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1. Daily Mortality/Morbidity and Air Quality: Using Multivariate Time Series with Seasonally Varying Covariances

Author

Guowen Huang, Patrick Brown, Hwashin Hyun Shin, and Sze Hang Fu

Subjects
Statistics and Probability, Series (stratigraphy), Multivariate statistics, Statistics, Environmental science, Statistics, Probability and Uncertainty, Air quality index
Abstract

We study the associations between daily mortality and short-term variations in the ambient concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3) in four cities in Canada. First, a novel multivariate time series model within Bayesian framework is proposed for exposure assessment, where the response is a mixture of Gamma and Half-Cauchy distributions and the correlations between pollutants vary seasonally. A case-crossover design and conditional logistic regression model is used to relate exposure to disease data for each city, which then are combined to obtain a global estimate of exposure health effects allowing exposure uncertainty. The results suggest that every 10 ppb increase in O3 is associated with a 3.88% (95% credible interval [CI], 2.5%, 5.18%) increase in all-cause mortality, a 5.04% (2.84%, 7.43%) increase in circulatory mortality, a 7.87% (2.4%, 12.9%) increase in respiratory mortality, a 0.76% (0.19%, 1.35%) increase in all-cause morbidity and a 6.6% (0.58%, 12.7%) increase in respiratory morbidity. Similarly, every 10 ppb increase in NO2 is associated with a 2.13% (0.42%, 3.87%) increase in circulatory morbidity. The health impacts of PM2.5 are not found to be present once other pollutants are accounted for.

Published
2022

3. Circulatory health risks from additive multi-pollutant models: short-term exposure to three common air pollutants in Canada

Author

Hwashin Hyun Shin, James Owen, Aubrey Maquiling, Rajendra Prasad Parajuli, and Marc Smith-Doiron

Subjects
Health, Toxicology and Mutagenesis, Environmental Chemistry, General Medicine, Pollution
Abstract

Numerous studies have reported adverse health effects of ambient air pollution on circulatory health outcomes mainly based on single-pollutant models. However, limited studies have focused on adjusted effect of multi-pollutant exposures on public health. This study aimed to examine short-term effects of three common air pollutants—ground-level ozone (ozone), nitrogen dioxide (NO2), and fine particulate matter (PM2.5)—through multi-pollutant models for mixed effect of adjustment. Daily data (circulatory hospitalization and mortality) and hourly data (air pollutants and temperature) were collected for 24 Canadian cities for 2001–2012. We applied generalized additive over-dispersion Poisson regression models with 1, 2, or 3 pollutants for city-specific risks, and Bayesian hierarchical models for national risks. This study found little mixed effect of adjustment through multi-pollutant models (ozone and/or NO2 and/or PM2.5) for circulatory hospitalization or mortality in Canada for 2001–2012, indicating that the 1-pollutant model did not result in considerable under- or over-estimates. It seemed weak-to-moderate correlations among air pollutants did not change the significant effect of one air pollutant after accounting for others. Inconsistent findings between other previous studies and this study indicate the need of comparable study design for multi-pollutant effect analysis.

Published
2022

5. Comparison of hospitalization and mortality associated with short-term exposure to ambient ozone and PM

Author

Hwashin Hyun, Shin, Priyanka, Gogna, Aubrey, Maquiling, Rajendra Prasad, Parajuli, Lani, Haque, and Benjamin, Burr

Subjects
Hospitalization, Male, Air Pollutants, Canada, Ozone, Air Pollution, Humans, Female, Particulate Matter, Environmental Exposure, Cities
Abstract

Hospitalization and mortality (H-M) have been linked to air pollution separately. However, previous studies have not adequately compared whether air pollution is a stronger risk factor for hospitalization or mortality. This study aimed to investigate differences in H-M risk from short-term ozone and PMDaily ozone, PMOverall, ozone and PMThis study found H-M differences attributable to ozone and PM

Published
2020

6. Pollutant-sex specific differences in respiratory hospitalization and mortality risk attributable to short-term exposure to ambient air pollution

Author

Priyanka Gogna, Parvin Dehghani, Rajendra Prasad Parajuli, Aubrey Maquiling, and Hwashin Hyun Shin

Subjects
Male, medicine.medical_specialty, Canada, Environmental Engineering, Time Factors, 010504 meteorology & atmospheric sciences, Nitrogen Dioxide, 010501 environmental sciences, Health outcomes, 01 natural sciences, chemistry.chemical_compound, Ozone, Environmental health, Air Pollution, medicine, Environmental Chemistry, Humans, Nitrogen dioxide, Respiratory system, Waste Management and Disposal, 0105 earth and related environmental sciences, Pollutant, Air Pollutants, Ambient air pollution, business.industry, Public health, Bayes Theorem, Environmental Exposure, Pollution, Sex specific, Hospitalization, chemistry, Environmental Pollutants, Female, Particulate Matter, business, Lower mortality
Abstract

