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Brazil has experienced unprecedented wildfires recently. We aimed to investigate the association of wildfire-related fine particulate matter (PM 2.5 ) with cause-specific cardiovascular mortality, and to estimate the attributable mortality burden. Exposure to wildfire-related PM 2.5 was defined as exposure to annual mean wildfire-related PM 2.5 concentrations in the 1-year prior to death. The variant difference-in-differences method was employed to explore the wildfire-related PM 2.5 -cardiovascular mortality association. We found that, in Brazil, compared with the population in the first quartile (Q1: ≤1.82 μg/m 3 ) of wildfire-related PM 2.5 exposure, those in the fourth quartile (Q4: 4.22-17.12 μg/m 3 ) of wildfire-related PM 2.5 exposure had a 2.2% (RR: 1.022, 95% CI: 1.013-1.032) higher risk for total cardiovascular mortality, 3.1% (RR: 1.031, 95% CI: 1.014-1.048) for ischaemic heart disease mortality, and 2.0% (RR: 1.020, 95% CI: 1.002-1.038) for stroke mortality. From 2010 to 2018, an estimation of 35,847 (95% CI: 22,424-49,177) cardiovascular deaths, representing 17.77 (95% CI: 11.12-24.38) per 100,000 population, were attributable to wildfire-related PM 2.5 exposure. Targeted health promotion strategies should be developed for local governments to protect the public from the risk of wildfire-related cardiovascular premature deaths., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Model-estimated air pollution exposure products have been widely used in epidemiological studies to assess the health risks of particulate matter with diameters of ≤2.5 µm (PM2.5). However, few studies have assessed the disparities in health effects between model-estimated and station-observed PM2.5 exposures., Methods: We collected daily all-cause, respiratory and cardiovascular mortality data in 347 cities across 15 countries and regions worldwide based on the Multi-City Multi-Country collaborative research network. The station-observed PM2.5 data were obtained from official monitoring stations. The model-estimated global PM2.5 product was developed using a machine-learning approach. The associations between daily exposure to PM2.5 and mortality were evaluated using a two-stage analytical approach., Results: We included 15.8 million all-cause, 1.5 million respiratory and 4.5 million cardiovascular deaths from 2000 to 2018. Short-term exposure to PM2.5 was associated with a relative risk increase (RRI) of mortality from both station-observed and model-estimated exposures. Every 10-μg/m3 increase in the 2-day moving average PM2.5 was associated with overall RRIs of 0.67% (95% CI: 0.49 to 0.85), 0.68% (95% CI: -0.03 to 1.39) and 0.45% (95% CI: 0.08 to 0.82) for all-cause, respiratory, and cardiovascular mortality based on station-observed PM2.5 and RRIs of 0.87% (95% CI: 0.68 to 1.06), 0.81% (95% CI: 0.08 to 1.55) and 0.71% (95% CI: 0.32 to 1.09) based on model-estimated exposure, respectively., Conclusions: Mortality risks associated with daily PM2.5 exposure were consistent for both station-observed and model-estimated exposures, suggesting the reliability and potential applicability of the global PM2.5 product in epidemiological studies., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Enormous health burden has been associated with air pollution and its effects continue to grow. However, the impact of air pollution on labour productivity at the population level is still unknown. This study assessed the association between premature death due to PM 2.5 exposure and the loss of productivity-adjusted life years (PALYs), in Brazil. We applied a novel variant of the difference-in-difference (DID) approach to assess the association. Daily all-cause mortality data in Brazil were collected from 2000-2019. The PALYs lost increased by 5.11% (95% CI: 4.10-6.13%), for every 10 µg/m 3 increase in the 2-day moving average of PM 2.5 . A total of 9,219,995 (95% CI: 7,491,634-10,921,141) PALYs lost and US$ 268.05 (95% CI: 217.82-317.50) billion economic costs were attributed to PM 2.5 exposure, corresponding to 7.37% (95% CI: 5.99-8.73%) of the total PALYs lost due to premature death. This study also found that 5,005,306 PALYs could be avoided if the World Health Organization (WHO) air quality guideline (AQG) level was met. In conclusion, this study demonstrates that ambient PM 2.5 exposure is associated with a considerable labour productivity burden relating to premature death in Brazil, while over half of the burden could be prevented if the WHO AQG was met. The findings highlight the need to reduce ambient PM 2.5 levels and provide strong evidence for the development of strategies to mitigate the economic impacts of air pollution., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The acute health effects of short-term (hours to days) exposure to fine particulate matter (PM 2·5 ) have been well documented; however, the global mortality burden attributable to this exposure has not been estimated. We aimed to estimate the global, regional, and urban mortality burden associated with short-term exposure to PM 2·5 and the spatiotemporal variations in this burden from 2000 to 2019., Methods: We combined estimated global daily PM 2·5 concentrations, annual population counts, country-level mortality rates, and epidemiologically derived exposure-response functions to estimate the mortality attributable to short-term PM 2·5 exposure from 2000 to 2019, in the continental regions and in 13 189 urban centres worldwide at a spatial resolution of 0·1° × 0·1°. We tested the robustness of our mortality estimates with different theoretical minimum risk exposure levels, lag effects, and exposure-response functions., Findings: Approximately 1 million (95% CI 690 000-1·3 million) premature deaths per year from 2000 to 2019 were attributable to short-term PM 2·5 exposure, representing 2·08% (1·41-2·75) of total global deaths or 17 (11-22) premature deaths per 100 000 population. Annually, 0·23 million (0·15 million-0·30 million) deaths attributable to short-term PM 2·5 exposure were in urban areas, constituting 22·74% of the total global deaths attributable to this cause and accounting for 2·30% (1·56-3·05) of total global deaths in urban areas. The sensitivity analyses showed that our worldwide estimates of mortality attributed to short-term PM 2·5 exposure were robust., Interpretation: Short-term exposure to PM 2·5 contributes a substantial global mortality burden, particularly in Asia and Africa, as well as in global urban areas. Our results highlight the importance of mitigation strategies to reduce short-term exposure to air pollution and its adverse effects on human health., Funding: Australian Research Council and the Australian National Health and Medical Research Council., Competing Interests: Declaration of interests MJA holds investigator-initiated grants from Pfizer, Boehringer-Ingelheim, Sanofi, and GSK for research unrelated to this study; has conducted an unrelated consultancy for, and received assistance with conference attendance from, Sanofi; and has received a speaker's fee from GSK. