Modification of heat-related effects on mortality by air pollution concentration, at small-area level, in the Attica prefecture, Greece.

IF 5.3 2区 环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES
Sofia Zafeiratou, Evangelia Samoli, Antonis Analitis, Konstantina Dimakopoulou, Christos Giannakopoulos, Konstantinos V Varotsos, Alexandra Schneider, Massimo Stafoggia, Kristin Aunan, Klea Katsouyanni
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引用次数: 0

Abstract

Background: The independent effects of short-term exposure to increased air temperature and air pollution on mortality are well-documented. There is some evidence indicating that elevated concentrations of air pollutants may lead to increased heat-related mortality, but this evidence is not consistent. Most of these effects have been documented through time-series studies using city-wide data, rather than at a finer spatial level. In our study, we examined the possible modification of the heat effects on total and cause-specific mortality by air pollution at municipality level in the Attica region, Greece, during the warm period of the years 2000 to 2016.

Methods: A municipality-specific over-dispersed Poisson regression model during the warm season (May-September) was used to investigate the heat effects on mortality and their modification by air pollution. We used the two-day average of the daily mean temperature and daily mean PM10, NO2 and 8 hour-max ozone (O3), derived from models, in each municipality as exposures. A bivariate tensor smoother was applied for temperature and each pollutant alternatively, by municipality. Α random-effects meta-analysis was used to obtain pooled estimates of the heat effects at different pollution levels. Heterogeneity of the between-levels differences of the heat effects was evaluated with a Q-test.

Results: A rise in mean temperature from the 75th to the 99th percentile of the municipality-specific temperature distribution resulted in an increase in total mortality of 12.4% (95% Confidence Interval (CI):7.76-17.24) on low PM10 days, and 21.25% (95% CI: 17.83-24.76) on high PM10 days. The increase on mortality was 10.09% (95% CI: - 5.62- 28.41) on low ozone days, and 14.95% (95% CI: 10.79-19.27) on high ozone days. For cause-specific mortality an increasing trend of the heat effects with increasing PM10 and ozone levels was also observed. An inconsistent pattern was observed for the modification of the heat effects by NO2, with higher heat effects estimated in the lower level of the pollutant.

Conclusions: Our results support the evidence of elevated heat effects on mortality at higher levels of PM10 and 8 h max O3. Under climate change, any policy targeted at lowering air pollution levels will yield significant public health benefits.

在希腊阿提卡省,空气污染浓度在小区域范围内对与热有关的死亡率影响的修正。
背景:短期暴露于升高的气温和空气污染对死亡率的独立影响已得到充分证实。一些证据表明,空气污染物浓度升高可能会导致与高温有关的死亡率上升,但这些证据并不一致。这些影响大多是通过使用全市数据进行时间序列研究,而不是在更精细的空间层次上进行记录的。在我们的研究中,我们考察了在 2000 年至 2016 年的温暖时期,希腊阿提卡地区市一级的空气污染对总死亡率和特定病因死亡率的高温效应可能产生的影响:在温暖季节(5 月至 9 月)期间,我们采用了特定城市的过度分散泊松回归模型来研究高温对死亡率的影响及其受空气污染影响的程度。我们将每个城市的日平均气温、日平均 PM10、二氧化氮和 8 小时最大臭氧(O3)的两天平均值作为暴露量。按城市对温度和每种污染物交替使用了双变量张量平滑器。采用Α随机效应荟萃分析法对不同污染水平下的热效应进行集合估计。通过 Q 检验评估了热效应在不同水平间差异的异质性:在 PM10 浓度较低的日子里,平均气温从城市特定温度分布的第 75 个百分位数上升到第 99 个百分位数会导致总死亡率上升 12.4%(95% 置信区间:7.76-17.24),在 PM10 浓度较高的日子里会导致总死亡率上升 21.25%(95% 置信区间:17.83-24.76)。在低臭氧日,死亡率增加了 10.09%(95% CI:-5.62-28.41),在高臭氧日,死亡率增加了 14.95%(95% CI:10.79-19.27)。就特定原因死亡率而言,随着 PM10 和臭氧浓度的增加,热效应也呈上升趋势。在二氧化氮对热效应的影响方面,观察到了一种不一致的模式,即污染物水平越低,热效应越高:我们的研究结果证明,在 PM10 和最大臭氧浓度为 8 小时的情况下,热效应对死亡率的影响更大。在气候变化的情况下,任何旨在降低空气污染水平的政策都将产生显著的公共健康效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Environmental Health
Environmental Health 环境科学-公共卫生、环境卫生与职业卫生
CiteScore
10.10
自引率
1.70%
发文量
115
审稿时长
3.0 months
期刊介绍: Environmental Health publishes manuscripts on all aspects of environmental and occupational medicine and related studies in toxicology and epidemiology. Environmental Health is aimed at scientists and practitioners in all areas of environmental science where human health and well-being are involved, either directly or indirectly. Environmental Health is a public health journal serving the public health community and scientists working on matters of public health interest and importance pertaining to the environment.
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