Background Many studies have reported associations of individual pollutants with respiratory hospitalization and mortality based on different populations, which makes it difficult to directly compare adverse health effects among multiple air pollutants. Objectives The study goal is to compare acute respiratory-related hospitalization and mortality associated with short-term exposure to three ambient air pollutants and analyze differences in health risks by season, age and sex. Methods Hourly measurements of air pollutants (ozone, NO2, PM2.5) and temperature were collected from ground-monitors for 24 cities along with daily hospitalization (1996–2012) and mortality (1984–2012) data. National associations between air pollutant and health outcome were estimated for season (warm, cold vs. year-round), age (base ≥ 1, seniors > 65), and sex (females ≥ 1 and males ≥ 1) using Bayesian hierarchical models. Results Overall, the three air pollutants were significantly associated with acute respiratory health outcomes at different lag-days. For respiratory hospitalization, the increased risks in percent changes with 95% posterior intervals for a 10-unit increase in each pollutant were: ozone (lag1, 0.7% (0.4, 0.9)), NO2 (lag0, 0.7% (0.1, 1.4)), and PM2.5 (lag1, 1.3% (0.7, 1.9)). For respiratory mortality: ozone (lag2, 1.2% (0.4, 1.9)), NO2 (lag1, 2.1% (0.6, 3.5)), and PM2.5 (lag1, 0.6% (−1.0, 2.2)). While some differences in risk were observed by season and age group, sex-specific differences were more pronounced. Compared with males, females had a higher respiratory mortality risk (1.8% (0.6, 2.9) vs 0.5% (−0.3, 1.3)) from ozone, a higher respiratory hospitalization risk (0.9% (0.0, 1.8) vs 0.6% (−0.3, 1.4)) but lower mortality risk (1.4% (−1.0, 3.7) vs 2.2% (0.4, 4.0)) from NO2, and a lower hospitalization risk (0.7% (−0.2, 1.7) vs 1.8% (1.0, 2.6)) from PM2.5. Conclusion This study reports significant health effects of short-term exposure to three ambient air pollutants on respiratory hospitalization (ozone≈NO2 NO2 ≈ PM2.5 per-IQR) and mortality (ozone≈NO2 > PM2.5) in Canada. Pollutant-sex-specific differences were found, but inconclusive due to limited biological and physiological explanations. Further studies are warranted to understand the pollutant-sex specific differences.

Published
2020

7. Mortality from COVID-19 in 12 countries and 6 states of the United States

Author

Patrick Brown, Kamal Rai, Carlo La Vecchia, Peter S Rodriguez, Kathleen Qu, Mathew G Brown, Hwashin Hyun Shin, Xuyang Tang, Leslie Newcombe, Wilson Suraweera, Craig Schultz, Isaac Bogoch, Hellen Gelband, Nico Nagelkerke, and Prabhat Jha

Subjects
Excess mortality, education.field_of_study, Coronavirus disease 2019 (COVID-19), Mortality rate, Population, Psychological intervention, Outbreak, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Geography, 030220 oncology & carcinogenesis, Pandemic, 030212 general & internal medicine, China, education, Demography
Abstract

ImportanceReliable estimates of COVID-19 mortality are crucial to aid control strategies and to assess the effectiveness of interventions.ObjectiveProject COVID-19 mortality trends to October 1, 2020, in 12 countries or regions that constitute >90% of the global COVID-19 deaths reported as of April 12, 2020.Design, Setting, and ParticipantsThe Global COVID-19 Assessment of Mortality (GCAM) is an open, transparent, and continuously updated (www.cghr.org/covid) statistical model that combines actual COVID-19 mortality counts with Bayesian inference to forecast COVID-19 deaths, the date of peak deaths, and the duration of excess mortality. The analyses covered a total of 700 million population above age 20 in 12 countries or regions: USA; Italy; Spain; France; UK; Iran; Belgium; a province of China (Hubei, which accounted for 90% of reported Chinese deaths); Germany; the Netherlands; Switzerland; and Canada; and six US states: New York, New Jersey, Michigan, Louisiana, California, and Washington.ResultsForecasted deaths across the 12 current high-burden countries sum 167,000 to 593,000 (median 253,000). The trajectory of US deaths (49,000-249,000 deaths; median 86,000)—over half of which are expected in states beyond the initial six states analysed in this study—will have the greatest impact on the eventual total. Mortality ranges are 25,000-109,000 (median 46,000) in the UK; 23,000-31,000 (median 26,000) in Italy; 21,000-37,000 (median 26,000) in France and 21,000-32,000 (median 25,000) in Spain. Estimates are most precise for Hubei, China—where the epidemic curve is complete—and least precise in California, where it is ongoing. New York has the highest cumulative median mortality rate per million (1135), about 12-fold that of Germany. Mortality trajectories are notably flatter in Germany, California, and Washington State, each of which took physical distancing and testing strategies seriously. Using past country-specific mortality as a guide, GCAM predicts surge capacity needs, reaching more than twice existing capacity in a number of places., In every setting, the results might be sensitive to undercounts of COVID-19 deaths, which are already apparent.Conclusion and RelevanceMortality from COVID-19 will be substantial across many settings, even in the best case scenario. GCAM will provide continually updated and increasingly precise estimates as the pandemic progresses.The coronavirus disease (COVID-19) pandemic has already caused over 115,000 deaths, with global deaths doubling every week.1-3Mortality is less biased than case reporting, which is affected by testing policies. However, the daily reporting of COVID-19 deaths is already known to undercount actual deaths, varying over time and place.4-6Reliable estimates of total COVID-19 mortality, the date of peak deaths, and of the duration of excess mortality are crucial to aid responses to the current and potential future pandemics. We have developed the Global COVID-19 Assessment of Mortality (GCAM), a statistical model to project COVID-19 mortality trends to October 1 2020 in 12 countries or regions that constitute >90% of the global COVID-19 deaths reported as of April 12th. We report also on six US states that account for 70% of the American totals to date (Supplementary Appendix).1We quantify the COVID-19 mortality trajectory ranges in each setting. A semi-automated website (www.cghr.org/covid) provides daily updates. GCAM is open, transparent, and uses a reasonably simple method that employs publicly reported mortality data to make plausible projections. The method is designed to improve as more mortality data become available over longer time periods.