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Little is known about the associations between long-term exposure to wildfire-related fine particulate matter (PM 2.5 ) and mortality. We aimed to explore theses associations using the data from the UK Biobank cohort. Long-term wildfire-related PM 2.5 exposure was defined as the 3-year cumulative concentrations of wildfire-related PM 2.5 within a 10-km buffer surrounding the residential address for each individual. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using the time-varying Cox regression model. We included 492,394 participants aged between 38 and 73 years. We found that after adjusting for potential covariates, a 10 μg/m 3 increase of wildfire-related PM 2.5 exposure was associated with a 0.4% higher risk of all-cause mortality (HR = 1.004 [95% CI: 1.001, 1.006]) and nonaccidental mortality (HR = 1.004 [95% CI: 1.002, 1.006]), and a 0.5% higher risk of neoplasm mortality (HR = 1.005 [95% CI: 1.002, 1.008]). However, no significant associations were observed between wildfire-related PM 2.5 exposure and mortality from cardiovascular, respiratory, and mental diseases. Additionally, no significant modification effects of a series of modifiers were observed. Targeted health protection strategies should be adopted in response to wildfire-related PM 2.5 exposure, in order to reduce the risk of premature mortality., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Wildfires are thought to be increasing in severity and frequency as a result of climate change 1-5 . Air pollution from landscape fires can negatively affect human health 4-6 , but human exposure to landscape fire-sourced (LFS) air pollution has not been well characterized at the global scale 7-23 . Here, we estimate global daily LFS outdoor fine particulate matter (PM 2.5 ) and surface ozone concentrations at 0.25° × 0.25° resolution during the period 2000-2019 with the help of machine learning and chemical transport models. We found that overall population-weighted average LFS PM 2.5 and ozone concentrations were 2.5 µg m -3 (6.1% of all-source PM 2.5 ) and 3.2 µg m -3 (3.6% of all-source ozone), respectively, in 2010-2019, with a slight increase for PM 2.5 , but not for ozone, compared with 2000-2009. Central Africa, Southeast Asia, South America and Siberia experienced the highest LFS PM 2.5 and ozone concentrations. The concentrations of LFS PM 2.5 and ozone were about four times higher in low-income countries than in high-income countries. During the period 2010-2019, 2.18 billion people were exposed to at least 1 day of substantial LFS air pollution per year, with each person in the world having, on average, 9.9 days of exposure per year. These two metrics increased by 6.8% and 2.1%, respectively, compared with 2000-2009. Overall, we find that the global population is increasingly exposed to LFS air pollution, with socioeconomic disparities., (© 2023. The Author(s).)

Background: In 2014, wildfires ignited a coal mine in Australia, burning for 6 weeks, releasing large amounts of fine particulate matter ≤2.5 μm in diameter (PM 2.5 ). We investigated the association between individual PM 2.5 exposure and emergency department presentations (EDPs) within 5 years post-fire., Methods: Survey and exposure data for 2725 residents from an exposed and unexposed town were linked with ED administrative data from 2009 to 2019. The association between individual PM 2.5 and EDPs was assessed using recurrent survival analysis., Results: A 10 μg/m 3 increase in PM 2.5 was associated with a 10% increase in respiratory EDPs (HR = 1.10; 95%CI:1.00-1.22) over 5 years post-fire. Increased risks of EDPs for ischaemic heart disease (HR = 1.39; 95%CI:1.12-1.73), atherothrombotic disease (HR = 1.27; 95%CI:1.08-1.50), and cardiovascular disease (HR = 1.10, 95%CI:0.99-1.22) were evident within 2.5 years., Conclusion: PM 2.5 exposure from a 6-week mine fire increased the 5-year risk of respiratory conditions. An increased risk of CVD within 2.5 years post-fire subsided after this time., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Michael Abramson reports a relationship with Pfizer that includes: funding grants. Michael Abramson reports a relationship with Boehringer-Ingelheim that includes: funding grants. Michael Abramson reports a relationship with Sanofi that includes: consulting or advisory and funding grants. Michael Abramson reports a relationship with GSK that includes: funding grants and speaking and lecture fees. Dion Stub reports a relationship with National Heart Foundation of Australia that includes: funding grants. Yuming Guo reports a relationship with Australian National Health and Medical Research Council that includes: funding grants., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Wildfire imposes a high mortality burden on Brazil. However, there is a limited assessment of the health economic losses attributable to wildfire-related fine particulate matter (PM 2.5 )., Methods: We collected daily time-series data on all-cause, cardiovascular, and respiratory mortality from 510 immediate regions in Brazil during 2000-2016. The chemical transport model GEOS-Chem driven with Global Fire Emissions Database (GFED), in combination with ground monitored data and machine learning was used to estimate wildfire-related PM 2.5 data at a resolution of 0.25° × 0.25°. A time-series design was applied in each immediate region to assess the association between economic losses due to mortality and wildfire-related PM 2.5 and the estimates were pooled at the national level using a random-effect meta-analysis. We used a meta-regression model to explore the modification effect of GDP and its sectors (agriculture, industry, and service) on economic losses., Results: During 2000-2016, a total of US$81.08 billion economic losses (US$5.07 billion per year) due to mortality were attributable to wildfire-related PM 2.5 in Brazil, accounting for 0.68% of economic losses and equivalent to approximately 0.14% of Brazil's GDP. The attributable fraction (AF) of economic losses due to wildfire-related PM 2.5 was positively associated with the proportion of GDP from agriculture, while negatively associated with the proportion of GDP from service., Conclusion: Substantial economic losses due to mortality were associated with wildfires, which could be influenced by the agriculture and services share of GDP per capita. Our estimates of the economic losses of mortality could be used to determine optimal levels of investment and resources to mitigate the adverse health impacts of