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Åström, Christofer
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Publications (10 of 43) Show all publications
Wen, B., Wu, Y., Guo, Y., Gasparrini, A., Tong, S., Overcenco, A., . . . Li, S. (2024). Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study. Environment International, 187, Article ID 108712.
Open this publication in new window or tab >>Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study
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2024 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 187, article id 108712Article in journal (Refereed) Published
Abstract [en]

Background: Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects. Objectives: We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality.

Methods: We collected data on total, cardiovascular, and respiratory mortality and meteorology from 758 locations in 47 countries or regions from 1972 to 2020. We defined inter-day TV as the standard deviation (SD) of daily mean temperatures across the lag interval, and intra-day TV as the average SD of minimum and maximum temperatures on each day. In the first stage, inter-day and intra-day TVs were modelled simultaneously in the quasi-Poisson time-series model for each location. In the second stage, a multi-level analysis was used to pool the location-specific estimates.

Results: Overall, the mortality risk due to each interquartile range [IQR] increase was higher for intra-day TV than for inter-day TV. The risk increased by 0.59% (95% confidence interval [CI]: 0.53, 0.65) for all-cause mortality, 0.64% (95% CI: 0.56, 0.73) for cardiovascular mortality, and 0.65% (95% CI: 0.49, 0.80) for respiratory mortality per IQR increase in intra-day TV0–7 (0.9 °C). An IQR increase in inter-day TV0–7 (1.6 °C) was associated with 0.22% (95% CI: 0.18, 0.26) increase in all-cause mortality, 0.44% (95% CI: 0.37, 0.50) increase in cardiovascular mortality, and 0.31% (95% CI: 0.21, 0.41) increase in respiratory mortality. The proportion of all-cause deaths attributable to intra-day TV0–7 and inter-day TV0–7 was 1.45% and 0.35%, respectively. The mortality risks varied by lag interval, climate area, season, and climate type.

Conclusions: Our results indicated that intra-day TV may explain the main part of the mortality risk related to TV and suggested that comprehensive evaluations should be proposed in more countries to help protect human health.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Inter-day, Intra-day, Mortality, Temperature variability
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-224246 (URN)10.1016/j.envint.2024.108712 (DOI)2-s2.0-85192145675 (Scopus ID)
Funder
EU, Horizon 2020, 820655
Available from: 2024-05-15 Created: 2024-05-15 Last updated: 2024-05-15Bibliographically approved
Domingo, N. G. .., Fiore, A. M., Lamarque, J.-F., Kinney, P. L., Jiang, L., Gasparrini, A., . . . Chen, K. (2024). Ozone-related acute excess mortality projected to increase in the absence of climate and air quality controls consistent with the Paris Agreement. One Earth, 7(2), 325-335
Open this publication in new window or tab >>Ozone-related acute excess mortality projected to increase in the absence of climate and air quality controls consistent with the Paris Agreement
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2024 (English)In: One Earth, ISSN 2590-3330, E-ISSN 2590-3322, Vol. 7, no 2, p. 325-335Article in journal (Refereed) Published
Abstract [en]

Short-term exposure to ground-level ozone in cities is associated with increased mortality and is expected to worsen with climate and emission changes. However, no study has yet comprehensively assessed future ozone-related acute mortality across diverse geographic areas, various climate scenarios, and using CMIP6 multi-model ensembles, limiting our knowledge on future changes in global ozone-related acute mortality and our ability to design targeted health policies. Here, we combine CMIP6 simulations and epidemiological data from 406 cities in 20 countries or regions. We find that ozone-related deaths in 406 cities will increase by 45 to 6,200 deaths/year between 2010 and 2014 and between 2050 and 2054, with attributable fractions increasing in all climate scenarios (from 0.17% to 0.22% total deaths), except the single scenario consistent with the Paris Climate Agreement (declines from 0.17% to 0.15% total deaths). These findings stress the need for more stringent air quality regulations, as current standards in many countries are inadequate.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
acute excess mortality, bias correction, climate change, CMIP6, Ozone, Paris Agreement, projection, shared socioeconomic pathways, short-term exposure
National Category
Climate Research
Identifiers
urn:nbn:se:umu:diva-220318 (URN)10.1016/j.oneear.2024.01.001 (DOI)001188239700001 ()38420618 (PubMedID)2-s2.0-85183166139 (Scopus ID)
Available from: 2024-02-13 Created: 2024-02-13 Last updated: 2024-05-07Bibliographically approved
Rai, M., Stafoggia, M., de'Donato, F., Scortichini, M., Zafeiratou, S., Vazquez Fernandez, L., . . . Breitner, S. (2023). Heat-related cardiorespiratory mortality: effect modification by air pollution across 482 cities from 24 countries. Environment International, 174, Article ID 107825.
Open this publication in new window or tab >>Heat-related cardiorespiratory mortality: effect modification by air pollution across 482 cities from 24 countries
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2023 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 174, article id 107825Article in journal (Refereed) Published
Abstract [en]