Published
2020
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8. Temporal trends in associations between ozone and circulatory mortality in age and sex in Canada during 1984-2012

Author

Marc Smith-Doiron, Hwashin Hyun Shin, Rajendra Prasad Parajuli, and Aubrey Maquiling

Subjects
Male, Canada, Environmental Engineering, Ozone, 010504 meteorology & atmospheric sciences, Ground Level Ozone, Names of the days of the week, 010501 environmental sciences, Age and sex, Warm season, 01 natural sciences, chemistry.chemical_compound, Adverse health effect, Air Pollution, Environmental Chemistry, Medicine, Cities, Mortality, Waste Management and Disposal, 0105 earth and related environmental sciences, Air Pollutants, business.industry, Confounding, Bayes Theorem, Pollution, chemistry, Circulatory system, Female, Seasons, business, Demography
Abstract

Background Considerable research has been conducted on the association between ground-level ozone (ozone) and various causes of mortality, but the relationships by age and sex (biological) have been inconsistent, and temporal trends remain unexplored. Objectives The study goals are to investigate the adverse health effects of short-term exposure to ozone on circulatory mortality by age and sex, and to examine trends in annual health effects. Methods Daily ozone, temperature, and circulatory mortality counts (ICD I00-I99) were collected for 24 urban cities for 29 years (1984–2012). Associations between ozone and circulatory mortality were estimated using generalized additive Poisson models for season (warm vs. cold), age [base (≥1) vs. seniors (>65)], and sex, accounting for confounders (calendar-time, temperature, day of the week). City-specific estimates were pooled to represent national associations through Bayesian hierarchical models. Results While the cold season returned insignificant estimates, the warm season showed statistically significant associations: a 10 ppb increase in ozone was associated with 0.7% increase in circulatory mortality with a 95% posterior interval of 0.2%, 1.1%. One-day lagged ozone in the warm season showed little age differences [0.7% (0.23%, 1.12%) vs. 0.8% (0.22%, 1.27%)], but visible sex differences: females were at a higher circulatory mortality risk than males [1.1% (0.31%, 1.71%) vs. 0.3% (−0.46%, 0.98%)]. Annual estimates suggest overall up-down temporal changes; a slightly increasing trend until 2002–2004, and a generally decreasing trend thereafter. Conclusion This study found noticeable sex-related differences in circulatory mortality attributable to short-term exposure to ozone. Further research is warranted to understand whether sex alone, or unknown interactions with other factors derived the differences, and to clarify the specific biological mechanisms underlying differences in risk estimates between females and males.

Published
2019

9. Comparison of hospitalization and mortality associated with short-term exposure to ambient ozone and PM2.5 in Canada

Author

Aubrey Maquiling, Benjamin Burr, Rajendra Prasad Parajuli, Hwashin Hyun Shin, Lani Haque, and Priyanka Gogna

Subjects
Environmental Engineering, Ozone, Ground Level Ozone, Health, Toxicology and Mutagenesis, 0208 environmental biotechnology, Air pollution, 02 engineering and technology, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Ambient ozone, chemistry.chemical_compound, Risk of mortality, Credible interval, Environmental Chemistry, Medicine, Risk factor, 0105 earth and related environmental sciences, Pollutant, business.industry, Public Health, Environmental and Occupational Health, General Medicine, General Chemistry, Pollution, 020801 environmental engineering, chemistry, business, Demography
Abstract

Background: Hospitalization and mortality (H-M) have been linked to air pollution separately. However, previous studies have not adequately compared whether air pollution is a stronger risk factor for hospitalization or mortality. This study aimed to investigate differences in H-M risk from short-term ozone and PM2.5 exposures, and determine whether differences are modified by season, age, and sex. Methods: Daily ozone, PM2.5, temperature, and all-cause H-M counts (ICD-10, A00-R99) were collected for 22–24 Canadian cities for up to 29 years. Generalized additive Poisson models were employed to estimate associations between each pollutant and health outcome, which were compared across season (warm, cold, or year-round), age (all ages or seniors > 65), and sex. Results: Overall, ozone and PM2.5 showed higher season-specific risk of mortality than hospitalization: warm-season ozone: 0.54% (95% credible interval, 0.20, 0.85) vs. 0.14% (0.02, 0.27) per 10 ppb; and year-round PM2.5: 0.90% (0.33, 1.41) vs. 0.29% (0.03, 0.56) per 10 μg/m3. While age showed little H-M difference, sex appeared to be a modifier of H-M risk. While females had higher mortality risk, males had higher hospitalization risk: for females, ozone 0.87% (0.36, 1.35) vs. −0.03% (−0.18, 0.11) and PM2.5 1.19% (0.40, 1.90) vs. 0.19% (−0.10, 0.47); and for males ozone 0.20% (−0.28, 0.65) vs. 0.35% (0.18, 0.51). Conclusion: This study found H-M differences attributable to ozone and PM2.5, suggesting that both are stronger risk factors for mortality than hospitalization. In addition, there were clear H-M differences by sex: specifically, females showed higher mortality risk and males showed higher hospitalization risk.