wildfires., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Exposure to wildfire smoke has been linked with a range of health outcomes. However, to date, evidence is limited for the association between wildfire-specific PM 2.5 , a primary emission of wildfire smoke, and adverse birth outcomes., Objective: We aimed to estimate the risk and burden of preterm birth/term low birth weight, associated with maternal exposure to wildfire-specific PM 2.5 ., Methods: A total of 330,884 birth records with maternal information were collected from the New South Wales Australia from 2015 to 2019, covering 523 residential communities. Daily wildfire-specific PM 2.5 at a 0.25° × 0.25° (≈ 25 km × 25 km) resolution was estimated by a machine learning method combining 3-D chemical transport model (GEOS-Chem) and reanalysis meteorological data. Cox proportional hazards models were implemented to evaluate the association between wildfire-specific PM 2.5 and preterm birth/term low birth weight. Number and fraction of preterm birth/term low birth weight attributable to wildfire-specific PM 2.5 during pregnancy were calculated., Results: Per one interquartile-range rise in wildfire-specific PM 2.5 was found to be associated with 6.9% (HR: 1.069, 95% CI: 1.058-1.081) increased risk of preterm birth and 3.6% (HR: 1.036, 95% CI: 1.014-1.058) higher risk of term low birth weight. The most susceptible gestational window was the 2nd trimester for preterm birth whereas the 1st for term low birth weight. We estimated that 14.30% preterm births and 8.04% term low birth weight cases were attributable to maternal exposure to wildfire-specific PM 2.5 during the whole pregnancy. Male infants and mothers aged ≥ 40, experiencing temperature extremes or living in the inner region, and concepted during spring had higher risks of preterm birth/term low birth weight associated with wildfire-specific PM 2.5 . Comparatively, mothers with advanced age have a higher risk of preterm birth while younger mothers were more likely to deliver term newborns with low birth weight, when being exposed to wildfire-specific PM 2.5 . Pregnancy-induced hypertension enhanced the risk of preterm birth associated with wildfire-specific PM 2.5 ., Conclusions: This study strengthened robust evidence on the enhanced risk of preterm birth/term low birth weight associated with maternal exposure to wildfire-specific PM 2.5 . In light of higher frequency and intensity of wildfire occurrences globally, more special attention should be paid to pregnant women by policy makers., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

To assess mortality risks and burdens associated with short-term exposure to wildfire-related fine particulate matter with diameter ≤ 2.5 μm (PM 2.5 ), we collect daily mortality data from 2000 to 2016 for 510 immediate regions in Brazil, the most wildfire-prone area. We integrate data from multiple sources with a chemical transport model at the global scale to isolate daily concentrations of wildfire-related PM 2.5 at a 0.25 × 0.25 resolution. With a two-stage time-series approach, we estimate (i) an increase of 3.1% (95% confidence interval [CI]: 2.4, 3.9%) in all-cause mortality, 2.6% (95%CI: 1.5, 3.8%) in cardiovascular mortality, and 7.7% (95%CI: 5.9, 9.5) in respiratory mortality over 0-14 days with each 10 μg/m 3 increase in daily wildfire-related PM 2.5 ; (ii) 0.65% of all-cause, 0.56% of cardiovascular, and 1.60% of respiratory mortality attributable to acute exposure to wildfire-related PM 2.5 , corresponding to 121,351 all-cause deaths, 29,510 cardiovascular deaths, and 31,287 respiratory deaths during the study period. In this study, we find stronger associations in females and adults aged ≥ 60 years, and geographic difference in the mortality risks and burdens., (© 2022. The Author(s).)

Background: Long-term exposure to fine particles ≤2.5 μm in diameter (PM2.5) has been linked to cancer mortality. However, the effect of wildfire-related PM2.5 exposure on cancer mortality risk is unknown. This study evaluates the association between wildfire-related PM2.5 and site-specific cancer mortality in Brazil, from 2010 to 2016., Methods and Findings: Nationwide cancer death records were collected during 2010-2016 from the Brazilian Mortality Information System. Death records were linked with municipal-level wildfire- and non-wildfire-related PM2.5 concentrations, at a resolution of 2.0° latitude by 2.5° longitude. We applied a variant difference-in-differences approach with quasi-Poisson regression, adjusting for seasonal temperature and gross domestic product (GDP) per capita. Relative risks (RRs) and 95% confidence intervals (CIs) for the exposure for specific cancer sites were estimated. Attributable fractions and cancer deaths were also calculated. In total, 1,332,526 adult cancer deaths (age ≥ 20 years), from 5,565 Brazilian municipalities, covering 136 million adults were included. The mean annual wildfire-related PM2.5 concentration was 2.38 μg/m3, and the annual non-wildfire-related PM2.5 concentration was 8.20 μg/m3. The RR for mortality from all cancers was 1.02 (95% CI 1.01-1.03, p < 0.001) per 1-μg/m3 increase of wildfire-related PM2.5 concentration, which was higher than the RR per 1-μg/m3 increase of non-wildfire-related PM2.5 (1.01 [95% CI 1.00-1.01], p = 0.007, with p for difference = 0.003). Wildfire-related PM2.5 was associated with mortality from cancers of the nasopharynx (1.10 [95% CI 1.04-1.16], p = 0.002), esophagus (1.05 [95% CI 1.01-1.08], p = 0.012), stomach (1.03 [95% CI 1.01-1.06], p = 0.017), colon/rectum (1.08 [95% CI 1.05-1.11], p < 0.001), larynx (1.06 [95% CI 1.02-1.11], p = 0.003), skin (1.06 [95% CI 1.00-1.12], p = 0.003), breast (1.04 [95% CI 1.01-1.06], p = 0.007), prostate (1.03 [95% CI 1.01-1.06], p = 0.019), and testis (1.10 [95% CI 1.03-1.17], p = 0.002). For all cancers combined, the attributable deaths were 37 per 100,000 population and ranged from 18/100,000 in the Northeast Region of Brazil to 71/100,000 in the Central-West Region. Study limitations included a potential lack of assessment of the joint effects of gaseous pollutants, an inability to capture the migration of residents, and an inability to adjust for some potential confounders., Conclusions: Exposure to wildfire-related PM2.5 can increase the risks of cancer mortality for many cancer sites, and the effect for wildfire-related PM2.5 was higher than for PM2.5 from non-wildfire sources., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Michael Abramson holds investigator initiated grants for unrelated research from Pfizer, Boehringer-Ingelheim, Sanofi and GSK. He has undertaken an unrelated consultancy for and received assistance with conference attendance from Sanofi. He has also received a speaker’s fee from GSK.YG is a member of the Editorial Board of PLOS Medicine. All other authors declare no competing interests.

