for females. Increased population density and PM2.5concentrations were associated with stronger heat effects on mortality. Conclusions: Our study strengthens the evidence of adverse heat effects on respiratory mortality in Northern Europe by identifying vulnerable subgroups and subregions. This may contribute to the development of targeted policies for adaptation to climate change.
AU  - Zafeiratou, S.*
AU  - Samoli, E.*
AU  - Analitis, A.*
AU  - Gasparrini, A.*
AU  - Stafoggia, M.*
AU  - De'Donato, F.K.*
AU  - Rao, S.*
AU  - Zhang, S.
AU  - Breitner-Busch, S.
AU  - Masselot, P.*
AU  - Aunan, K.*
AU  - Schneider, A.E.
AU  - Katsouyanni, K.*
C1  - 68214
C2  - 54854
CY  - Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
TI  - Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe.
JO  - Environ. Epi.
VL  - 7
IS  - 5
PB  - Lippincott Williams & Wilkins
PY  - 2023
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - Background: Minimum mortality temperature (MMT) is an important indicator to assess the temperature-mortality association, indicating long-term adaptation to local climate. Limited evidence about the geographical variability of the MMT is available at a global scale. Methods: We collected data from 658 communities in 43 countries under different climates. We estimated temperature-mortality associations to derive the MMT for each community using Poisson regression with distributed lag nonlinear models. We investigated the variation in MMT by climatic zone using a mixed-effects meta-analysis and explored the association with climatic and socioeconomic indicators. Results: The geographical distribution of MMTs varied considerably by country between 14.2 and 31.1 °C decreasing by latitude. For climatic zones, the MMTs increased from alpine (13.0 °C) to continental (19.3 °C), temperate (21.7 °C), arid (24.5 °C), and tropical (26.5 °C). The MMT percentiles (MMTPs) corresponding to the MMTs decreased from temperate (79.5th) to continental (75.4th), arid (68.0th), tropical (58.5th), and alpine (41.4th). The MMTs indreased by 0.8 °C for a 1 °C rise in a community's annual mean temperature, and by 1 °C for a 1 °C rise in its SD. While the MMTP decreased by 0.3 centile points for a 1 °C rise in a community's annual mean temperature and by 1.3 for a 1 °C rise in its SD. Conclusions: The geographical distribution of the MMTs and MMTPs is driven mainly by the mean annual temperature, which seems to be a valuable indicator of overall adaptation across populations. Our results suggest that populations have adapted to the average temperature, although there is still more room for adaptation.
AU  - Tobias, A.*
AU  - Hashizume, M.*
AU  - Honda, Y.*
AU  - Sera, F.*
AU  - Ng, C.F.S.*
AU  - Kim, Y.*
AU  - Royé, D.*
AU  - Chung, Y.*
AU  - Dang, T.N.*
AU  - Kim, H.*
AU  - Lee, W.*
AU  - Iñiguez, C.*
AU  - Vicedo-Cabrera, A.M.*
AU  - Abrutzky, R.*
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  - Kan, H.*
AU  - Osorio, S.*
AU  - Kyselý, J.*
AU  - Urban, A.*
AU  - Orru, H.*
AU  - Indermitte, E.*
AU  - Jaakkola, J.J.K.*
AU  - Ryti, N.R.I.*
AU  - Pascal, M.*
AU  - Huber, V.*
AU  - Schneider, A.E.
AU  - Katsouyanni, K.*
AU  - Analitis, A.*
AU  - Entezari, A.*
AU  - Mayvaneh, F.*
AU  - Goodman, P.J.*
AU  - Zeka, A.*
AU  - Michelozzi, P.*
AU  - de'Donato, F.*
AU  - Alahmad, B.*
AU  - Diaz, M.H.*
AU  - De la Cruz Valencia, C.*
AU  - Overcenco, A.*
AU  - Houthuijs, D.*
AU  - Ameling, C.*
AU  - Rao, S.*
AU  - Di Ruscio, F.*
AU  - Carrasco, G.*
AU  - Seposo, X.*
AU  - Nunes, B.*
AU  - Madureira, J.*
AU  - Holobaca, I.H.*
AU  - Scovronick, N.*
AU  - Acquaotta, F.*
AU  - Forsberg, B.*
AU  - Åström, C.*
AU  - Ragettli, M.S.*
AU  - Guo, Y.L.*
AU  - Chen, B.Y.*
AU  - Li, S.*
AU  - Colistro, V.*
AU  - Zanobetti, A.*
AU  - Schwartz, J.*
AU  - Dung, D.V.*
AU  - Armstrong, B.*
AU  - Gasparrini, A.*
C1  - 63886
C2  - 51643
TI  - Geographical variations of the minimum mortality temperature at a global scale: A multicountry study.