Published
2021

10. Closing the Green Gap: The Impact of Environmental Commitment and Advertising Believability

Author

Hwashin Hyun Shin, Sangdo Oh, Sukki Yoon, and Yeonshin Kim

Subjects
Social psychology (sociology), Social Psychology, Brand names, media_common.quotation_subject, 05 social sciences, Closing (real estate), Advertising, Research findings, Affect (psychology), Green advertising, Consistency (negotiation), 0502 economics and business, 050211 marketing, Psychology, Social psychology, 050203 business & management, media_common
Abstract

We investigated how consumer and message characteristics affect the consistency between message acceptance and purchase intention for green products (viz., green gap). Participants were 231 adults who were approached in various public places in South Korea (e.g., shopping malls). We used 2 mock advertisements with fictitious brand names. Our data showed that participants who were committed to environmentally friendly behaviors, as measured by their past proenvironmental behaviors, displayed a tighter relationship between accepting green advertising messages and intending to purchase green products. Furthermore, the acceptance–intention relationship was even stronger among participants who were strongly committed to environmentally friendly behaviors and who also found the advertising message believable. Our research findings add to the literature on the attitude–behavior relationship by demonstrating that both dispositional and message factors strengthen thought–action connections.

Published
2016

12. Mortality and Hospitalization Linked to Fine Particulate Matter in Canada: Is There a Trend in Risk between 2001 and 2012?

Author

Lani Haque, Wesley S. Burr, Hwashin Hyun Shin, Branka Jovic, Dave Stieb, Marc Smith-Doiron, and Harun Kalayci

Subjects
National health, medicine.medical_specialty, Fine particulate, Environmental health, Public health, Epidemiology, medicine, Air pollution, General Earth and Planetary Sciences, Environmental science, Particulates, medicine.disease_cause, General Environmental Science
Abstract

Background: The Air Health Trend Indicator is designed to estimate public health risk related to short-term exposure to air pollution and to detect trends in annual national health risks. Trends in...

Published
2018

14. The Oakville Oil Refinery Closure and Its Influence on Local Hospitalizations: A Natural Experiment on Sulfur Dioxide

Author

Robert Dales, Branka Jovic, Hwashin Hyun Shin, Marc Smith-Doiron, Ling Liu, Wesley S. Burr, Dave Stieb, and Lisa Marie Kauri

Subjects
Adult, Male, Natural experiment, Adolescent, Health, Toxicology and Mutagenesis, air pollution, Air pollution, Oil and Gas Industry, lcsh:Medicine, Population health, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Article, Health data, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Environmental health, medicine, Humans, sulfur dioxide, respiratory hospitalization, 030212 general & internal medicine, Child, Sulfur dioxide, Aged, natural experiment, 0105 earth and related environmental sciences, Aged, 80 and over, Ontario, Air Pollutants, standardized hospitalization ratio, lcsh:R, Oil refinery, Public Health, Environmental and Occupational Health, Infant, Environmental Exposure, Middle Aged, Refinery, Hospitalization, chemistry, Child, Preschool, Community health, Environmental science, Female, Seasons
Abstract

Background: An oil refinery in Oakville, Canada, closed over 2004&ndash, 2005, providing an opportunity for a natural experiment to examine the effects on oil refinery-related air pollution and residents&rsquo, health. Methods: Environmental and health data were collected for the 16 years around the refinery closure. Toronto (2.5 million persons) and the Greater Toronto Area (GTA, 6.3 million persons) were used as control and reference populations, respectively, for Oakville (160,000 persons). We compared sulfur dioxide and age- and season-standardized hospitalizations, considering potential factors such as changes in demographics, socio-economics, drug prescriptions, and environmental variables. Results: The closure of the refinery eliminated 6000 tons/year of SO2 emissions, with an observed reduction of 20% in wind direction-adjusted ambient concentrations in Oakville. After accounting for trends, a decrease in cold-season peak-centered respiratory hospitalizations was observed for Oakville (reduction of 2.2 cases/1000 persons per year, p = 0.0006 ) but not in Toronto (p = 0.856) and the GTA (p = 0.334). The reduction of respiratory hospitalizations in Oakville post closure appeared to have no observed link to known confounders or effect modifiers. Conclusion: The refinery closure allowed an assessment of the change in community health. This natural experiment provides evidence that a reduction in emissions was associated with improvements in population health. This study design addresses the impact of a removed source of air pollution.

Published
2018
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15. Air Health Trend Indicator: Association between Short-Term Exposure to Ground Ozone and Circulatory Hospitalizations in Canada for 17 Years, 1996–2012

Author

Lani Haque, Hwashin Hyun Shin, Dave Stieb, Wesley S. Burr, Harun Kalayci, Marc Smith-Doiron, and Branka Jovic

Subjects
Male, Time Factors, Heart disease, Health, Toxicology and Mutagenesis, Air pollution, Myocardial Ischemia, lcsh:Medicine, Disease, 010501 environmental sciences, medicine.disease_cause, ground-ozone, 01 natural sciences, chemistry.chemical_compound, 0302 clinical medicine, Credible interval, 030212 general & internal medicine, General Environmental Science, Air Pollutants, public health risk, Middle Aged, cerebrovascular disease, Hospitalization, trend, Circulatory system, Female, Public Health, medicine.medical_specialty, Canada, Ozone, Heart Diseases, Age and sex, Warm season, Article, 03 medical and health sciences, Environmental health, Air Pollution, medicine, Humans, hospitalizations, Bayesian hierarchical model, 0105 earth and related environmental sciences, Aged, business.industry, Public health, other heart disease, lcsh:R, Public Health, Environmental and Occupational Health, Bayes Theorem, Environmental Exposure, medicine.disease, ischemic heart disease, Term (time), Cerebrovascular Disorders, chemistry, General Earth and Planetary Sciences, business, Demography
Abstract

