Mortality risk attributable to wildfire-related PM_2·5 pollution: a global time series study in 749 locations

Gongbo Chen¹, Yuming Guo², Xu Yue³, Shilu Tong⁴, Antonio Gasparrini⁵, Michelle L Bell⁶, Ben Armstrong⁷, Joel Schwartz⁸, Jouni J K Jaakkola⁹, Antonella Zanobetti⁸, Eric Lavigne¹⁰, Paulo Hilario Nascimento Saldiva¹¹, Haidong Kan¹², Dominic Royé¹³, Ai Milojevic⁷, Ala Overcenco¹⁴, Aleš Urban¹⁵, Alexandra Schneider¹⁶, Alireza Entezari¹⁷, Ana Maria Vicedo-Cabrera¹⁸, Ariana Zeka¹⁹, Aurelio Tobias²⁰, Baltazar Nunes²¹, Barrak Alahmad⁸, Bertil Forsberg²², Shih-Chun Pan²³, Carmen Íñiguez²⁴, Caroline Ameling²⁵, César De la Cruz Valencia²⁶, Christofer Åström²², Danny Houthuijs²⁵, Do Van Dung²⁷, Evangelia Samoli²⁸, Fatemeh Mayvaneh¹⁷, Francesco Sera²⁹, Gabriel Carrasco-Escobar³⁰, Yadong Lei³¹, Hans Orru³², Ho Kim³³, Iulian-Horia Holobaca³⁴, Jan Kyselý¹⁵, João Paulo Teixeira³⁵, Joana Madureira³⁶, Klea Katsouyanni²⁸, Magali Hurtado-Díaz²⁶, Marek Maasikmets³⁷, Martina S Ragettli³⁸, Masahiro Hashizume³⁹, Massimo Stafoggia⁴⁰, Mathilde Pascal⁴¹, Matteo Scortichini⁴⁰, Micheline de Sousa Zanotti Stagliorio Coêlho¹¹, Nicolás Valdés Ortega⁴², Niilo R I Ryti⁹, Noah Scovronick⁴³, Patricia Matus⁴², Patrick Goodman⁴⁴, Rebecca M Garland⁴⁵, Rosana Abrutzky⁴⁶, Samuel Osorio Garcia⁴⁷, Shilpa Rao⁴⁸, Simona Fratianni⁴⁹, Tran Ngoc Dang²⁷, Valentina Colistro⁵⁰, Veronika Huber⁵¹, Whanhee Lee⁶, Xerxes Seposo⁵², Yasushi Honda⁵³, Yue Leon Guo⁵⁴, Tingting Ye⁵⁵, Wenhua Yu⁵⁵, Michael J Abramson⁵⁵, Jonathan M Samet⁵⁶, Shanshan Li⁵⁷

Affiliations

¹ Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
² Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: yuming.guo@monash.edu.
³ Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing, China.
⁴ Shanghai Children's Medical Center, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
⁵ Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
⁶ School of Environment, Yale University, New Haven, CT, USA.
⁷ Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
⁸ Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
⁹ Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland.
¹⁰ School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada.
¹¹ Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
¹² Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China.
¹³ Department of Geography, University of Santiago de Compostela, CIBER of Epidemiology and Public Health (CIBERESP), Spain.
¹⁴ National Agency for Public Health of the Ministry of Health, Chisinau, Moldova.
¹⁵ Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.
¹⁶ Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.
¹⁷ Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran.
¹⁸ Institute of Social and Preventive Medicine and Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
¹⁹ Institute of Environment, Health and Societies, Brunel University London, London, UK.
²⁰ Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
²¹ Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal.
²² Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
²³ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.
²⁴ Department of Statistics and Computational Research. Universitat de València, Valencia, CIBERESP, Spain.
²⁵ National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands.
²⁶ Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
²⁷ Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
²⁸ Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece.
²⁹ Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy.
³⁰ Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru.
³¹ Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China.
³² Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
³³ Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.
³⁴ Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania.
³⁵ Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal.
³⁶ Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
³⁷ Estonian Environmental Research Centre, Tallinn, Estonia.
³⁸ Swiss Tropical and Public Health Institute, Basel, Switzerland; Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
³⁹ Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁴⁰ Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
⁴¹ Santé Publique France, Department of Environmental and occupational Health, French National Public Health Agency, Saint Maurice, France.
⁴² Department of Public Health, Universidad de los Andes, Santiago, Chile.
⁴³ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁴⁴ Technological University Dublin, Dublin, Ireland.
⁴⁵ Council for Scientific and Industrial Research, Pretoria, South Africa; Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; Unit for Environmental Sciences and Management, North West University, South Africa.
⁴⁶ Instituto de Investigaciones Gino Germani, Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina.
⁴⁷ Department of Environmental Health, University of São Paulo, São Paulo, Brazil.
⁴⁸ Norwegian institute of Public Health, Oslo, Norway.
⁴⁹ Department of Earth Sciences, University of Torino, Turin, Italy.
⁵⁰ Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay.
⁵¹ Potsdam Institute for Climate Impact Research, Potsdam, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Seville, Spain.
⁵² School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
⁵³ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
⁵⁴ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan.
⁵⁵ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁵⁶ The Colorado School of Public Health, University of Colorado, Aurora.
⁵⁷ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: shanshan.li@monash.edu.