Italy is among the countries with the highest ozone concentration in Europe. However, the mortality burden of ozone and related economic loss has not been fully characterized. This study aimed to estimate the ozone-mortality association in Italy and evaluate attributable mortality burden and related economic loss in 2015-2019. We collected daily all-cause mortality data stratified by age and sex from 2015 to 2019 in 107 provinces of Italy. A two-stage time-series framework was applied to estimate the association between daily maximum eight-hour average ozone and mortality as well as economic loss. An overall increase in the risk of mortality (RR=1.0043, 95% CI: 1.0029, 1.0057) was associated with every 10 µg/m 3 increase in ozone. Generally, a total of 70,060 deaths and $65 billion economic loss were attributed to ozone exposure, corresponding to 3.11% of mortality and about 0.5% of the national GDP during the study period, respectively. The highest ozone-related mortality burden (30,910 deaths) and economic loss ($29.24 billion) were observed in the hot season. This nationwide study suggested considerable mortality burden and economic loss were associated with exposure to ozone. More actions and policies should be proposed to reduce ozone levels and help the public protect their health., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: Emerging evidence has shown that ambient air pollution affects brain health, but little is known about its effect on epileptic seizures. This work aimed to assess the association between daily exposure to ambient air pollution and the risk of epileptic seizures., Methods: This study used epileptic seizure data from two independent data sources (NeuroVista and Seer App seizure diary). In the NeuroVista data set, 3273 seizures were recorded using intracranial electroencephalography (iEEG) from 15 participants with refractory focal epilepsy in Australia in 2010-2012. In the seizure diary data set, 3419 self-reported seizures were collected through a mobile application from 34 participants with epilepsy in Australia in 2018-2021. Daily average concentrations of carbon monoxide (CO), nitrogen dioxide (NO 2 ), ozone (O 3 ), particulate matter ≤10 μm in diameter (PM 10 ), and sulfur dioxide (SO 2 ) were retrieved from the Environment Protection Authority (EPA) based on participants' postcodes. A patient-time-stratified case-crossover design with the conditional Poisson regression model was used to determine the associations between air pollutants and epileptic seizures., Results: A significant association between CO concentrations and epileptic seizure risks was observed, with an increased seizure risk of 4% (relative risk [RR]: 1.04, 95% confidence interval [CI]: 1.01-1.07) for an interquartile range (IQR) increase of CO concentrations (0.13 parts per million), whereas no significant associations were found for the other four air pollutants in the whole study population. Female participants had a significantly increased risk of seizures when exposed to elevated CO and NO 2 , with RRs of 1.05 (95% CI: 1.01-1.08) and 1.09 (95% CI: 1.01-1.16), respectively. In addition, a significant association was observed between CO and the risk of subclinical seizures (RR: 1.20, 95% CI: 1.12-1.28)., Significance: Daily exposure to elevated CO concentrations may be associated with an increased risk of epileptic seizures, especially for subclinical seizures., (© 2022 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Purpose of Review: Health effects of long-term exposure to ambient PM 2.5 vary with regions, and 75% of the deaths attributable to PM 2.5 were estimated in Asia-Pacific in 2017. This systematic review aims to summarize the existing evidence from cohort studies on health effects of long-term exposure to ambient PM 2.5 in Asia-Pacific., Recent Findings: In Asia-Pacific, 60 cohort studies were conducted in Australia, Mainland China, Hong Kong, Taiwan, and South Korea. They consistently supported associations of long-term exposure to PM 2.5 with increased all-cause/non-accidental and cardiovascular mortality as well as with incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Evidence for other health effects was limited. Inequalities were identified in PM 2.5 -health associations. To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM 2.5 exposure in understudied regions, the health effects of long-term PM 2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM 2.5 -health associations. Study design, especially exposure assessment methods, should be improved., (© 2022. The Author(s).)