The Air Health Trend Indicator is designed to estimate the public health risk related to short-term exposure to air pollution and to detect trends in the annual health risks. Daily ozone, circulatory hospitalizations and weather data for 24 cities (about 54% of Canadians) for 17 years (1996&ndash, 2012) were used. This study examined three circulatory causes: ischemic heart disease (IHD, 40% of cases), other heart disease (OHD, 31%) and cerebrovascular disease (CEV, 14%). A Bayesian hierarchical model using a 7-year estimator was employed to find trends in the annual national associations by season, lag of effect, sex and age group (&le, 65 vs. &gt, 65). Warm season 1-day lagged ozone returned higher national risk per 10 ppb: 0.4% (95% credible interval, &minus, 0.3&ndash, 1.1%) for IHD, 0.4% (&minus, 0.2&ndash, 1.0%) for OHD, and 0.2% (&minus, 0.8&ndash, 1.2%) for CEV. Overall mixed trends in annual associations were observed for IHD and CEV, but a decreasing trend for OHD. While little age effect was identified, some sex-specific difference was detected, with males seemingly more vulnerable to ozone for CEV, although this finding needs further investigation. The study findings could reduce a knowledge gap by identifying trends in risk over time as well as sub-populations susceptible to ozone by age and sex.

Published
2018

16. Meta-Analysis Methods to Estimate the Shape and Uncertainty in the Association Between Long-Term Exposure to Ambient Fine Particulate Matter and Cause-Specific Mortality Over the Global Concentration Range

Author

Majid Ezzati, Hwashin Hyun Shin, Bryan Hubbell, Stephen S. Lim, Aaron J. Cohen, C. Arden Pope, and Richard T. Burnett

Subjects
Estimation, Small number, Bayesian probability, Pooling, 010501 environmental sciences, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Frequentist inference, Physiology (medical), Meta-analysis, Prior probability, Statistics, Econometrics, Range (statistics), Environmental science, 030212 general & internal medicine, Safety, Risk, Reliability and Quality, 0105 earth and related environmental sciences
Abstract

Estimates of excess mortality associated with exposure to ambient concentrations of fine particulate matter have been obtained from either a single cohort study or pooling information from a small number of studies. However, standard frequentist methods of pooling are known to underestimate statistical uncertainty in the true risk distribution when the number of studies pooled is small. Alternatively, Bayesian pooling methods using noninformative priors yield unrealistically large amounts of uncertainty in this case. We present a new hybrid frequentist-bayesian framework for meta-analysis that incorporates features of both frequentist and Bayesian approaches, yielding estimated uncertainty distributions that are more useful for burden estimation. We also present an example of mortality risk due to long-term exposure to ambient fine particulate matter obtained from a small number of cohort studies conducted in the United States and Europe. We compare our new risk uncertainty distribution to that obtained by the integrated exposure-response (IER) model used in the Global Burden of Disease 2010 project for which risk was modeled over the entire global concentration range. We suggest a method to incorporate our new risk uncertainty distribution based on the relatively low concentrations observed in the United States and western Europe into the IER model, thus extending risk estimation to the global concentration range.

Published
2015

17. Associations between personal exposures to VOCs and alterations in cardiovascular physiology: Detroit Exposure and Aerosol Research Study (DEARS)

Author

Rob Bard, Hwashin Hyun Shin, Robert H. Brook, Paul D. Jones, Ron Williams, and Karen D. Oliver

Subjects
Atmospheric Science, business.industry, Cardiovascular health, Cardiovascular physiology, Aerosol, Toxicology, Blood pressure, Environmental health, medicine.artery, Cohort, Heart rate, Medicine, Brachial artery, business, General Environmental Science, Exposure assessment
Abstract

Background An adult cohort consisting of 63 participants engaged in the US EPA's recent Detroit Exposure and Aerosol Research Study (DEARS) and a University of Michigan cardiovascular sub-study conducted during summer and winter periods over 3 years between 2004 and 2007 (5 seasons in total). Through all participants' wearing of a monitoring vest, personal exposures to various air pollutants were measured. Purpose The study objective was to identify the association between personal exposure to volatile organic compounds (VOCs) and six cardiovascular health endpoints in an adult non-smoking cohort of the DEARS. Methods Twenty five VOCs were collected using the DEARS exposure vest incorporating advanced passive diffusion tube. Six cardiovascular health endpoints including systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), brachial artery diameter (BAD), brachial artery flow-mediated dilatation (FMD) and nitroglycerin-mediated arterial dilatation (NMD) were collected by novel, in-home clinical examinations. To reduce the number of personal VOCs highly correlated to each other, a principal component analysis was conducted. Accounting for more individual variations in association between personal VOCs and cardiovascular health endpoints, a linear mixed model was employed, where cohort subjects were not necessarily to have the same linear association. Results Applying the principal component analysis, 3 out of 12 components were retained, which appeared to involve a petroleum source (1st component), a 1-3 butadiene source (2nd component), and an ambient (Freon) source (3rd component). Petroleum related VOCs were associated with increases in FMD and showed mixed relationships with NMD (lag 0–1 day increased NMD, lag 2 days decreased NMD). Butadiene related VOCs decreased DBP but increased HR and BAD. Freon (ambient background) related VOCs increased HR. Conclusions We observed mixed and variable results in this first study to evaluate the relationships between personal exposures to VOCs of different origin on cardiovascular physiology. In sum, the findings suggest that VOCs may have rapid impacts upon the human cardiovascular system; however, understanding the health implications and the mechanisms responsible is beyond the scope of this investigation.

