期刊
BMJ-BRITISH MEDICAL JOURNAL
卷 368, 期 -, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmj.m108
关键词
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资金
- UK Medical Research Council [MR/M022625/1, MR/R013349/1]
- UK Natural Environment Research Council [NE/R009384/1]
- National Natural Science Foundation of China [91843302, 91643205]
- China Medical Board Collaborating Program [16-250]
- Fundacao para a Ciencia e a Tecnologia (FCT) [SFRH/BPD/115112/2016]
- Spanish Ministry of Economy, Industry and Competitiveness (MINECO) [PCIN-2017-046]
- German Federal Ministry of Education and Research (BMBF) [01LS1201A2]
- Czech Science Foundation [18-22125S]
- Estonian Ministry of Education and Research [IUT34-17]
- Japanese Society for the Promotion of Science invitational fellowships for research in Japan [S18149]
- career development fellowship of the Australian National Health and Medical Research Council [APP1107107, APP1163693]
- Science and Technology Commission of Shanghai Municipality [18411951600, K21004000001-10A0500-0710]
- National Research Foundation of Korea
- Future Planning and Korea Ministry of Environment as the Climate Change Correspondence RD Program [2013001310002]
- CSIR parliamentary grant
- National Institute of Environmental Health Sciences [P30ES019776, RD835871]
- US Environmental Protection Agency
- Fundação para a Ciência e a Tecnologia [SFRH/BPD/115112/2016] Funding Source: FCT
- MRC [MR/R013349/1, MR/M022625/1] Funding Source: UKRI
- NERC [NE/R009384/1] Funding Source: UKRI
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 mu g/m(3) 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 mu g/m(3)) 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 mu g/m(3)), 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.
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