Long-term exposure to PM 2.5 has been linked to lung cancer incidence and mortality, but limited evidence existed for other cancers. This study aimed to assess the association between PM 2.5 on cancer specific mortality. An ecological study based on the cancer mortality data collected from 5,565 Brazilian cities during 2010-2018 using a difference-in-differences approach with quasi-Poisson regression, was applied to examine PM 2.5 -cancer mortality associations. Globally gridded annual average surface PM 2.5 concentration was extracted and linked with the residential municipality of participants in this study. Sex, age stratified and exposure-response estimations were also conducted. Totalling 1,768,668 adult cancer deaths records of about 208 million population living across 5,565 municipalities were included in this study. The average PM 2.5 concentration was 7.63 μg/m 3 (standard deviation 3.32) with range from 2.95 μg/m 3 to 28.5 μg/m 3 . With each 10 μg/m 3 increase in three-year-average (current year and previous two years) concentrations of PM 2.5 , the relative risks (RR) of cancer mortality were 1.16 (95% confidence interval [CI]: 1.11-1.20) for all-site cancers. The PM 2.5 exposure was significantly associated with several cancer-specific mortalities including oral, nasopharynx, oesophagus, and stomach, colon rectum, liver, gallbladder, larynx, lung, bone, skin, female breast, cervix, prostate, brain and leukaemia. No safe level of PM 2.5 exposure was observed in the exposure-response curve for all types of cancer. In conclusion, with nationwide cancer death records in Brazil, we found that long-term exposure to ambient PM 2.5 increased risks of mortality for many cancer types. Even low level PM 2.5 concentrations had significant impacts on cancer mortality., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

High surrounding road density could increase traffic-related air pollution, noise and the risk of traffic injuries, which are major public health concerns for children. We collected geographical data for all childcare centers (16,146) in Australia and provided the data on the road density surrounding them. The road density was represented by the child care center's nearest distance to main road and motorway, and the length of main road/motor way within 100~1000-meter buffer zone surrounding the child care center. We also got the data of PM 2.5 concentration from 2013 to 2018 and standard Normalized Difference Vegetation Index (NDVI) data from 2013 to 2019 according to the longitude and latitude of the child care centers. This data might help researchers to evaluate the health impacts of road density on child health, and help policy makers to make transportation, educational and environmental planning decisions to protect children from exposure to traffic-related hazards in Australia., (© 2022. The Author(s).)

Background: Little is known about the long-term health impacts of exposures to landscape fire smoke. We aimed to evaluate the association between exposure to coal mine fire-related particulate matter 2.5 μm or less in diameter (PM2.5) and hospitalisation in the 5 years following the 6-week Hazelwood coal mine fire in Australia in 2014., Methods: We surveyed 2725 residents (mean age: 58.3 years; 54.3% female) from an exposed and a comparison town. Individual PM2.5 exposures during the event were estimated using modelled PM2.5 concentrations related to the coal mine fire and self-reported location data. The individual exposure and survey data were linked with hospitalisation records between January 2009 and February 2019. Recurrent event survival analysis was used to evaluate relationships between PM2.5 exposure and hospitalisation following mine fire, adjusting for important covariates., Results: Each 10-µg/m3 increase in mine fire-related PM2.5 was associated with a 9% increased hazard [hazard ratio (HR) = 1.09; 95% confidence interval (CI): 1.01, 1.17] of respiratory hospitalisation over the next 5 years, with stronger associations observed for females (HR = 1.16; 95% CI: 1.06, 1.27) than males (HR = 0.99; 95% CI: 0.89, 1.11). In particular, increased hazards were observed for hospitalisations for asthma (HR = 1.43; 95% CI: 1.19, 1.73) and chronic obstructive pulmonary disease (HR = 1.14; 95% CI: 1.02, 1.28). No such association was found for hospitalisations for cardiovascular diseases, mental illness, injuries, type 2 diabetes, renal diseases or neoplasms., Conclusions: A 6-week exposure to coal mine fire-related PM2.5 was associated with increased hazard of respiratory hospitalisations over the following 5 years, particularly for females., (© The Author(s) 2021; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Particulate matter with aerodynamic diameter ≤2.5 μm (PM 2.5 ) concentrations vary between countries with similar carbon dioxide (CO 2 ) emissions, which can be partially explained by differences in air pollution control efficacy. However, no indicator of air pollution control efficacy has yet been developed. We aimed to develop such an indicator, and to evaluate its global and temporal distribution and its association with country-level health metrics. A novel indicator, ambient population-weighted average PM 2.5 concentration per unit per capita CO 2 emission (PM 2.5 /CO 2 ), was developed to assess country-specific air pollution control efficacy (abbreviated as APCI). We estimated and mapped the global average distribution of APCI and its changes during 2000-2016 across 196 countries. Pearson correlation coefficients and Generalized Additive Mixed Model (GAMM) were used to evaluate the relationship between APCI and health metrics. APCI varied by country with an inverse association with economic development. APCI showed an almost stable trend globally from 2000 to 2016, with the low-income groups increased and several countries (China, India, Bangladesh) decreased. The Pearson correlation coefficients between APCI and life expectancy at birth (LE), infant-mortality rate (IMR), under-five year of age mortality rate (U5MR) and logarithm of per capita GDP (LPGDP) were -0.57, 0.65, 0.66, -0.59 respectively (all P values < 0.001). APCI could explain international variation of LE, IMR and U5MR. The associations between APCI and LE, IMR, U5MR were independent of per capita GDP and climatic factors. We consider APCI to be a good indicator for air pollution control efficacy given its relation to important population health indicators. Our findings provide a new metric to interpret health inequity across the globe from the