Published
2015

18. Department of Error

Author

BIJU ABRAHAM, Rajiv Chowdhury, Hassan Magdy Abd El Razek, ZOUBIDA ZAIDI, Marcella Montico, Ileana Beatriz Heredia-Pi, Burcu Kucuk Bicer, Samer Hamidi, Rintaro Mori, Nataliya Foigt, Samir Bhatt, Kalpana Balakrishnan, Lope Barrero, John McGrath, Bishal Gyawali, Ingrid Wolfe, Konstantinos Stroumpoulis, Ibrahim Ginawi, Sibhatu Biadgilign, Carla Farinha, Kenji Shibuya, Sait Mentes Birlik, Vafa Rahimi-Movaghar, RAJESH SAGAR, Pengpeng Ye, Peter Meaney, Boris Bikbov, Sivadasanpillai Harikrishnan, Aleksandra Barac, Daniel Kim, Graeme Hankey, Giancarlo Logroscino, Bruno Sunguya, Heidi J. Larson, Amador Goodridge, Khalid Altirkawi, João Fernandes, Joan B Soriano, Edson Servan-Mori, Francis Mhimbira, Ibrahim Abubakar, Peter Gething, Gholamreza Roshandel, Bemnet Amare Tedla, Rakhi Dandona, Rajaa Al-Raddadi, Rafael Lozano, Scott Patten, Diego Augusto Santos Silva, RAJ VERMA, Maziar Moradi-Lakeh, Norberto Perico, Om Prakash Singh, Eyal Oren, Eduardo Bernabe, Bach Tran, Fisaha Haile Tesfay (PhD), Ben Schöttker, Mustafa Younis, Jiabin Shen, Rafael Tabares-Seisdedos, Mahdi Mahdavi, Yousef Khader, Gizachew A Tessema, Charles Wiysonge, Hajo Zeeb, Ana Maria Nogales Vasconcelos, AMANUEL GEBREMEDHIN, Azmeraw T. Amare, Jacob Olusanya, Angel Paternina-Caicedo, Maria Dolores Sanchez-Niño, Yohannes Adama Melaku, Vivekanand Jha, George Mugambage Ruhago, Olalekan Uthman, Farshad Farzadfar, Nelson Alvis-Guzmán, Khurshid Alam, Srinivas Murthy, Johanna Marianna Geleijnse, Alemayehu Mekonnen, Ivo Rakovac, Soraya Seedat, Amir Kasaeian, Yibeltal Bayou, Andrew Kemp, David Pereira, Raimundas Lunevicius, EMERITO JOSE A. FARAON, Samantha Colquhoun, Ai Koyanagi, Ted Miller, JUNG-CHEN CHANG, Demewoz Haile, Zubair Kabir, Suleman Atique, Richard Franklin, Jose Martinez-Raga, Sergey Soshnikov, Yohannes Kinfu, Konrad Pesudovs, Johan Ärnlöv, Adugnaw Berhane, Alireza Esteghamati, Niranjan Kissoon, Shafiu Mohammed, Jean Nachega, Derrick Bennett, Karzan Mohammad, Hwashin Hyun SHIN, Tissa Wijeratne, and Subas Neupane

Subjects
Child mortality, Burden of disease, 03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, History, 030212 general & internal medicine, General Medicine, Article, 3. Good health, Demography
Abstract

GBD 2015 Child Mortality Collaborators. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1725–74—In this Article, Mohsen Naghavi, Michael J Kutz, Chantal Huynh, Samer Hamidi, Addisu Shunu Beyene, and Stephen S Lim should have been listed as authors. The affiliation details for Simon I Hay have been updated. The funding statement for Simon I Hay has been added. These corrections have been made to the online version as of Jan 5, 2017.

Published
2017

19. Global, regional, and national levels and causes of maternal mortality during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Author

