Air pollution remains a major public health concern, particularly in large metropolitan areas. This study aimed to evaluate the short-term association between ambient air pollution levels and non-accidental mortality in Istanbul between 2013 and 2019. In this ecological time-series study, daily mortality data were analyzed using quasi-Poisson regression models incorporating distributed lag non-linear models (DLNM) to estimate exposure-response relationships. Citywide daily mean concentrations of major air pollutants were derived from all eligible monitoring stations. Effect estimates were expressed as relative risks (RRs) with 95% confidence intervals (CIs) per 10 µg/m2 increase in particulate matter concentrations. During the 7-year period, average particulate matter levels frequently exceeded World Health Organization (WHO) guideline values. A 10 µg/m2 increase in PM10 was associated with a 1.7% increase in daily mortality (RR: 1.017; 95% CI: 1.009-1.025), while a similar increase in PM2.5 was associated with a 3.3% increase (RR: 1.033; 95% CI: 1.021-1.046). Mortality increases were more pronounced among individuals aged ≥ 65 years. Periods of consecutive high pollution were also associated with excess mortality. Short-term increases in particulate matter concentrations were associated with elevated mortality in Istanbul, particularly among older adults. These results support the relevance of WHO guideline values in the local context and highlight the importance of sustained air quality control policies.
Ambient air pollution remains an environmental health concern, yet national evidence in Türkiye integrating multiple pollutants, WHO guideline exceedance, mortality patterns, and monitoring network changes is limited. We analyzed seven annual observations (2018–2024) for PM10, SO2, CO, NO2, and O3. For each pollutant-year, the national indicator was the unweighted mean of eligible station annual means from official bulletins; mortality outcomes were crude national rates. Linear trends were estimated by OLS regression and assessed alongside Mann–Kendall tests, Sen’s slopes, and strict common-station sensitivity analyses. PM2.5 was excluded because monitoring coverage and annual reporting were not sufficiently comparable across years. PM10 decreased from 50.4 to 41.0 µg/m3 and SO2 from 13.2 to 8.5 µg/m3, with significant negative linear trends. The all-station NO2 indicator increased from 29.2 to 34.4 µg/m3, but its linear trend was not statistically significant (slope = 0.879 µg/m3/year; p = 0.055) and was absent in the common-station analysis (slope = −0.021; p = 0.950). PM10 guideline exceedance remained nearly universal, and NO2 exceedance remained high. Among mortality outcomes, only neoplasm mortality declined significantly. Air quality trends were pollutant-specific and, for NO2, sensitive to monitoring network composition. The ecological design does not permit causal inference regarding pollutant–mortality relationships.
Ömer Acat, Sibel Acat, Okan Imre· Atmosphere· 0 citations
Abstract Objective To investigate associations between short-term fluctuations in urban background air pollution and the incidence of COVID-19 across three Swedish cities using detailed individual-level data. Methods A case-crossover analysis was conducted using individual-level data from a prospective cohort of adults across three Swedish cities (Stockholm, Gothenburg and Uppsala), including 3999 confirmed COVID-19 cases. Subjects were classified as cases on the date of their first positive PCR test, which occurred between 7 March 2020 and 26 January 2022. Exposure data for daily levels of PM2.5, PM10 and NO2 were obtained from urban background monitoring stations. Lag-specific and cumulative associations were examined using distributed lag models and distributed lag non-linear models, adjusting for meteorological variables. Results A significant association was observed between elevated PM2.5 levels and testing positive for COVID-19 on the same day (lag 0), with an OR of 1.084 (95% CI 1.011 to 1.162) per IQR (3.3 µg/m³) increase. Similar lag 0 effects were found across the three cities. For PM10, the most consistent associations were observed at lag 3. For NO2, significant effects at lag 0 emerged only after excluding the final COVID-19 wave. Subgroup analyses showed similar effects among individuals with pre-existing respiratory conditions, though results were less consistent. Conclusions Our findings suggest that short-term fluctuations in air pollution, particularly for PM2.5, are associated with the timing of confirmed COVID-19 cases. A possible explanation for the short lag association is that air pollution exacerbates symptoms, prompting individuals to seek testing, rather than directly facilitating new infections.
