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Liu, C.* ; Chen, R.* ; Sera, F.* ; Vicedo-Cabrera, A.M.* ; Guo, Y.* ; Tong, S.* ; Lavigne, E.* ; Correa, P.M.* ; Ortega, N.V.* ; Achilleos, S.* ; Royé, D.* ; Jaakkola, J.J.* ; Ryti, N.* ; Pascal, M.* ; Schneider, A.E. ; Breitner-Busch, S. ; Entezari, A.* ; Mayvaneh, F.* ; Raz, R.* ; Honda, Y.* ; Hashizume, M.* ; Ng, C.F.S.* ; Gaio, V.* ; Madureira, J.* ; Holobaca, I.H.* ; Tobias, A.* ; Iñiguez, C.* ; Guo, Y.L.* ; Pan, S.C.* ; Masselot, P.* ; Bell, M.L.* ; Zanobetti, A.* ; Schwartz, J.* ; Gasparrini, A.* ; Kan, H.*

Interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities: Two stage time series analysis.

BMJ 383:e075203 (2023)
Publ. Version/Full Text DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
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.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Air-pollution; Particles; Health
ISSN (print) / ISBN 0959-8138
e-ISSN 1756-1833
Journal BMJ
Quellenangaben Volume: 383, Issue: , Pages: , Article Number: e075203 Supplement: ,
Publisher British Medical Association
Publishing Place London
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)
Grants 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
National Natural Science Foundation of China