Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis
Background: Air pollution is a leading cause of mortality and morbidity worldwide. Short-term exposure (from one hour to days) to selected air pollutants has been associated with human mortality. This systematic review was conducted to analyse the evidence on the effects of short-term exposure to pa...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Environment International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412020318316 |
| _version_ | 1818937714444075008 |
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| author | Pablo Orellano Julieta Reynoso Nancy Quaranta Ariel Bardach Agustin Ciapponi |
| author_facet | Pablo Orellano Julieta Reynoso Nancy Quaranta Ariel Bardach Agustin Ciapponi |
| author_sort | Pablo Orellano |
| collection | DOAJ |
| description | Background: Air pollution is a leading cause of mortality and morbidity worldwide. Short-term exposure (from one hour to days) to selected air pollutants has been associated with human mortality. This systematic review was conducted to analyse the evidence on the effects of short-term exposure to particulate matter with aerodynamic diameters less or equal than 10 and 2.5 µm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on all-cause mortality, and PM10 and PM2.5 on cardiovascular, respiratory, and cerebrovascular mortality. Methods: We included studies on human populations exposed to outdoor air pollution from any source, excluding occupational exposures. Relative risks (RRs) per 10 µg/m3 increase in air pollutants concentrations were used as the effect estimates. Heterogeneity between studies was assessed using 80% prediction intervals. Risk of bias (RoB) in individual studies was analysed using a new domain-based assessment tool, developed by a working group convened by the World Health Organization and designed specifically to evaluate RoB within eligible air pollution studies included in systematic reviews. We conducted subgroup and sensitivity analyses by age, sex, continent, study design, single or multicity studies, time lag, and RoB. The certainty of evidence was assessed for each exposure-outcome combination. The protocol for this review was registered with PROSPERO (CRD42018087749). Results: We included 196 articles in quantitative analysis. All combinations of pollutants and all-cause and cause-specific mortality were positively associated in the main analysis, and in a wide range of sensitivity analyses. The only exception was NO2, but when considering a 1-hour maximum exposure. We found positive associations between pollutants and all-cause mortality for PM10 (RR: 1.0041; 95% CI: 1.0034–1.0049), PM2.5 (RR: 1.0065; 95% CI: 1.0044–1.0086), NO2 (24-hour average) (RR: 1.0072; 95% CI: 1.0059–1.0085), and O3 (RR: 1.0043; 95% CI: 1.0034–1.0052). PM10 and PM2.5 were also positively associated with cardiovascular, respiratory, and cerebrovascular mortality. We found some degree of heterogeneity between studies in three exposure-outcome combinations, and this heterogeneity could not be explained after subgroup analysis. RoB was low or moderate in the majority of articles. The certainty of evidence was judged as high in 10 out of 11 combinations, and moderate in one combination. Conclusions: This study found evidence of a positive association between short-term exposure to PM10, PM2.5, NO2, and O3 and all-cause mortality, and between PM10 and PM2.5 and cardiovascular, respiratory and cerebrovascular mortality. These results were robust through several sensitivity analyses. In general, the level of evidence was high, meaning that we can be confident in the associations found in this study. |
| first_indexed | 2024-12-20T05:56:21Z |
| format | Article |
| id | doaj.art-9410c9207e9e450e8f65532468c07b19 |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-12-20T05:56:21Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-9410c9207e9e450e8f65532468c07b192022-12-21T19:51:02ZengElsevierEnvironment International0160-41202020-09-01142105876Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysisPablo Orellano0Julieta Reynoso1Nancy Quaranta2Ariel Bardach3Agustin Ciapponi4Centro de Investigaciones y Transferencia San Nicolás, Universidad Tecnológica Nacional (CONICET), San Nicolás, Argentina; Corresponding author at: Colon 332, San Nicolas, Provincia de Buenos Aires, ZIP 2900, Argentina.Hospital General “San Felipe”, San Nicolás, ArgentinaFacultad Regional San Nicolás, Universidad Tecnológica Nacional, San Nicolás, Argentina; Comisión de Investigaciones Científicas de la Provincia de Buenos Aires, La Plata, ArgentinaInstituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, ArgentinaInstituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, ArgentinaBackground: Air pollution is a leading cause of mortality and morbidity worldwide. Short-term exposure (from one hour to days) to selected air pollutants has been associated with human mortality. This systematic review was conducted to analyse the evidence on the effects of short-term exposure to particulate matter with aerodynamic diameters less or equal than 10 and 2.5 µm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on all-cause mortality, and PM10 and PM2.5 on cardiovascular, respiratory, and cerebrovascular mortality. Methods: We included studies on human populations exposed to outdoor air pollution from any source, excluding occupational exposures. Relative risks (RRs) per 10 µg/m3 increase in air pollutants concentrations were used as the effect estimates. Heterogeneity between studies was assessed using 80% prediction intervals. Risk of bias (RoB) in individual studies was analysed using a new domain-based assessment tool, developed by a working group convened by the World Health Organization and designed specifically to evaluate RoB within eligible air pollution studies included in systematic reviews. We conducted subgroup and sensitivity analyses by age, sex, continent, study design, single or multicity studies, time lag, and RoB. The certainty of evidence was assessed for each exposure-outcome combination. The protocol for this review was registered with PROSPERO (CRD42018087749). Results: We included 196 articles in quantitative analysis. All combinations of pollutants and all-cause and cause-specific mortality were positively associated in the main analysis, and in a wide range of sensitivity analyses. The only exception was NO2, but when considering a 1-hour maximum exposure. We found positive associations between pollutants and all-cause mortality for PM10 (RR: 1.0041; 95% CI: 1.0034–1.0049), PM2.5 (RR: 1.0065; 95% CI: 1.0044–1.0086), NO2 (24-hour average) (RR: 1.0072; 95% CI: 1.0059–1.0085), and O3 (RR: 1.0043; 95% CI: 1.0034–1.0052). PM10 and PM2.5 were also positively associated with cardiovascular, respiratory, and cerebrovascular mortality. We found some degree of heterogeneity between studies in three exposure-outcome combinations, and this heterogeneity could not be explained after subgroup analysis. RoB was low or moderate in the majority of articles. The certainty of evidence was judged as high in 10 out of 11 combinations, and moderate in one combination. Conclusions: This study found evidence of a positive association between short-term exposure to PM10, PM2.5, NO2, and O3 and all-cause mortality, and between PM10 and PM2.5 and cardiovascular, respiratory and cerebrovascular mortality. These results were robust through several sensitivity analyses. In general, the level of evidence was high, meaning that we can be confident in the associations found in this study.http://www.sciencedirect.com/science/article/pii/S0160412020318316Air pollutantsMortalityTime series studiesObservational studySystematic reviewMeta-analysis |
| spellingShingle | Pablo Orellano Julieta Reynoso Nancy Quaranta Ariel Bardach Agustin Ciapponi Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis Environment International Air pollutants Mortality Time series studies Observational study Systematic review Meta-analysis |
| title | Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis |
| title_full | Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis |
| title_fullStr | Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis |
| title_full_unstemmed | Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis |
| title_short | Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis |
| title_sort | short term exposure to particulate matter pm10 and pm2 5 nitrogen dioxide no2 and ozone o3 and all cause and cause specific mortality systematic review and meta analysis |
| topic | Air pollutants Mortality Time series studies Observational study Systematic review Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S0160412020318316 |
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