Coarse Particulate Air Pollution and Daily Mortality: A Global Study in 205 Cities

Cong Liu, Jing Cai, Renjie Chen, Francesco Sera, Yuming Guo, Shilu Tong, Shanshan Li, Eric Lavigne, Patricia Matus Correa, Nicolas Valdes Ortega, Hans Orru, Marek Maasikmets, Jouni J.K. Jaakkola, Niilo Ryti, Susanne Breitner, Alexandra Schneider, Klea Katsouyanni, Evangelia Samoli, Masahiro Hashizume, Yasushi HondaChris Fook Sheng Ng, Magali Hurtado Diaz, César De la Cruz Valencia, Shilpa Rao, Alfonso Diz Lois Palomares, Susana Pereira da Silva, Joana Madureira, Iulian Horia Holobâc, Simona Fratianni, Noah Scovronick, Rebecca M. Garland, Aurelio Tobias, Carmen Íñiguez, Bertil Forsberg, Christofer Åström, Ana Maria Vicedo-Cabrera, Martina S. Ragettli, Yue Liang Leon Guo, Shih Chun Pan, Ai Milojevic, Michelle L. Bell, Antonella Zanobetti, Joel Schwartz, Antonio Gasparrini, Haidong Kan

Research output: Contribution to journalArticleResearchpeer-review

20 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)999-1007
Number of pages9
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number8
Publication statusPublished - 15 Oct 2022


  • air pollution
  • mortality
  • multicenter study
  • PM2.5-10
  • time-series study

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