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Meta-Analysis
. 2020 Jun:261:114165.
doi: 10.1016/j.envpol.2020.114165. Epub 2020 Feb 13.

Short- and intermediate-term exposure to NO2 and mortality: A multi-county analysis in China

Mike Z He  1 , Patrick L Kinney  2 , Tiantian Li  3 , Chen Chen  4 , Qinghua Sun  4 , Jie Ban  4 , Jiaonan Wang  4 , Siliang Liu  1 , Jeff Goldsmith  5 , Marianthi-Anna Kioumourtzoglou  1
Affiliations
Meta-Analysis

Short- and intermediate-term exposure to NO2 and mortality: A multi-county analysis in China

Mike Z He et al. Environ Pollut. 2020 Jun.

Abstract

Nitrogen dioxide (NO2) is a well-established traffic emissions tracer and has been associated with multiple adverse health outcomes. Short- and long-term exposure to NO2 has been studied and is well-documented in existing literature, but information on intermediate-term NO2 effects and mortality is lacking, despite biological plausibility. We obtained daily NO2 and mortality data from 42 counties in China from 2013 to 2015. Distributed-lag non-linear models were employed to investigate the relationship between non-accidental mortality and NO2 up to 30 days before the event, including PM2.5, temperature, relative humidity, and holidays as covariates in a random effects meta-analysis pooling county-specific estimates. We repeated the analysis for cardiovascular- and respiratory-related mortality, and explored sex-stratified associations. Per 10 μg/m3 increase in NO2, we estimated a 0.13% (95%CI: 0.03, 0.23%), 0.57% (95%CI: -0.04, 1.18%), and -0.14% (95%CI: -1.63, 1.37%) change in non-accidental mortality for same-day and previous-day NO2 (lag0-1 cumulated), in the preceding 7 days (lag0-7 cumulated), and in the preceding 30 days (lag0-30 cumulated), respectively. The strongest estimate was observed for respiratory-related mortality in the lag0-30 cumulated effect for women (3.12%; 95%CI: -1.66, 8.13%). We observed a trend of higher effect estimates of intermediate-term NO2 exposure on respiratory mortality compared to that of the short-term, although the differences were not statistically significant. Our results at longer lags for all-cause and cardiovascular mortality were sensitive to modeling choices. Future work should further investigate intermediate-term air pollution exposure given their potential biological relevance, but in larger scale settings.

Keywords: Air pollution; Epidemiology; Intermediate-term effects; Nitrogen dioxide; Random-effects meta-analysis.

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Conflict of interest statement

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Geographic distribution of study counties.
Figure 2.
Figure 2.
30-day lag-specific cumulated effect estimates per 10 μg/m3 NO2 increase for a) non-accidental mortality; b) cardiovascular mortality; and c) respiratory mortality.
See this image and copyright information in PMC

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