Background: Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. Objectives: We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest months) in 482 locations across 24 countries.

Methods: Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 µm [PM2.5]) were obtained from 2000 to 2018. We used location-specific confounder-adjusted Quasi-Poisson regression with a tensor product between air temperature and the air pollutant. We extracted heat effects at low, medium, and high levels of pollutants, defined as the 5th, 50th, and 95th percentile of the location-specific pollutant concentrations. Country-specific and overall estimates were derived using a random-effects multilevel meta-analytical model.

Results: Heat was associated with increased cardiorespiratory mortality. Moreover, the heat effects were modified by elevated levels of all air pollutants in most locations, with stronger effects for respiratory than cardiovascular mortality. For example, the percent increase in respiratory mortality per increase in the 2-day average summer temperature from the 75th to the 99th percentile was 7.7% (95% Confidence Interval [CI] 7.6–7.7), 11.3% (95%CI 11.2–11.3), and 14.3% (95% CI 14.1–14.5) at low, medium, and high levels of PM2.5, respectively. Similarly, cardiovascular mortality increased by 1.6 (95%CI 1.5–1.6), 5.1 (95%CI 5.1–5.2), and 8.7 (95%CI 8.7–8.8) at low, medium, and high levels of O3, respectively.

Discussion: We observed considerable modification of the heat effects on cardiovascular and respiratory mortality by elevated levels of air pollutants. Therefore, mitigation measures following the new WHO Air Quality Guidelines are crucial to enhance better health and promote sustainable development.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Air pollution, Air temperature, Cardiovascular mortality, Effect modification, Heat, Respiratory mortality
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-206020 (URN)10.1016/j.envint.2023.107825 (DOI)000981629200001 ()2-s2.0-85150267738 (Scopus ID)
Funder
EU, Horizon 2020, 820655
Available from: 2023-03-28 Created: 2023-03-28 Last updated: 2023-09-05Bibliographically approved
Stafoggia, M., Michelozzi, P., Schneider, A., Armstrong, B., Scortichini, M., Rai, M., . . . de' Donato, F. K. (2023). Joint effect of heat and air pollution on mortality in 620 cities of 36 countries. Environment International, 181, Article ID 108258.
Open this publication in new window or tab >>Joint effect of heat and air pollution on mortality in 620 cities of 36 countries
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2023 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 181, article id 108258Article in journal (Refereed) Published
Abstract [en]

Background: The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent.

Objectives: To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries.

Methods: We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995–2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants.

Results: We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2.

Conclusions: Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Air pollution, Air temperature, Effect modification, Epidemiology, Mortality
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-215864 (URN)10.1016/j.envint.2023.108258 (DOI)37837748 (PubMedID)2-s2.0-85173794067 (Scopus ID)
Funder
EU, Horizon 2020, 820655
Available from: 2023-11-01 Created: 2023-11-01 Last updated: 2023-11-01Bibliographically approved
de Bont, J., Pickford, R., Åström, C., Colomar, F., Dimakopoulou, K., de Hoogh, K., . . . Ljungman, P. (2023). Mixtures of long-term exposure to ambient air pollution, built environment and temperature and stroke incidence across Europe. Environment International, 179, Article ID 108136.
Open this publication in new window or tab >>Mixtures of long-term exposure to ambient air pollution, built environment and temperature and stroke incidence across Europe
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2023 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 179, article id 108136Article in journal (Refereed) Published
Abstract [en]

Introduction: The complex interplay of multiple environmental factors and cardiovascular has scarcely been studied. Within the EXPANSE project, we evaluated the association between long-term exposure to multiple environmental indices and stroke incidence across Europe.