point of climate change and air pollution control efficacy., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Long-term exposure to PM 2.5 has been linked to cancer incidence and mortality. However, it was unknown whether there was an association with cancer hospitalizations., Methods: Data on cancer hospitalizations and annual PM 2.5 concentrations were collected from 1,814 Brazilian cities during 2002-2015. A difference-in-difference approach with quasi-Poisson regression was applied to examine State-specific associations. The State-specific associations were pooled at a national level using random-effect meta-analyses. PM 2.5 attributable burden were estimated for cancer hospitalization admissions, inpatient days and costs., Results: We included 5,102,358 cancer hospitalizations (53.8% female). The mean annual concentration of PM 2.5 was 7.0 μg/m 3 (standard deviation: 4.0 μg/m 3 ). With each 1 μg/m 3 increase in two-year-average (current year and previous one year) concentrations of PM 2.5 , the relative risks (RR) of hospitalization were 1.04 (95% confidence interval [CI]: 1.02 to 1.07) for all-site cancers from 2002 to 2015 without sex and age differences. We estimated that 33.82% (95%CI: 14.97% to 47.84%) of total cancer hospitalizations could be attributed to PM 2.5 exposure in Brazil during the study time. For every 100,000 population, 1,190 (95%CI: 527 to 1,836) cancer hospitalizations, 8,191 (95%CI: 3,627 to 11,587) inpatient days and US$788,775 (95%CI: $349,272 to $1,115,825) cost were attributable to PM 2.5 exposure., Conclusions: Long-term exposure to ambient PM 2.5 was positively associated with hospitalization for many cancer types in Brazil. Inpatient days and cost would be saved if the annual PM 2.5 exposure was reduced., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Few studies have explored the associations between ambient air pollution and blood lipid levels. This study aimed to fill this knowledge gap based on a routine health examination cohort in Shijiazhuang, China., Methods: We included 7063 participants who took the routine health examination for 2-3 times at Hebei General Hospital from January 2016 to December 2018. Individual serum levels of cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured. Their three-month average exposure to air pollution prior to the routine health examinations was estimated using inverse distance weighted method. We used linear mixed-effects regression models to examine the associations between air pollution and levels of blood lipids while controlling for age, gender, body mass index (BMI), smoking, alcohol drinking, temperature, humidity, with a random effect for each individual., Results: Particles with diameters ≤2.5 μm and ≤10 μm (PM 2.5 and PM 10 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ) and ozone (O 3 ) were all positively associated with TC, TG, and LDL-C and negatively associated with HDL-C, in single pollutant models. Each 10 μg/m 3 increment of 3-month average PM 2.5 was associated with 0.65% [95% confidence interval (CI): 0.03%-1.28%], 0.56% (95%CI: 0.33%-0.79%) and 0.63% (95%CI: 0.35%-0.91%) increment in TG, TC, and LDL-C, and 0.91% (95%CI: 0.68%-1.13%) decrease in HDL-C. In two-pollutant models, the effects of gaseous pollutants on blood lipids were weakened, while those of PMs were strengthened. Stronger associations were presented in the elderly (≥60 years) and overweight/obese (BMI ≥ 24) participants., Conclusions: Ambient air pollution had significantly adverse effects on blood lipid levels, especially in overweight/obese and elderly individuals., Capsule: Significant associations between increased air pollution and worse blood lipid levels were found, especially in overweight/obese and elderly individuals., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Although the association between long-term exposure to PM 2.5 and mortality has been evaluated intensively, little is known about the socioeconomic disparity in the association., Methods: We collected data on annual all-cause mortality, PM 2.5 concentration, socioeconomic and demographic characteristics of 2640 counties from the two most recent Chinese censuses in 2000 and 2010. We applied the difference-in-differences (DID) method to estimate PM 2.5 -mortality association for counties at different quartiles of literacy rate, college rate, urbanization rate and GDP per capita, respectively., Results: Overall, every 10 µg/m 3 increase in annual average PM 2.5 was associated with 3.8% (95% confidence interval [CI]: 3.0-5.0) increase of all-cause mortality. The stratified analysis suggested higher health impact of exposure in counties with lower socioeconomic status. For counties of the lowest quartile (Q 1 ) of literacy rate, college rate, urbanization rate and GDP per capita, the effect estimates were 6.0% (95% CI: 4.2-7.7), 4.4% (95% CI: 2.8-6.0), 3.5% (95% CI: 2.0-5.1) and 4.9% (95% CI: 2.7-7.1), respectively. There was strong evidence for elevated risk in mortality associated with PM 2.5 of all socioeconomic factors in the lowest quartile (Q 1 ) compared with the highest quartile counties (Q 4 ) (p-value for difference < 0.05)., Conclusions: There was socioeconomic disparity in the PM 2.5 -mortality association in China. Dwellers living in less developed counties are more vulnerable to long-term exposure to ambient PM 2.5 than those living in developed counties., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Aim: To determine the associations between outdoor air pollution and hospital outpatient visits for mental disorders in China., Methods: We obtained data of 111,842 hospital outpatient visits for mental disorders from the largest hospitals of 13 cities, China, between January 01, 2013 and December 31, 2015. We collected air pollutant data including particulate matter ≤2.5 µm in diameter (PM 2.5 ), particulate matter ≤10 µm in diameter (PM 10 ), nitrogen dioxide (NO 2 ), ozone (O 3 ) and sulphur dioxide (SO 2 ) from China National Environmental Monitoring Centre during the same period. We conducted a time-stratified case-crossover design with conditional logistic regression models to determine the associations., Results: A 10 µg/m 3 increase in PM 2.5 , PM 10 , NO 2 and SO 2 was associated with a significant increase in hospital outpatient visits for mental disorders on the current day. When stratified by age, sex and season, the effects of PM 2.5 and NO 2 were robust among different subgroups at lag05 days. PM 10 showed positive associations in males, in cold season, and in depression patients. SO 2 showed positive associations in males, in cold season, and in anxiety patients. O 3 showed positive associations in females, in warm season, and in depression patients. Nearly one sixth hospital outpatient visits for mental disorders can be attributable to NO 2 ., Conclusions: Short-term increase in PM 2.5 , PM 10 , NO 2 , SO 2 and O 3 concentrations was significantly associated with exacerbation of mental disorders in China as indicated by increases in hospital outpatient visits. NO 2 had more serious health threat than other pollutants in terms of mental disorders. Our findings strongly suggest a need for more strict emission control regulations to protect mental health from air pollution., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

