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Liu, C.* ; Cai, J.* ; Chen, R.* ; Sera, F.* ; Guo, Y.* ; Tong, S.* ; Li, S.* ; Lavigne, E.* ; Correa, P.M.* ; Ortega, N.V.* ; Orru, H.* ; Maasikmets, M.* ; Jaakkola, J.J.K.* ; Ryti, N.* ; Breitner-Busch, S. ; Schneider, A.E. ; Katsouyanni, K.* ; Samoli, E.* ; Hashizume, M.* ; Honda, Y.* ; Ng, C.F.S.* ; Diaz, M.H.* ; Valencia, C.C.* ; Rao, S.* ; Palomares, A.D.* ; Silva, S.P.D.* ; Madureira, J.* ; Holobâc, I.H.* ; Fratianni, S.* ; Scovronick, N.* ; Garland, R.M.* ; Tobias, A.* ; Iñiguez, C.* ; Forsberg, B.* ; Åström, C.* ; Vicedo-Cabrera, A.M.* ; Ragettli, M.S.* ; Guo, Y.L.* ; Pan, S.C.* ; Milojevic, A.* ; Bell, M.L.* ; Zanobetti, A.* ; Schwartz, J.* ; Gasparrini, A.* ; Kan, H.*

Coarse particulate air pollution and daily mortality: A global study in 205 cities.

Am. J. Respir. Crit. Care Med. 206, 999-1007 (2022)

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RATIONALE: The associations between ambient coarse particulate matter (PM2.5-10) and daily mortality is not fully understood at 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, 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 particulate matter. A two-stage time-series analytic approach was applied, with over-dispersed generalized linear models and multilevel meta-analysis. We fitted two-pollutant models to test the independent effect of PM2.5-10 from co-pollutants (fine particulate matter, 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 co-pollutants 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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