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Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries
Authors
Ben Armstrong
Michelle L. Bell
+40 more
Bing-Yu Chen
Julio Cruz
Bertil Forsberg
Rebecca M. Garland
Antonio Gasparrini
Yue-Liang Leon Guo
Yuming Guo
Masahiro Hashizume
Yasushi Honda
Veronika Huber
Magali Hurtado-Diaz
Ene Indermitte
Haidong Kan
Klea Katsouyanni
Ho Kim
Jan Kyselý
Eric Lavigne
Cong Liu
Joana Madureira
Ai Milojevic
Chris Fook Sheng Ng
Hans Orru
Mathilde Pascal
Martina S. Ragettli
Martin Röösli
Evangelia Samoli
Alexandra Schneider
Joel Schwartz
Matteo Scortichini
Noah Scovronick
Francesco Sera
Susana Silva
Massimo Stafoggia
Aurelio Tobias
Shilu Tong
Aleš Urban
Ana M. Vicedo-Cabrera
Antonella Zanobetti
Christofer Åström
Carmen Íñiguez
Publication date
1 January 2020
Publisher
London : BMJ Publ. Group
Doi
Cite
Abstract
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. © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
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oai:oa.tib.eu:123456789/10571
Last time updated on 23/12/2022