Methods: Participants from three traditional adult cohorts (Germany, Netherlands and Sweden) and four administrative cohorts (Catalonia [region Spain], Rome [city-wide], Greece and Sweden [nationwide]) were followed until incident stroke, death, migration, loss of follow-up or study end. We estimated exposures at residential addresses from different exposure domains: air pollution (nitrogen dioxide (NO2), particulate matter < 2.5 μm (PM2.5), black carbon (BC), ozone), built environment (green/blue spaces, impervious surfaces) and meteorology (seasonal mean and standard deviation of temperatures). Associations between environmental exposures and stroke were estimated in single and multiple-exposure Cox proportional hazard models, and Principal Component (PC) Analyses derived prototypes for specific exposures domains. We carried out random effects meta-analyses by cohort type.

Results: In over 15 million participants, increased levels of NO2 and BC were associated with increased higher stroke incidence in both cohort types. Increased Normalized Difference Vegetation Index (NDVI) was associated with a lower stroke incidence in both cohort types, whereas an increase in impervious surface was associated with an increase in stroke incidence. The first PC of the air pollution domain (PM2.5, NO2 and BC) was associated with an increase in stroke incidence. For the built environment, higher levels of NDVI and lower levels of impervious surfaces were associated with a protective effect [%change in HR per 1 unit = −2.0 (95 %CI, −5.9;2.0) and −1.1(95 %CI, −2.0; −0.3) for traditional adult and administrative cohorts, respectively]. No clear patterns were observed for distance to blue spaces or temperature parameters.

Conclusions: We observed increased HRs for stroke with exposure to PM2.5, NO2 and BC, lower levels of greenness and higher impervious surface in single and combined exposure models.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Air pollution, Green space, Meta-analysis, Multiple environmental exposures, Stroke, Urban exposome
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-214060 (URN)10.1016/j.envint.2023.108136 (DOI)37598594 (PubMedID)2-s2.0-85168497402 (Scopus ID)
Funder
EU, Horizon 2020, 874627Swedish Research Council Formas, 2022-00468
Available from: 2023-09-06 Created: 2023-09-06 Last updated: 2023-09-06Bibliographically approved
Liu, C., Cai, J., Chen, R., Sera, F., Guo, Y., Tong, S., . . . Kan, H. (2022). Coarse particulate air pollution and daily mortality: a global study in 205 cities. American Journal of Respiratory and Critical Care Medicine, 206(8), 999-1007
Open this publication in new window or tab >>Coarse particulate air pollution and daily mortality: a global study in 205 cities
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2022 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 206, no 8, p. 999-1007Article in journal (Refereed) Published
Abstract [en]

RATIONALE: The associations between ambient coarse particulate matter (PM2.5-10) and daily mortality is not fully understood at a global scale.

OBJECTIVES: To evaluate the short-term associations between PM2.5-10 and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide.

METHODS: We collected daily mortality (total, cardiovascular, respiratory) and air pollution data from 205 cities in 20 countries/regions. Concentrations of PM2.5-10 were computed as the difference between inhalable and fine particulate matter. A two-stage time-series analytic approach was applied, with over-dispersed generalized linear models and multilevel meta-analysis. We fitted two-pollutant models to test the independent effect of PM2.5-10 from co-pollutants (fine particulate matter, nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide). Exposure-response relationship curves were pooled and regional analyses were conducted.

MEASUREMENTS AND MAIN RESULTS: A 10 μg/m3 increase in PM2.5-10 concentration on lag 0-1 day was associated with increments of 0.51% (95% confidence interval [CI]: 0.18%, 0.84%), 0.43% (95%CI: 0.15%, 0.71%) and 0.41% (95%CI: 0.06%, 0.77%) in total, cardiovascular, and respiratory mortality, respectively. The associations varied by country and region. These associations were robust to adjustment by all co-pollutants in two-pollutant models, especially for PM2.5. The exposure-response curves for total, cardiovascular, and respiratory mortality were positive, with steeper slopes at lower exposure ranges and without discernible thresholds.

