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Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries

Vicedo-Cabrera, Ana M. and Sera, Francesco and Liu, Cong and Armstrong, Ben and Milojevic, Ai and Guo, Yuming and Tong, Shilu and Lavigne, Eric and Kyselý, Jan and Urban, Aleš and Orru, Hans and Indermitte, Ene and Pascal, Mathilde and Huber, Veronika and Schneider, Alexandra and Katsouyanni, Klea and Samoli, Evangelia and Stafoggia, Massimo and Scortichini, Matteo and Hashizume, Masahiro and Honda, Yasushi and Ng, Chris Fook Sheng and Hurtado-Diaz, Magali and Cruz, Julio and Silva, Susana and Madureira, Joana and Scovronick, Noah and Garland, Rebecca M. and Kim, Ho and Tobias, Aurelio and Íñiguez, Carmen and Forsberg, Bertil and Åström, Christofer and Ragettli, Martina S. and Röösli, Martin and Guo, Yue-Liang Leon and Chen, Bing-Yu and Zanobetti, Antonella and Schwartz, Joel and Bell, Michelle L. and Kan, Haidong and Gasparrini, Antonio. (2020) Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries. BMJ, 368. m108.

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Abstract

To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide.; Two stage time series analysis.; 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network.; 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).; 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.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Environmental Exposures and Health > Physical Hazards and Health (Röösli)
UniBasel Contributors:Röösli, Martin and Ragettli, Martina
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:BMJ Publishing Group
ISSN:0959-8138
e-ISSN:1756-1833
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:05 Mar 2020 08:32
Deposited On:05 Mar 2020 08:32

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