Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries. Vicedo-Cabrera, A. M., Sera, F., Liu, C., Armstrong, B., Milojevic, A., Guo, Y., Tong, S., Lavigne, E., Kyselý, J., Urban, A., Orru, H., Indermitte, E., Pascal, M., Huber, V., Schneider, A., Katsouyanni, K., Samoli, E., Stafoggia, M., Scortichini, M., Hashizume, M., Honda, Y., Ng, C. F. S., Hurtado-Diaz, M., Cruz, J., Silva, S., Madureira, J., Scovronick, N., Garland, R. M., Kim, H., Tobias, A., Íñiguez, C., Forsberg, B., Åström, C., Ragettli, M. S., Röösli, M., Guo, Y. L., Chen, B., Zanobetti, A., Schwartz, J., Bell, M. L., Kan, H., & Gasparrini, A. BMJ, February, 2020. Publisher: British Medical Journal Publishing Group Section: Research
Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries [link]Paper  doi  abstract   bibtex   
Objective To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. Design Two stage time series analysis. Setting 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. Population Deaths for all causes or for external causes only registered in each city within the study period. Main outcome measures Daily total mortality (all or non-external causes only). Results A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 µg/m3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively. Conclusions Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.
@article{vicedo-cabrera_short_2020,
	title = {Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries},
	volume = {368},
	copyright = {Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. http://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.},
	issn = {1756-1833},
	shorttitle = {Short term association between ozone and mortality},
	url = {https://www.bmj.com/content/368/bmj.m108},
	doi = {10.1136/bmj.m108},
	abstract = {Objective To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide.
Design Two stage time series analysis.
Setting 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network.
Population Deaths for all causes or for external causes only registered in each city within the study period.
Main outcome measures Daily total mortality (all or non-external causes only).
Results A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95\% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m3) was 0.26\% (95\% confidence interval 0.24\% to 0.28\%), corresponding to 8203 annual excess deaths (95\% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20\% (0.18\% to 0.22\%) when restricting to days above the WHO guideline (100 µg/m3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14\%, 0.09\%, and 0.05\%, respectively.
Conclusions Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.},
	language = {en},
	urldate = {2020-03-09},
	journal = {BMJ},
	author = {Vicedo-Cabrera, Ana M. and Sera, Francesco and Liu, Cong and Armstrong, Ben and Milojevic, Ai and Guo, Yuming and Tong, Shilu and Lavigne, Eric and Kyselý, Jan and Urban, Aleš and Orru, Hans and Indermitte, Ene and Pascal, Mathilde and Huber, Veronika and Schneider, Alexandra and Katsouyanni, Klea and Samoli, Evangelia and Stafoggia, Massimo and Scortichini, Matteo and Hashizume, Masahiro and Honda, Yasushi and Ng, Chris Fook Sheng and Hurtado-Diaz, Magali and Cruz, Julio and Silva, Susana and Madureira, Joana and Scovronick, Noah and Garland, Rebecca M. and Kim, Ho and Tobias, Aurelio and Íñiguez, Carmen and Forsberg, Bertil and Åström, Christofer and Ragettli, Martina S. and Röösli, Martin and Guo, Yue-Liang Leon and Chen, Bing-Yu and Zanobetti, Antonella and Schwartz, Joel and Bell, Michelle L. and Kan, Haidong and Gasparrini, Antonio},
	month = feb,
	year = {2020},
	pmid = {32041707},
	note = {Publisher: British Medical Journal Publishing Group
Section: Research},
}
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