Carl Abelardo T. Antonio, Rob E. Dorrington, Belinda K Lloyd, Elisabete Weiderpass, Kovin Naidoo, Leslie T. Cooper, Sandra Nolte, Eduardo A. Undurraga, Mohammad A. AlMazroa, R. Kumar, Xiaofeng Liang, Amanda J. Mason-Jones, Kazem Rahimi, Sanjay Basu, Vasiliy Victorovich Vlassov, André Karch, Dipan Bose, Vivekanand Jha, Adansi A. Amankwaa, Kaire Innos, Ione Jayce Ceola Schneider, Itamar S. Santos, Anwar Rafay, Bolajoko O. Olusanya, Tommi Vasankari, Nana Kwaku Mainoo, Saleem M Rana, Wagner Marcenes, Fortuné Gbètoho Gankpé, Rana J. Asghar, Lela Sturua, Nicholas J K Breitborde, Corine Karema, Charles R. Newton, Uche S. Uchendu, Jongmin Lee, Inga Dora Sigfusdottir, Harish Chander Gugnani, Kaushalendra Kumar, Reza Assadi, Ibrahim Abubakar, Konstantinos Stroumpoulis, Megan Coggeshall, Timothy M. Wolock, Ronny Westerman, Samath D Dharmaratne, Katya Anne Shackelford, Anders Larsson, Jeffrey A. Towbin, Jixiang Ma, Lynne Gaffikin, Konstantin Kazanjan, Mohammad Ali Sahraian, Mohammad H. Forouzanfar, Yichong Li, Felix Sayinzoga, Daniel Dicker, Philimon Gona, Maurice Giroud, Maysaa El Sayed Zaki, Shiwei Liu, Lorenzo Monasta, Chantal Huynh, Abdullatif Husseini, Ted R. Miller, Solomon Meseret Woldeyohannes, D. Alex Quistberg, Justin Beardsley, Majed Asad, Uʇur Dilmen, Alaa Badawi, Hsien-Ho Lin, Haidong Kan, Vinod K. Paul, Mitsuru Mukaigawara, James Leigh, Xiao Nong Zou, Sajjad Ur Rahman, Valentina Arsić Arsenijević, Gokalp Kadri Yentur, Man Mohan Mehndiratta, Murugesan Raju, Stephanie J. London, Kingsley N. Ukwaja, Young-Ho Khang, Knud Juel, Mohsen Naghavi, Rasmus Havmoeller, Gelin Xu, Semaw Ferede Abera, Devina Nand, Norito Kawakami, Neil Pearce, Elisabeth Barboza França, Ferrán Catalá-López, Ketevan Goginashvili, Vegard Skirbekk, Neeraj Bedi, Barthelemy Kuate Defo, Andrew H. Kemp, H. Dean Hosgood, Vafa Rahimi-Movaghar, Konrad Pesudovs, Linhong Wang, Xiao Rong Wang, Alan D. Lopez, Ademola Lukman Adelekan, Joshua A. Salomon, Walter Mendoza, Aref A. Bin Abdulhak, Ivy Shiue, G Anil Kumar, Yuichiro Yano, Luke D. Knibbs, Jung-Chen Chang, Yousef Khader, Caitlyn Steiner, Selen Begüm Uzun, Luciano A. Sposato, Gabrielle deVeber, Raghib Ali, Andre Pascal Kengne, Chakib Nejjari, Rafael Alfonso-Cristancho, Tania Georgina Sánchez Pimienta, Roberto Tchio Talongwa, Hilda L Harb, Ali H. Mokdad, Edward J Mills, Angel J Paternina Caicedo, Xiaohong Li, Luke Nyakarahuka, Diego De Leo, Rashmi Gupta, Robert G. Weintraub, Tim Driscoll, Sun Ha Jee, Carolina Maria Teixeira, Ole Frithjof Norheim, Zulfiqar A Bhutta, Hwashin Hyun Shin, Palwasha Anwari, Daniel Pope, Hassan Amini, Jae-Hyun Park, Saad B. Omer, Eric L. Ding, Narayanaswamy Venketasubramanian, Juan Liang, Tara Templin, Arindam Basu, Farshad Farzadfar, Yang Yang, Xuan Che, Scott Weichenthal, Jeyaraj D Pandian, David L. Tirschwell, Adrian Davis, Hilton Lam, Feng Tan, Stephen S Lim, Soewarta Kosen, Atsushi Goto, Ratilal Lalloo, Yanping Wang, Glen Mola, Paulo A. Lotufo, Dhruv S. Kazi, Jose C. Adsuar, Amany H Refaat, Ruben Castro, Gene F. Kwan, Johanna M. Geleijnse, Emerito Jose A. Faraon, Costas A. Christophi, Theo Vos, Sara Sheikhbahaei, Guilherme V. Polanczyk, Jed D. Blore, Azmeraw T. Amare, Kyle R. Heuton, Walid Ammar, Louisa Degenhardt, Andrew Vallely, Guohong Jiang, Ricky Leung, Jasvinder A. Singh, Zewdie Aderaw Alemu, A Artaman, Steven E. Lipshultz, Carlos A Castañeda-Orjuela, Seyed-Mohammad Fereshtehnejad, Sadaf G. Sepanlou, Mark J. Nieuwenhuijsen, John Q. Wong, Manami Inoue, Coen H. Van Gool, James D. Wilkinson, Ejaz Ahmad Khan, Yoshihiro Kokubo, Manuela Mendonca Felicio, Farshad Pourmalek, Boris I. Pavlin, Karen Sliwa, Robert G. Nelson, Tom Achoki, Edmond K. Kabagambe, Orish Ebere Orisakwe, Christopher J L Murray, In-Hwan Oh, Uchechukwu K.A. Sampson, Ulrich O Mueller, Austin E Schumacher, Edson Serván-Mori, Berrak Bora Basara, Simon I. Hay, Anil Kaul, Foad Abd-Allah, Takayoshi Ohkubo, Kim Yun Jin, Abdullah Sulieman Terkawi, Mall Leinsalu, Sergei Petrovich Ermakov, Marek Majdan, Ileana B. Heredia Pi, Christina Papachristou, Scott B. Patten, Rajeev Gupta, Kalpana Balakrishnan, Mustafa Z. Younis, Kenji Shibuya, Graça Maria Ferreira De Lima, Andrea P. Silva, Maziar Moradi-Lakeh, Anand Dayama, Eiman Jahangir, Stefan Ma, Karen M. Tabb, Nicholas J Kassebaum, Shams Eldin Ali Hassan Khalifa, Mazin J. Al Kahbouri, Nadim E. Karam, Jun Zhu, Chandrashekhar T Sreeramareddy, Dinorah González-Castell, Diego Gonzalez-Medina, Aliya Naheed, Ryan M Barber, Salvador Villalpando, Yang Liu, Chanda Kulkarni, Vinay