PMID: 34508679
DOI: 10.1016/S2542-5196(21)00200-X

Free article

Meta-Analysis

Mortality risk attributable to wildfire-related PM_2·5 pollution: a global time series study in 749 locations

Gongbo Chen et al. Lancet Planet Health. 2021 Sep.

Free article

. 2021 Sep;5(9):e579-e587.

doi: 10.1016/S2542-5196(21)00200-X.

Authors

Affiliations

¹ Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
² Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: yuming.guo@monash.edu.
³ Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing, China.
⁴ Shanghai Children's Medical Center, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
⁵ Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
⁶ School of Environment, Yale University, New Haven, CT, USA.
⁷ Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
⁸ Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
⁹ Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland.
¹⁰ School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada.
¹¹ Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
¹² Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China.
¹³ Department of Geography, University of Santiago de Compostela, CIBER of Epidemiology and Public Health (CIBERESP), Spain.
¹⁴ National Agency for Public Health of the Ministry of Health, Chisinau, Moldova.
¹⁵ Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.
¹⁶ Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.
¹⁷ Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Khorasan Razavi, Iran.
¹⁸ Institute of Social and Preventive Medicine and Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
¹⁹ Institute of Environment, Health and Societies, Brunel University London, London, UK.
²⁰ Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
²¹ Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal.
²² Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
²³ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.
²⁴ Department of Statistics and Computational Research. Universitat de València, Valencia, CIBERESP, Spain.
²⁵ National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands.
²⁶ Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
²⁷ Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
²⁸ Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece.
²⁹ Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy.
³⁰ Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru.
³¹ Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China.
³² Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
³³ Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.
³⁴ Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania.
³⁵ Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal.
³⁶ Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
³⁷ Estonian Environmental Research Centre, Tallinn, Estonia.
³⁸ Swiss Tropical and Public Health Institute, Basel, Switzerland; Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
³⁹ Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁴⁰ Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
⁴¹ Santé Publique France, Department of Environmental and occupational Health, French National Public Health Agency, Saint Maurice, France.
⁴² Department of Public Health, Universidad de los Andes, Santiago, Chile.
⁴³ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁴⁴ Technological University Dublin, Dublin, Ireland.
⁴⁵ Council for Scientific and Industrial Research, Pretoria, South Africa; Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; Unit for Environmental Sciences and Management, North West University, South Africa.
⁴⁶ Instituto de Investigaciones Gino Germani, Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina.
⁴⁷ Department of Environmental Health, University of São Paulo, São Paulo, Brazil.
⁴⁸ Norwegian institute of Public Health, Oslo, Norway.
⁴⁹ Department of Earth Sciences, University of Torino, Turin, Italy.
⁵⁰ Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay.
⁵¹ Potsdam Institute for Climate Impact Research, Potsdam, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Seville, Spain.
⁵² School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
⁵³ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
⁵⁴ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan.
⁵⁵ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁵⁶ The Colorado School of Public Health, University of Colorado, Aurora.
⁵⁷ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: shanshan.li@monash.edu.

PMID: 34508679
DOI: 10.1016/S2542-5196(21)00200-X

Abstract

Background: Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM_2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM_2·5 and mortality across various regions of the world.

Methods: For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfire-related PM_2·5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM_2·5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM_2·5 exposure was calculated.

Findings: 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m³ increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM_2·5 exposure were 1·019 (95% CI 1·016-1·022) for all-cause mortality, 1·017 (1·012-1·021) for cardiovascular mortality, and 1·019 (1·013-1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48-0·75) of all-cause deaths, 0·55% (0·43-0·67) of cardiovascular deaths, and 0·64% (0·50-0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM_2·5 exposure during the study period.

Interpretation: Short-term exposure to wildfire-related PM_2·5 was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires.

Funding: Australian Research Council, Australian National Health & Medical Research Council.

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Conflict of interest statement

Declaration of interests We declare no competing interests.

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Mortality risk attributable to wildfire-related PM_2·5 pollution: a global time series study in 749 locations

Affiliations

Mortality risk attributable to wildfire-related PM_2·5 pollution: a global time series study in 749 locations

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