OBJECTIVE: To evaluate associations of wildfire fine particulate matter ≤2.5 mm in diameter (PM2.5) with diabetes across multiple countries and territories. RESEARCH DESIGN AND METHODS: We collected data on 3,612,135 diabetes hospitalizations from 1,008 locations in Australia, Brazil, Canada, Chile, New Zealand, Thailand, and Taiwan during 2000–2019. Daily wildfire-specific PM2.5 levels were estimated through chemical transport models and machine-learning calibration. Quasi-Poisson regression with distributed lag nonlinear models and random-effects meta-analysis were applied to estimate associations between wildfire-specific PM2.5 and diabetes hospitalization. Subgroup analyses were by age, sex, location income level, and country or territory. Diabetes hospitalizations attributable to wildfire-specific PM2.5 and nonwildfire PM2.5 were compared. RESULTS: Each 10 µg/m3 increase in wildfire-specific PM2.5 levels over the current day and previous 3 days was associated with relative risks (95% CI) of 1.017 (1.011–1.022), 1.023 (1.011–1.035), 1.023 (1.015–1.032), 0.962 (0.823–1.032), 1.033 (1.001–1.066), and 1.013 (1.004–1.022) for all-cause, type 1, type 2, malnutrition-related, other specified, and unspecified diabetes hospitalization, respectively. Stronger associations were observed for all-cause, type 1, and type 2 diabetes in Thailand, Australia, and Brazil; unspecified diabetes in New Zealand; and type 2 diabetes in high-income locations. An estimate of 0.67% (0.16–1.18%) and 1.02% (0.20–1.81%) for all-cause and type 2 diabetes hospitalizations were attributable to wildfire-specific PM2.5. Compared with nonwildfire PM2.5, wildfire-specific PM2.5 posed greater risks of all-cause, type 1, and type 2 diabetes and were responsible for 38.7% of PM2.5-related diabetes hospitalizations. CONCLUSIONS: We show the relatively underappreciated links between diabetes and wildfire air pollution, which can lead to a nonnegligible proportion of PM2.5-related diabetes hospitalizations. Precision prevention and mitigation should be developed for those in advantaged communities and in Thailand, Australia, and Brazil. [ABSTRACT FROM AUTHOR]

Although some studies have found that short-term PM 2.5 exposure is associated with lung cancer deaths, its impact on other cancer sites is unclear. To answer this research question, this time-stratified case-crossover study used individual cancer death data between January 1, 2000, and December 31, 2019, extracted from the Brazilian mortality information system to quantify the associations between short-term PM 2.5 exposure and cancer mortality from 25 common cancer sites. Daily PM 2.5 concentration was aggregated at the municipality level as the key exposure. The study included a total of 34,516,120 individual death records, with the national daily mean PM 2.5 exposure 15.3 (SD 4.3) μg/m3. For every 10-μg/m3 increase in three-day average PM 2.5 exposure, the odds ratio (OR) for all-cancer mortality was 1.04 (95% CI 1.03–1.04). Apart from all-cancer deaths, PM 2.5 exposure may impact cancers of oesophagus (1.04, 1.00–1.08), stomach (1.05, 1.02–1.08), colon-rectum (1.04, 1.01–1.06), lung (1.04, 1.02–1.06), breast (1.03, 1.00–1.06), prostate (1.07, 1.04–1.10), and leukaemia (1.05, 1.01–1.09). During the study period, acute PM 2.5 exposure contributed to an estimated 1,917,994 cancer deaths, ranging from 0 to 6,054 cases in each municipality. Though there has been a consistent downward trend in PM 2.5 -related all-cancer mortality risks from 2000 to 2019, the impact remains significant, indicating the continued importance of cancer patients avoiding PM 2.5 exposure. This nationwide study revealed a notable association between acute PM 2.5 exposure and heightened overall and site-specific cancer mortality for the first time to our best knowledge. The findings suggest the importance of considering strategies to minimize such exposure in cancer care guidelines. The 20-year analysis of nationwide death records in Brazil revealed that heightened short-term exposure to PM 2.5 is associated with increased cancer mortality at various sites, although this association has gradually decreased over time. Despite the declining impact, the research highlights the persistent adverse effects of PM 2.5 on cancer mortality, emphasizing the importance of continued research and preventive measures to address the ongoing public health challenges posed by air pollution. [Display omitted] • First investigation for acute PM2.5 exposure and site-specific cancer mortality. • Significant adverse effects were observed at various cancer sites. • Potential adaptation exists in the PM2.5-cancer association. • Cancer guidelines may include acute PM2.5 exposure avoidance. [ABSTRACT FROM AUTHOR]

Brazil has experienced unprecedented wildfires recently. We aimed to investigate the association of wildfire-related fine particulate matter (PM 2.5) with cause-specific cardiovascular mortality, and to estimate the attributable mortality burden. Exposure to wildfire-related PM 2.5 was defined as exposure to annual mean wildfire-related PM 2.5 concentrations in the 1-year prior to death. The variant difference-in-differences method was employed to explore the wildfire-related PM 2.5 -cardiovascular mortality association. We found that, in Brazil, compared with the population in the first quartile (Q1: ≤1.82 μg/m3) of wildfire-related PM 2.5 exposure, those in the fourth quartile (Q4: 4.22–17.12 μg/m3) of wildfire-related PM 2.5 exposure had a 2.2% (RR: 1.022, 95% CI: 1.013–1.032) higher risk for total cardiovascular mortality, 3.1% (RR: 1.031, 95% CI: 1.014–1.048) for ischaemic heart disease mortality, and 2.0% (RR: 1.020, 95% CI: 1.002–1.038) for stroke mortality. From 2010 to 2018, an estimation of 35,847 (95% CI: 22,424–49,177) cardiovascular deaths, representing 17.77 (95% CI: 11.12–24.38) per 100,000 population, were attributable to wildfire-related PM 2.5 exposure. Targeted health promotion strategies should be developed for local governments to protect the public from the risk of wildfire-related cardiovascular premature deaths. [Display omitted] • Wildfire-related PM 2.5 was associated with cardiovascular (CVD) mortality. • Wildfire-related PM 2.5 was associated with ischemic heart disease and stroke. • An estimated 35,847 CVD deaths attributable to wildfire-related PM 2.5. [ABSTRACT FROM AUTHOR]

