Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;8(9):e657-e665.
doi: 10.1016/S2542-5196(24)00168-2.

Temporal variations in the short-term effects of ambient air pollution on cardiovascular and respiratory mortality: a pooled analysis of 380 urban areas over a 22-year period

Maximilian Schwarz  1 , Annette Peters  2 , Massimo Stafoggia  3 , Francesca de'Donato  3 , Francesco Sera  4 , Michelle L Bell  5 , Yuming Guo  6 , Yasushi Honda  7 , Veronika Huber  8 , Jouni J K Jaakkola  9 , Aleš Urban  10 , Ana Maria Vicedo-Cabrera  11 , Pierre Masselot  12 , Eric Lavigne  13 , Souzana Achilleos  14 , Jan Kyselý  10 , Evangelia Samoli  15 , Masahiro Hashizume  16 , Chris Fook Sheng Ng  17 , Susana das Neves Pereira da Silva  18 , Joana Madureira  19 , Rebecca M Garland  20 , Aurelio Tobias  21 , Ben Armstrong  22 , Joel Schwartz  23 , Antonio Gasparrini  12 , Alexandra Schneider  24 , Susanne Breitner  25 ; MCC Collaborative Research Network
Collaborators, Affiliations
Free article

Temporal variations in the short-term effects of ambient air pollution on cardiovascular and respiratory mortality: a pooled analysis of 380 urban areas over a 22-year period

Maximilian Schwarz et al. Lancet Planet Health. 2024 Sep.
Free article

Abstract

Background: Ambient air pollution, including particulate matter (such as PM10 and PM2·5) and nitrogen dioxide (NO2), has been linked to increases in mortality. Whether populations' vulnerability to these pollutants has changed over time is unclear, and studies on this topic do not include multicountry analysis. We evaluated whether changes in exposure to air pollutants were associated with changes in mortality effect estimates over time.

Methods: We extracted cause-specific mortality and air pollution data collected between 1995 and 2016 from the Multi-Country Multi-City (MCC) Collaborative Research Network database. We applied a two-stage approach to analyse the short-term effects of NO2, PM10, and PM2·5 on cause-specific mortality using city-specific time series regression analyses and multilevel random-effects meta-analysis. We assessed changes over time using a longitudinal meta-regression with time as a linear fixed term and explored potential sources of heterogeneity and two-pollutant models.

Findings: Over 21·6 million cardiovascular and 7·7 million respiratory deaths in 380 cities across 24 countries over the study period were included in the analysis. All three air pollutants showed decreasing concentrations over time. The pooled results suggested no significant temporal change in the effect estimates per unit exposure of PM10, PM2·5, or NO2 and mortality. However, the risk of cardiovascular mortality increased from 0·37% (95% CI -0·05 to 0·80) in 1998 to 0·85% (0·55 to 1·16) in 2012 with a 10 μg/m3 increase in PM2·5. Two-pollutant models generally showed similar results to single-pollutant models for PM fractions and indicated temporal differences for NO2.

Interpretation: Although air pollution levels decreased during the study period, the effect sizes per unit increase in air pollution concentration have not changed. This observation might be due to the composition, toxicity, and sources of air pollution, as well as other factors, such as socioeconomic determinants or changes in population distribution and susceptibility.

Funding: None.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests We declare no competing interests.

MeSH terms