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Environ Pollut. 2019 Nov;254(Pt B):113121. doi: 10.1016/j.envpol.2019.113121. Epub 2019 Aug 28.

Short-term associations between daily mortality and ambient particulate matter, nitrogen dioxide, and the air quality index in a Middle Eastern megacity.

Author information

1
Harvard T.H. Chan School of Public Health, Boston, MA, United States; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: heresh@hsph.harvard.edu.
2
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
3
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
4
Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
5
Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran.
6
Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
7
Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
8
Department of Epidemiology, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran; Modelling of Noncommunicable Diseases Research Center, Hamadan University of Medical Science, Hamadan, Iran.
9
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
10
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
11
Harvard T.H. Chan School of Public Health, Boston, MA, United States.
12
Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada.

Abstract

There is limited evidence for short-term association between mortality and ambient air pollution in the Middle East and no study has evaluated exposure windows of about a month prior to death. We investigated all-cause non-accidental daily mortality and its association with fine particulate matter (PM2.5), nitrogen dioxide (NO2), and the Air Quality Index (AQI) from March 2011 through March 2014 in the megacity of Tehran, Iran. Generalized additive quasi-Poisson models were used within a distributed lag linear modeling framework to estimate the cumulative effects of PM2.5, NO2, and the AQI up to a lag of 45 days. We further conducted multi-pollutant models and also stratified the analyses by sex, age group, and season. The relative risk (95% confidence interval (CI)) for all seasons, both sexes and all ages at lag 0 for PM2.5, NO2, and AQI were 1.004 (1.001, 1.007), 1.003 (0.999, 1.007), and 1.004 (1.001, 1.007), respectively, per inter-quartile range (IQR) increment (18.8 μg/m3 for PM2.5, 12.6 ppb for NO2, and 31.5 for AQI). In multi-pollutant models, the PM2.5 associations were almost independent from NO2. However, the RRs for NO2 were slightly attenuated after adjustment for PM2.5 but they were still largely independent from PM2.5. The cumulative relative risks (95% CI) per IQR increment reached maximum during the cooler months, including: 1.13 (1.06, 1.20) for PM2.5 at lag 0-31 (for females, all ages); 1.17 (1.10, 1.25) for NO2 at lag 0-45 (for males, all ages); and 1.13 (1.07, 1.20) for the AQI at lag 0-30 (for females, all ages). Generally, the RRs were slightly larger for NO2 than PM2.5 and AQI. We found somewhat larger RRs in females, age group >65 years of age, and in cooler months. In summary, positive associations were found in most models. This is the first study to report short-term associations between all-cause non-accidental mortality and ambient PM2.5 and NO2 in Iran.

KEYWORDS:

Air pollution; Air quality index (AQI); Independent effect; Mortality; Nitrogen dioxide (NO(2)); Particulate matter (PM(2.5)); Short-term

PMID:
31493628
DOI:
10.1016/j.envpol.2019.113121
[Indexed for MEDLINE]
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