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Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis

Atkinson, RW; Kang, S; Anderson, HR; Mills, IC; Walton, HA (2014) Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis. THORAX, 69 (7). 660 - 665. ISSN 0040-6376 https://doi.org/10.1136/thoraxjnl-2013-204492
SGUL Authors: Anderson, Hugh Ross Atkinson, Richard William

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Abstract

Background Short-term exposure to outdoor fine particulate matter (particles with a median aerodynamic diameter <2.5 μm (PM2.5)) air pollution has been associated with adverse health effects. Existing literature reviews have been limited in size and scope. Methods We conducted a comprehensive, systematic review and meta-analysis of 110 peer-reviewed time series studies indexed in medical databases to May 2011 to assess the evidence for associations between PM2.5 and daily mortality and hospital admissions for a range of diseases and ages. We stratified our analyses by geographical region to determine the consistency of the evidence worldwide and investigated small study bias. Results Based upon 23 estimates for all-cause mortality, a 10 µg/m3 increment in PM2.5 was associated with a 1.04% (95% CI 0.52% to 1.56%) increase in the risk of death. Worldwide, there was substantial regional variation (0.25% to 2.08%). Associations for respiratory causes of death were larger than for cardiovascular causes, 1.51% (1.01% to 2.01%) vs 0.84% (0.41% to 1.28%). Positive associations with mortality for most other causes of death and for cardiovascular and respiratory hospital admissions were also observed. We found evidence for small study bias in single-city mortality studies and in multicity studies of cardiovascular disease. Conclusions The consistency of the evidence for adverse health effects of short-term exposure to PM2.5 across a range of important health outcomes and diseases supports policy measures to control PM2.5 concentrations. However, reasons for heterogeneity in effect estimates in different regions of the world require further investigation. Small study bias should also be considered in assessing and quantifying health risks from PM2.5

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
Keywords: Asthma Epidemiology, COPD epidemiology, Air Pollutants, Cardiovascular Diseases, Environmental Exposure, Hospitalization, Humans, Lung Diseases, Mortality, Particle Size, Particulate Matter, Science & Technology, Life Sciences & Biomedicine, Respiratory System, RESPIRATORY SYSTEM, PARTICULATE AIR-POLLUTION, PUBLICATION BIAS, MATTER, ASSOCIATION, DISEASE, Respiratory System, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: THORAX
ISSN: 0040-6376
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Dates:
DateEvent
4 April 2014Published
Web of Science ID: WOS:000337920700011
URI: https://openaccess.sgul.ac.uk/id/eprint/107166
Publisher's version: https://doi.org/10.1136/thoraxjnl-2013-204492

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