University of Oulu

Liu, C., Cai, J., Chen, R., Sera, F., Guo, Y., Tong, S., Li, S., Lavigne, E., Correa, P. M., Ortega, N. V., Orru, H., Maasikmets, M., Jaakkola, J. J. K., Ryti, N., Breitner, S., Schneider, A., Katsouyanni, K., Samoli, E., Hashizume, M., … 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.

Coarse particulate air pollution and daily mortality : a global study in 205 cities

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Author: Liu, Cong1; Cai, Jing1; Chen, Renjie1;
Organizations: 1School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
2Department of Statistics, Computer Science, and Applications “G. Parenti”, University of Florence, Florence, Italy
3Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
4School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
5Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
6School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
7Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
8School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
9School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
10Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
11Department of Public Health, Universidad de los Andes, Santiago, Chile
12School of Nursing and Obstetrics, Universidad de los Andes, Santiago, Chile
13Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
14Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
15Estonian Environmental Research Centre, Tallinn, Estonia
16Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
17Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
18Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
19School of Population Health & Environmental Sciences, King's College London
20Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
21Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
22School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
23Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
24Norwegian Institute of Public Health, Oslo, Norway
25Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisboa, Portugal
26EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
27Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
28Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania
29Department of Earth Sciences, University of Torino
30Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, USA
31Department of Geography, Geoinformatics and Meteorology, University of Pretoria, South Africa
32Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
33Department of Statistics and Operational Research, Universitat de València, València, Spain
34CIBER of Epidemiology and Public Health (CIBERESP)
35Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
36Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
37Swiss Tropical and Public Health Institute, Basel, Switzerland
38University of Basel, Allschwil, Switzerland
39Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei
40National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
41Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
42School of the Environment, Yale University, New Haven, CT, USA
43Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
44Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
45Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
46School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
47Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, China
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: American Thoracic Society, 2022
Publish Date: 2023-06-07


Rationale: The associations between ambient coarse particulate matter (PM2.5–10) and daily mortality are not fully understood on 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, and 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 PM. A two-stage time-series analytic approach was applied, with overdispersed generalized linear models and multilevel meta-analysis. We fitted two-pollutant models to test the independent effect of PM2.5–10 from copollutants (fine PM, 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 copollutants 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.

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Series: American journal of respiratory and critical care medicine
ISSN: 1073-449X
ISSN-E: 1535-4970
ISSN-L: 1073-449X
Volume: 206
Issue: 8
Pages: 999 - 1007
DOI: 10.1164/rccm.202111-2657OC
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: HK was supported by the National Natural Science Foundation of China (92043301 and 82030103). RC was supported by the National Natural Science Foundation of China (92143301). AG was supported by the Medical Research Council-UK (MR/R013349/1), the Natural Environment Research Council UK (NE/R009384/1). AG, SR and AP were supported by the European Union’s Horizon 2020 Project Exhaustion (820655). YG was supported by the Australian Research Council (DP210102076), the Australian National Health and Medical Research Council (APP2000581, APP1163693, and APP2008813). SL was supported by an Emerging Leader Fellowship of the Australian National Health and Medical Research Council (APP2009866). JM was supported by Fundação para a Ciência e a Tecnologia through the grant SFRH/BPD/115112/2016. YLG was supported by the Ministry of Science and Technology, Taiwan (MOST 110-2314-B-002-083).
Copyright information: Originally Published in: Liu, Cong; Cai, Jing; Chen, Renjie; Sera, Francesco; Guo, Yuming; Tong, Shilu; Li, Shanshan; Lavigne, Eric; Correa, Patricia Matus; Ortega, Nicolas Valdes; Orru, Hans; Maasikmets, Marek; Jaakkola, Jouni J K; Ryti, Niilo; Breitner, Susanne; Schneider, Alexandra; Katsouyanni, Klea; Samoli, Evangelia; Hashizume, Masahiro; Honda, Yasushi; Ng, Chris Fook Sheng; Diaz, Magali Hurtado; la Cruz Valencia, César De; Rao, Shilpa; Palomares, Alfonso Diz-Lois; Pereira da Silva, Susana; Madureira, Joana; Holobâc, Iulian Horia; Fratianni, Simona; Scovronick, Noah; Garland, Rebecca M; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Vicedo-Cabrera, Ana Maria; Ragettli, Martina S; Guo, Yue-Liang Leon; Pan, Shih-Chun; Milojevic, Ai; Bell, Michelle L; Zanobetti, Antonella; Schwartz, Joel; Gasparrini, Antonio; Kan, Haidong. Coarse Particulate Air Pollution and Daily Mortality: A Global Study in 205 Cities. American journal of respiratory and critical care medicine 2022;206:999-1007. DOI: 10.1164/rccm.202111-2657OC Copyright © 2022 by the American Thoracic Society. The final publication is available at