Andreas Tornevi, C. Janson, Andreas Palm et al.· BMJ Open Respiratory Researc...· 0 citations
Background Short-term exposure to ambient air pollution has been associated with cardiovascular disease (CVD) mortality, but localized evidence from subtropical cities in southwestern China remains limited. This 11-year time-series study aimed to evaluate the short-term associations between six criteria air pollutants and daily CVD mortality in Nanning, China. Methods We conducted a time-series analysis using daily data on CVD mortality, air pollutant concentrations, and meteorological variables from 2014 to 2024 in Nanning. Generalized additive quasi-Poisson models were used to estimate associations across single-day lags (lag0-lag7) and cumulative lag windows (lag0-1 to lag0-7), adjusting for long-term trends, temperature, relative humidity, and day of the week. Exposure-response relationships were assessed using natural cubic splines. Stratified analyses were conducted by season and age group, and two-pollutant models and sensitivity analyses were performed to evaluate robustness. Results A total of 87,913 CVD deaths were recorded during the study period, of which 57.5% occurred in males and 77.9% occurred among individuals aged ≥65 years. In single-day lag models, PM2.5, PM10, SO2, NO2, and O3-8h showed significant positive associations with CVD mortality at early lag days. At lag0, the RRs were 1.014 (95% CI: 1.008–1.020) for PM2.5, 1.009 (95% CI: 1.006–1.013) for PM10, and 1.018 (95% CI: 1.011–1.026) for NO2, while SO2 showed its largest estimate at lag1 [RR = 1.044 (95% CI: 1.018–1.069)]. In cumulative lag models, PM2.5, PM10, SO2, NO2, and O3-8h showed significant cumulative associations, whereas CO was significant mainly in shorter lag windows. Season-stratified analyses suggested pollutant-specific variation between cold and warm seasons, although formal pollutant-by-season interaction tests were not statistically significant. Age-stratified analyses indicated broader susceptibility among older adults. The main associations were generally robust in sensitivity analyses, distributed lag models, and two-pollutant models, particularly for PM2.5, PM10, and NO2. Conclusion Short-term exposure to ambient air pollution was associated with increased CVD mortality, particularly for PM2.5, PM10, and NO2, with consistent effects across single-day and cumulative lag structures. The results highlight the cardiovascular risks of particulate and traffic-related pollution and support pollutant-specific air quality management and targeted protection for older adults during high-pollution periods.
Xia Luo, Linhan Liang, Yang Yu et al.· Frontiers in Public Health· 0 citations
Background: Ambient particulate matter ≤2.5 μm (PM2.5) is a major environmental health risk contributing to global morbidity and mortality. Although its link with cardiovascular diseases is well established, evidence on the stroke burden attributable to PM2.5 exposure remains limited in Indonesia. Methods: This ecological study used Global Burden of Disease (GBD) 2021 data to analyze the association between PM2.5 exposure and stroke burden, including incidence, prevalence, and mortality, across 34 Indonesian provinces from 2011 to 2020. Age-standardized rates (ASRs) were assessed using a linear mixed model, with year as a repeated measure and province as a random effect to account for spatial and temporal variations. Findings: Mean PM2.5 concentrations ranged from 16.96 to 20.10 µg/m³, exceeding WHO and national air quality standards. Despite minor annual fluctuations in PM2.5, stroke mortality attributable to air pollution showed an increasing trend. Higher PM2.5 levels were significantly associated with ischemic stroke (IS) incidence (β = -0.117, p <0.001) and mortality (β = 0.152, p <0.001), as well as intracerebral hemorrhage (ICH) incidence (β = 0.017, p = 0.015), prevalence (β = 1.641, p <0.001), and mortality (β = 0.773, p = 0.004). The effect of PM2.5 exposure was greater for ICH than for IS. Conclusion: Long-term exposure to PM2.5 is significantly associated with stroke burden in Indonesia, particularly for ICH. Strengthening air quality management and stroke prevention policies is crucial, especially in high-risk regions. Novelty/Originality of this article: This study is the first to comprehensively assess the long-term association between PM2.5 and stroke subtypes using national-level GBD data across all Indonesian provinces, providing spatially and temporally robust evidence for public health policy in low- and middle-income tropical settings.
Salma Dhiya Rachmadani· Public Health Risk Assesment...· 0 citations
The findings indicate that long-term exposure to PM2.5 is associated with a significant increase in the risk of chronic respiratory conditions, cardiovascular diseases, and premature mortality, and integrated prevention strategies-combining policy measures, planning solutions, and technological innovations have proven effective in reducing ambient pollutant levels and associated health burdens.
Dragana Kerkez, S. Nešović, Kristina Filipović et al.· Zbornik radova· 0 citations
Background: Air quality in New York City has improved substantially in the past 2 decades due to reductions in both transported aerosols and local emissions. We estimated the short-term risk changes for three criteria air pollutants and corresponding attributable burdens. Methods: Trends in percent excess risk (PER) per same pollution increment and attributable counts and fractions for fine particles (PM2.5), nitrogen dioxide (NO2), and ozone (warm season only) were examined for Emergency Department (ED) visits (2005–2019) and hospitalizations (2000–2019) for youth asthma (ages 5–17), adult cardiovascular disease (CVD) (ages 40+), and older adult respiratory causes (ages 65+). Time-series models considered up to 3-day lag, adjusted for seasonal trends, day of week, holidays, and concurrent and delayed temperature. Results: Most pollutant-outcome pairs did not exhibit trends in PERs over time. NO2-attributable burden was higher than PM2.5 burden for asthma and CVD outcomes. We estimated about 4500 (17%) youth asthma ED visits and 1000 (2%) CVD hospitalizations on average annually (2005–2019) attributable to NO2 compared with 1900 (7%) youth asthma ED visits and 450 (1%) CVD hospitalizations attributable to PM2.5. NO2- and PM2.5-attributable health impacts declined about 50%–70%, driven by decreasing pollution levels and total morbidity burden depending on outcome, pollutant, and season. Ozone-attributable burden was mostly unchanged over time. Conclusion: With less decline and greater attributable impact than PM2.5, NO2 is increasingly important for measuring morbidity impacts from local sources (i.e., traffic and buildings) in New York City. Ozone impacts from regional source emissions persist.
A. Spira-Cohen, Rebecca Goldberg, Sarah Johnson et al.· Environmental Epidemiology· 0 citations