CONCLUSIONS: This study provides novel global evidence on the robust and independent associations between short-term exposure to ambient PM2.5-10 and total, cardiovascular and respiratory mortality, suggesting the need to establish a unique guideline or regulatory limit for daily concentrations of PM2.5-10.

Place, publisher, year, edition, pages
American Thoracic Society, 2022
Keywords
PM2.5-10, air pollution, mortality, multi-center study, time-series study
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:umu:diva-199029 (URN)10.1164/rccm.202111-2657OC (DOI)000871243100012 ()35671471 (PubMedID)2-s2.0-85140144957 (Scopus ID)
Available from: 2022-09-01 Created: 2022-09-01 Last updated: 2022-11-24Bibliographically approved
Olstrup, H., Åström, C. & Orru, H. (2022). Daily Mortality in Different Age Groups Associated with Exposure to Particles, Nitrogen Dioxide and Ozone in Two Northern European Capitals: Stockholm and Tallinn. Environments, 9(7), Article ID 83.
Open this publication in new window or tab >>Daily Mortality in Different Age Groups Associated with Exposure to Particles, Nitrogen Dioxide and Ozone in Two Northern European Capitals: Stockholm and Tallinn
2022 (English)In: Environments, E-ISSN 2076-3298, Vol. 9, no 7, article id 83Article in journal (Refereed) Published
Abstract [en]

Although the association between air pollution and mortality is well established, less is known about the effects in different age groups. This study analyzes the short-term associations between mortality in different age groups (0–14 years of age, 15–64 years of age, and 65+ years of age) and a number of air pollutants in two relatively clean northern European capitals: Stockholm and Tallinn. The concentrations in PM10 (particles with an aerodynamic diameter smaller than or equal to 10 µm), PM2.5–10 (coarse particles), PM2.5 (particles with an aerodynamic diameter smaller than or equal to 2.5 µm), BC (black carbon), PNC4 (particle number count of particles larger than or equal to 4 nm), NO2 (nitrogen dioxide), and O3 (ozone) were measured during the period of 2000–2016 in Stockholm and 2001–2018 in Tallinn (except for BC and PNC4 which were only measured in Stockholm). The excess risks in daily mortality associated with an interquartile range (IQR) increase in the measured air pollutants were calculated in both single- and multi-pollutant models for lag01 and lag02 (average concentration during the same and the previous day, and the same and the previous two days, respectively) using a quasi-Poisson regression model with a logistic link function. In general, the calculated excess risks per IQR increase were highest in the age group 0–14 years of age in both Stockholm and Tallinn. However, in Stockholm, a statistically significant effect was shown for PM2.5–10, and in Tallinn for O3. In the oldest age group (65+), statistically significant effects were shown for both PM2.5–10, PM10, and O3 in Stockholm, and for O3 in Tallinn.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
age groups, air pollution, children, daily mortality, elderly, exposure, short-term
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-198036 (URN)10.3390/environments9070083 (DOI)000831486000001 ()2-s2.0-85133542897 (Scopus ID)
Available from: 2022-07-15 Created: 2022-07-15 Last updated: 2023-09-05Bibliographically approved
Masselot, P., Sera, F., Schneider, R., Kan, H., Lavigne, É., Stafoggia, M., . . . Gasparrini, A. (2022). Differential mortality risks associated with PM2.5 components: a multi-country, multi-city study. Epidemiology, 33(2), 167-175
Open this publication in new window or tab >>Differential mortality risks associated with PM2.5 components: a multi-country, multi-city study
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2022 (English)In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 33, no 2, p. 167-175Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The association between fine particulate matter (PM2.5) and mortality widely differs between as well as within countries. Differences in PM2.5 composition can play a role in modifying the effect estimates, but there is little evidence about which components have higher impacts on mortality.

METHODS: We applied a two-stage analysis on data collected from 210 locations in 16 countries. In the first stage, we estimated location-specific relative risks (RR) for mortality associated with daily total PM2.5 through time series regression analysis. We then pooled these estimates in a meta-regression model that included city-specific logratio-transformed proportions of seven PM2.5 components as well as meta-predictors derived from city-specific socio-economic and environmental indicators.

