Modification of the effects of air pollutants on mortality by temperature: A systematic review and meta-analysis

Li, Jing and Woodward, Alistair and Hou, Xiang-Yu and Zhu, Tong and Zhang, Jinliang and Brown, Helen and Yang, Jun and Qin, Rennie and Gao, Jinghong and Gu, Shaohua and Li, Jing and Xu, Lei and Liu, Xiaobo and Liu, Qiyong (2017) Modification of the effects of air pollutants on mortality by temperature: A systematic review and meta-analysis. Science of the Total Environment, 575. pp. 1556-1570. ISSN 0048-9697


Highlights - This is the first review and meta-analysis on the modification of pollutants' effects on mortality by temperature. - We found temperature extremes modify the effects of PM10 and O3 on both non-accidental and cardiovascular mortality. - There may be value in promoting use of early warning systems on extremely hot or cold days that are also heavily polluted. Abstract Temperature extremes and air pollution both pose significant threats to human health, but it remains uncertain whether pollutants' effects on mortality are modified by temperature levels. In this review, we summarized epidemiologic evidence on the modification by temperature of the acute effects of air pollutants on non-accidental and cardiovascular mortality. The EMBASE, PubMed, ProQuest Dissertations and Theses, and Elsevier Science Direct databases were used to identify papers published up to 2nd December 2014. Studies with appropriate design, exposures and outcome indicators, quantitative estimates and high/intermediate quality were included. Twenty-one studies met the inclusion criteria, of which 12 reported the effects of PM10 on mortality modified by temperature, 10 studied O3, and the rest examined NO2, SO2, PM2.5, PM10-2.5, CO and black smoke. We divided temperature into low, medium, and high categories as defined in each study. In high temperature days, a 10μg/m3 increment in PM10 concentration corresponded to pooled estimates of 0.78% (95% CI: 0.44%, 1.11%) and 1.28% (0.66%, 1.91%) increase in non-accidental and cardiovascular mortality, both statistically significantly higher than the estimates in medium temperature stratum. Pooled effects of O3 on non-accidental mortality on low and high temperature days were increases of 0.48% (0.28%, 0.69%) and 0.47% (0.32%, 0.63%) respectively, for 10μg/m3 increase in exposure, both significantly higher than the increase of 0.20% (0.07%, 0.34%) on medium temperature days. The effect of O3 on cardiovascular mortality was strongest on high temperature days with pooled estimate of 1.63% (1.14%, 2.13%). No significant interactions between SO2/NO2 and temperature were detected by meta-analysis. Other pollutants were not analyzed due to the lack of suitable studies. In summary, we observed interactions between high temperature and PM10 and O3 in the effects on non-accidental and cardiovascular mortality. Low temperature modified the effects of air pollutants but not in a consistent fashion: the effect of PM10 oncardiovascular mortality was diminished but the association between O3 and non-accidental mortality was strengthened.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 18 Jun 2021 01:24
Last Modified: 19 Oct 2021 05:44
Uncontrolled Keywords: Air pollution; Extreme temperature; Meta-analysis; Modification; Mortality; Systematic review
Fields of Research (2008): 05 Environmental Sciences > 0502 Environmental Science and Management > 050204 Environmental Impact Assessment
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111705 Environmental and Occupational Health and Safety
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111706 Epidemiology
Fields of Research (2020): 42 HEALTH SCIENCES > 4202 Epidemiology > 420203 Environmental epidemiology
41 ENVIRONMENTAL SCIENCES > 4104 Environmental management > 410402 Environmental assessment and monitoring
Socio-Economic Objectives (2008): D Environment > 96 Environment > 9601 Air Quality > 960106 Urban and Industrial Air Quality
C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920412 Preventive Medicine
C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920405 Environmental Health
Socio-Economic Objectives (2020): 20 HEALTH > 2004 Public health (excl. specific population health) > 200412 Preventive medicine
20 HEALTH > 2002 Evaluation of health and support services > 200202 Evaluation of health outcomes
18 ENVIRONMENTAL MANAGEMENT > 1801 Air quality, atmosphere and weather > 180101 Air quality
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