Background Although many cohort studies have documented the long-term effects of ambient air pollution on mortality, but they suffer from residual confounding, being unable to control unmeasured confounders, and are often not population representative. A recently developed variant of difference-in-difference (DID) approach is promising to address these limitations. Methods We collected annual all-cause death data from 2,193 statistical areas level-2 (SA2) in Australia during 2001-2015. Area-level annual mean concentrations of PM2.5 and NO2 were derived from widely used grid (0.01°×0.01° and 0.1°×0.1°, respectively) datasets. The variant of DID method was used to evaluate the causal relationship between annual PM2.5 and NO2 and all-cause mortality. We further developed this method by considering non-linear associations and lag impacts using distributed lag non-linear model. Results The impacts of low PM2.5 (1.94-12.00 µg/m3) and NO2 (0-7.41 µg/m3) on all-cause mortality were non-linear and lasted for 0-3 year and 0-6 year, respectively. The moving average PM2.5 (0-3 year) and NO2 (0-6 year) showed non-significant impacts below the thresholds (4.44 µg/m3 and 1.10 µg/m3) observed, while every 1 µg/m3 increase above the thresholds were associated with 2.4% (95%CI: 1.6-3.3%) and 9.4% (95%CI: 7.9-10.8%) increase in all-cause mortality, respectively. We estimated that 3.0% (95%CI: 2.0-3.9%) and 9.9% (8.3-11.3%) deaths were attributable to PM2.5 and NO2, respectively. Conclusions We further developed the causal DID model and documented the deadly impacts of long-term exposure to low PM2.5 and NO2 with thresholds and lag periods. Key messages Long-term exposure to low PM2.5 and NO2 are still deadly but have thresholds. [ABSTRACT FROM AUTHOR]

Background: Limited evidence is available on the health effects of particulate matter (PM including PM2.5 with an aerodynamic diameter ≤ 2.5 μm; PM10, ≤ 10 μm; PM2.5–10, 2.5–10 μm) during the pandemic of COVID-19 in Italy. The aims of the study were to examine the associations between all-cause mortality and PM in the pandemic period and compare them to the normal periods (2015–2019). Methods: We collected daily data regarding all-cause mortality (stratified by age and gender), and PM concentrations for 107 Italian provinces from 1 January 2015 to 31 May 2020. A time-stratified case-cross design with the distributed lag non-linear model was used to examine the association between PM and all-cause mortality. We also compared the counts and fractions of death attributable to PM in two periods. Results: Italy saw an increase in daily death counts while slight decreases in PM concentrations in pandemic period. Each 10 µg/m3 increase in PM was associated with much higher increase in daily all-cause mortality during the pandemic period compared to the same months during 2015–2019 (increased mortality rate: 7.24% (95%CI: 4.84%, 9.70%) versus 1.69% (95%CI: 1.12%, 2.25%) for PM2.5; 3.45% (95%CI: 2.58%, 4.34%) versus 1.11% (95%CI: 0.79%, 1.42%) for PM10; 4.25% (95%CI: 2.99%, 5.52%) versus 1.76% (95%CI: 1.14%, 2.38%) for PM2.5–10). The counts and fractions of deaths attributable to PM were higher in 2020 for PM2.5 (attributable death counts: 20,062 versus 3927 per year in 2015–2019; attributable fractions: 10.2% versus 2.4%), PM10 (15,112 versus 3999; 7.7% versus 2.5%), and PM2.5–10 (7193 versus 2303; 3.7% versus 1.4%). Conclusion: COVID-19 pandemic increased the vulnerability and excess cases of all-cause mortality associated with short-term exposure to PM2.5, PM2.5–10, and PM10 in Italy, despite a decline in air pollution level. [ABSTRACT FROM AUTHOR]

Indonesia is facing serious air pollution. However, very few studies have been conducted to examine the health risks of air pollution in Indonesia, particularly for adolescents. To assess the association between long-term exposure to ambient particles with a diameter of <2.5 μm (PM 2.5) and fasting plasma glucose (FPG) in adolescents. A cross-sectional study was conducted in 482 adolescents aged 14–18 years in Yogyakarta, Indonesia in 2016. We finally included 469 (97.30%) participants who had no missing data for data analysis. We collected individual data on socio-demographics, behavioral habits, and health information through standardized questionnaires. Satellite-based PM 2.5 concentrations from 2013 to 2016 were assigned based on participants' residential addresses. The association between PM 2.5 and FPG was examined using a generalized linear regression model while FPG was modeled as a continuous variable. An ordered logistic regression model was used to assess the relationship between PM 2.5 and FPG categories. Every 1 μg/m³ increase in PM 2.5 was associated with a 0.34 mg/dL [95 confidence interval (95% CI): 0.08 mg/dL, 0.59 mg/dL] increase in FPG levels. Comparing with the low FPG level (under 86 mg/dL), every 1 μg/m³ increase in PM 2.5 was associated with a 10.20% (95% CI: 1.60%, 19.80%) increase in the odds of impaired fasting glucose (IFG) (100–125 mg/dL). Stratified analyses indicated greater effects on participants with hypertension [odds ratio (OR) = 1.30, 95% CI: 1.09, 1.57] and those had higher physical activities (OR = 1.36, 95% CI: 1.09, 1.57). Adolescents' sex, obesity status and different cutoff points of FPG did not modify the association between the exposure to PM 2.5 and FPG levels. Long-term exposure to PM 2.5 was associated with increased FPG levels in Indonesian non-diabetic adolescents. Image 1 • First assessment of PM 2.5 related fasting plasma glucose in Indonesian adolescents. • Increase in PM 2.5 was associated with elevated fasting plasma glucose. • Greater associations in teenagers with hypertension or higher physical activities. Long-term exposure to PM 2.5 was associated with higher FPG levels in adolescents without diabetes in Indonesia, which provides scientific evidence for elevated fasting plasma glucose risk related to PM 2.5 exposure. [ABSTRACT FROM AUTHOR]