RESULTS: We found associations between RR and several PM2.5 components. Increasing the ammonium (NH4+) proportion from 1% to 22%, while keeping a relative average proportion of other components, increased the RR from 1.0063 (95%CI: 1.0030-1.0097) to 1.0102 (95%CI:1.0070-1.0135). Conversely, an increase in nitrate (NO3-) from 1% to 71% resulted in a reduced RR, from 1.0100 (95%CI: 1.0067-1.0133) to 1.0037 (95%CI: 0.9998- 1.0077). Differences in composition explained a substantial part of the heterogeneity in PM2.5 risk.

CONCLUSIONS: These findings contribute to the identification of more hazardous emission sources. Further work is needed to understand the health impacts of PM2.5 components and sources given the overlapping sources and correlations among many components.

Place, publisher, year, edition, pages
Wolters Kluwer, 2022
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-190752 (URN)10.1097/EDE.0000000000001455 (DOI)000749166000005 ()34907973 (PubMedID)2-s2.0-85123973639 (Scopus ID)
Funder
EU, Horizon 2020, 820655EU, Horizon 2020, 874990
Available from: 2021-12-27 Created: 2021-12-27 Last updated: 2022-02-15Bibliographically approved
Choi, H. M., Lee, W., Roye, D., Heo, S., Urban, A., Entezari, A., . . . Bell, M. L. (2022). Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study. EBioMedicine, 84, Article ID 104251.
Open this publication in new window or tab >>Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study
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2022 (English)In: EBioMedicine, E-ISSN 2352-3964, Vol. 84, article id 104251Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting.

METHODS: We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations.

FINDINGS: Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries.

INTERPRETATION: Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change.

FUNDING: This publication was developed under Assistance Agreement No. RD83587101 awarded by the U.S. Environmental Protection Agency to Yale University. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Research reported in this publication was also supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012769. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Also, this work has been supported by the National Research Foundation of Korea (2021R1A6A3A03038675), Medical Research Council-UK (MR/V034162/1 and MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), Academy of Finland (Grant ID: 310372), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655 and 874990), Czech Science Foundation (22-24920S), Emory University's NIEHS-funded HERCULES Center (Grant ID: P30ES019776), and Grant CEX2018-000794-S funded by MCIN/AEI/ 10.13039/501100011033 The funders had no role in the design, data collection, analysis, interpretation of results, manuscript writing, or decision to publication.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Effect modification, Greenspace, Heat, Mortality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-200045 (URN)10.1016/j.ebiom.2022.104251 (DOI)000877614200004 ()36088684 (PubMedID)2-s2.0-85137373543 (Scopus ID)
Funder
NIH (National Institutes of Health), R01MD012769EU, Horizon 2020, 820655EU, Horizon 2020, 874990
Note

Errata: Hayon Michelle Choi, Whanhee Lee, Dominic Roye, Seulkee Heo, Aleš Urban, Alireza Entezari et al. Corrigendum to “Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study”, eBioMedicine, 2023, 87;104396. DOI: 10.1016/j.ebiom.2022.104396

Available from: 2022-10-06 Created: 2022-10-06 Last updated: 2023-03-06Bibliographically approved
Wu, Y., Wen, B., Li, S., Gasparrini, A., Tong, S., Overcenco, A., . . . Guo, Y. (2022). Fluctuating temperature modifies heat-mortality association around the globe. The Innovation, 3(2), Article ID 100225.
Open this publication in new window or tab >>Fluctuating temperature modifies heat-mortality association around the globe
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2022 (English)In: The Innovation, E-ISSN 2666-6758, Vol. 3, no 2, article id 100225Article in journal (Refereed) Published
Abstract [en]

Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days’ minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: −0.33 to 1.69), 1.34% (95% CI: −0.14 to 2.73), 1.99% (95% CI: 0.29–3.57), and 2.73% (95% CI: 0.76–4.50) of total deaths for Q1–Q4 (first quartile–fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25–9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: −0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health.

Place, publisher, year, edition, pages
Cell Press, 2022
Keywords
heat, modification effect, mortality, temperature variability
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-193406 (URN)10.1016/j.xinn.2022.100225 (DOI)000782121000003 ()2-s2.0-85126703036 (Scopus ID)
Available from: 2022-03-31 Created: 2022-03-31 Last updated: 2023-09-05Bibliographically approved
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