JO  - Environ. Epi.
VL  - 5
IS  - 5
PY  - 2021
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - By 2030, more than 80% of Europe's population will live in an urban environment. The urban exposome, consisting of factors such as where we live and work, where and what we eat, our social network, and what chemical and physical hazards we are exposed to, provides important targets to improve population health. The EXPANSE (EXposome Powered tools for healthy living in urbAN SEttings) project will study the impact of the urban exposome on the major contributors to Europe's burden of disease: Cardio-Metabolic and Pulmonary Disease. EXPANSE will address one of the most pertinent questions for urban planners, policy makers, and European citizens: "How to maximize one's health in a modern urban environment?" EXPANSE will take the next step in exposome research by (1) bringing together exposome and health data of more than 55 million adult Europeans and OMICS information for more than 2 million Europeans; (2) perform personalized exposome assessment for 5,000 individuals in five urban regions; (3) applying ultra-high-resolution mass-spectrometry to screen for chemicals in 10,000 blood samples; (4) evaluating the evolution of the exposome and health through the life course; and (5) evaluating the impact of changes in the urban exposome on the burden of cardiometabolic and pulmonary disease. EXPANSE will translate its insights and innovations into research and dissemination tools that will be openly accessible via the EXPANSE toolbox. By applying innovative ethics-by-design throughout the project, the social and ethical acceptability of these tools will be safeguarded. EXPANSE is part of the European Human Exposome Network.
AU  - Vlaanderen, J.*
AU  - de Hoogh, K.*
AU  - Hoek, G.*
AU  - Peters, A.
AU  - Probst-Hensch, N.*
AU  - Scalbert, A.*
AU  - Melén, E.*
AU  - Tonne, C.*
AU  - de Wit, G.A.*
AU  - Chadeau-Hyam, M.*
AU  - Katsouyanni, K.*
AU  - Esko, T.*
AU  - Jongsma, K.R.*
AU  - Vermeulen, R.*
AU  - EXPANSE Consortium (Pickford, R.)
AU  - EXPANSE Consortium (Standl, M.)
AU  - EXPANSE Consortium (Zhao, T.)
AU  - EXPANSE Consortium (Schneider, A.E.)
AU  - EXPANSE Consortium (Breitner-Busch, S.)
AU  - EXPANSE Consortium (Wolf, K.)
AU  - EXPANSE Consortium (Waldenberger, M.)
C1  - 62857
C2  - 51109
TI  - Developing the building blocks to elucidate the impact of the urban exposome on cardiometabolic-pulmonary disease: The EU EXPANSE project.
JO  - Environ. Epi.
VL  - 5
IS  - 4
PY  - 2021
SN  - 2474-7882
ER  - 

TY  - JOUR
AB  - Background: Recent epidemiological studies investigating the modifying effect of air temperature in ozone–mortality associations lack consensus as how to adjust for nonlinear and lagged temperature effect in addition to including an interaction term. Methods: We evaluated the influence of temperature confounding control on temperature-stratified ozone–mortality risks in a time series setting in eight European cities and 86 US cities, respectively. To investigate potential residual confounding, we additionally incorporated next day’s ozone in models with differing temperature control. Results: Using only a categorical variable for temperature or only controlling nonlinear effect of low temperatures yielded highly significant ozone effects at high temperatures but also significant residual confounding in both regions. Adjustment for nonlinear effect of temperature, especially high temperatures, substantially reduced ozone effects at high temperatures and residual confounding. Conclusions: Inadequate control for confounding by air temperature leads to residual confounding and an overestimation of the temperature-modifying effect in studies of ozone-related mortality.  
AU  - Chen, K.
AU  - Wolf, K.
AU  - Hampel, R.
AU  - Stafoggia, M.*
AU  - Breitner-Busch, S.
AU  - Cyrys, J.
AU  - Samoli, E.*
AU  - Andersen, Z.J.*
AU  - Bero-Bedada, G.*
AU  - Bellander, T.*
AU  - Hennig, F.*
AU  - Jacquemin, B.*
AU  - Pekkanen, J.*
AU  - Peters, A.
AU  - Schneider, A.E.
C1  - 53665
C2  - 44810
TI  - Does temperature-confounding control influence the modifying effect of air temperature in ozone–mortality associations?
JO  - Environ. Epi.
VL  - 2
IS  - 1
PY  - 2018
SN  - 2474-7882
ER  -