Nangia, Haidong Wang, Yongmei Li, Rosario Cárdenas, Randah R. Hamadeh, Suzanne Polinder, Van C. Lansingh, François Alla, Max Petzold, Bryan L. Sykes, Ubai Alsharif, Chuanhua Yu, Francesco Saverio Violante, Monika Sawhney, Ayse Abbasoglu Ozgoren, Graeme J. Hankey, Mouhanad Hammami, Iuri da Costa Leite, Dickens Akena, Rintaro Mori, Alanur Çavlin, Maia Kereselidze, Jonathan de la Cruz Monis, Deena Alasfoor, Taavi Lai, Eric Y. Tenkorang, Cyrus Cooper, Sudan Prasad Neupane, Dan Poenaru, Veena S. Kulkarni, Naohiro Yonemoto, Elizabeth Glaser, Sergey Soshnikov, Ziad A. Memish, Paul N. Jensen, Fabiola Mejía-Rodríguez, Ana C. Garcia, Rakhi Dandona, Emilie Agardh, Katherine B Gibney, Vasco Manuel Pedro Machado, Michelle L. Bell, David M. Pereira, Muluemebet Abera Wordofa, Samantha M. Colquhoun, Elena Alvarez, Stephen G. Waller, Ketevan Gambashidze, Eduardo Bernabé, Rafael Lozano, Damian G Hoy, Miltiadis K. Tsilimbaris, Hebe N. Gouda, Muhammad Imran Nisar, Zanfina Ademi, Andrew L. Thorne-Lyman, Denis Nash, Dima M. Qato, Luca Ronfani, Nobhojit Roy, Donald H. Silberberg, Monica S. Vavilala, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Lalit Dandona, Borja del Pozo-Cruz, Sumeet S. Chugh, Johan Ärnlöv, Tariku Jibat Beyene, Melvin Barrientos Marzan, Ami R. Moore, Marie Ng, Maigeng Zhou, Samia Alhabib, Massimo Cirillo, Soraya Seedat, Paul S. F. Yip, Nima Hafezi-Nejad, Amelia Bertozzi-Villa, Kebede Deribe, John Nelson Opio, Peter J. Allen, Marina Shakh-Nazarova, Bach Xuan Tran, Arsène Kouablan Adou, Yingfeng Zheng, Julio Cesar Montañez Hernandez, Yong Zhao, Nelson Alvis-Guzman, Bulat Idrisov, Alireza Esteghamati, Seok Jun Yoon, Kathryn H. Jacobsen, Kassebaum, Nicholas J., Bertozzi-Villa, Amelia, Coggeshall, Megan S., Shackelford, Katya A., Steiner, Caitlyn, Heuton, Kyle R., Gonzalez-Medina, Diego, Barber, Ryan, Huynh, Chantal, Dicker, Daniel, Templin, Tara, Wolock, Timothy M., Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Adou, Arsène Kouablan, Adsuar, José C., Agardh, Emilie E., Akena, Dicken, Alasfoor, Deena, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Al Kahbouri, Mazin J., Alla, Françoi, Allen, Peter J., Almazroa, Mohammad A., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzmán, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Amini, Hassan, Ammar, Walid, Antonio, Carl A.T., Anwari, Palwasha, Ärnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Ali, Asad, Majed Masoud, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Badawi, Alaa, Balakrishnan, Kalpana, Basu, Arindam, Basu, Sanjay, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Bernabe, Eduardo, Beyene, Tariku J., Bhutta, Zulfiqar, Abdulhak, Aref Bin, Blore, Jed D., Basara, Berrak Bora, Bose, Dipan, Breitborde, Nichola, Cárdenas, Rosario, Castañeda-Orjuela, Carlos A., Castro, Ruben Estanislao, Catalá-López, Ferrán, Cavlin, Alanur, Chang, Jung-Chen, Che, Xuan, Christophi, Costas A., Chugh, Sumeet S., Cirillo, Massimo, Colquhoun, Samantha M., Cooper, Leslie Trumbull, Cooper, Cyru, Da Costa Leite, Iuri, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Degenhardt, Louisa, De Leo, Diego, Del Pozo-Cruz, Borja, Deribe, Kebede, Dessalegn, Muluken, Deveber, Gabrielle A., Dharmaratne, Samath D., Dilmen, Uʇur, Ding, Eric L., Dorrington, Rob E., Driscoll, Tim R., Ermakov, Sergei Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A., Farzadfar, Farshad, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, De Lima, Graça Maria Ferreira, Forouzanfar, Mohammad H., França, Elisabeth B., Gaffikin, Lynne, Gambashidze, Ketevan, Gankpé, Fortuné Gbètoho, Garcia, Ana C., Geleijnse, Johanna M., Gibney, Katherine B., Giroud, Maurice, Glaser, Elizabeth L., Goginashvili, Ketevan, Gona, Philimon, González-Castell, Dinorah, Goto, Atsushi, Gouda, Hebe N., Gugnani, Harish Chander, Gupta, Rahul, Gupta, Rajeev, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Havmoeller, Rasmu, Hay, Simon I., Pi, Ileana B. Heredia, Hoek, Hans W., Hosgood, H Dean, Hoy, Damian G., Husseini, Abdullatif, Idrisov, Bulat T., Innos, Kaire, Inoue, Manami, Jacobsen, Kathryn H., Jahangir, Eiman, Jee, Sun Ha, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kabagambe, Edmond Kato, Kan, Haidong, Karam, Nadim E., Karch, André, Karema, Corine Kakizi, Kaul, Anil, Kawakami, Norito, Kazanjan, Konstantin, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre Pascal, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz Ahmed, Khang, Young-Ho, Knibbs, Luke, Kokubo, Yoshihiro, Kosen, Soewarta, Defo, Barthelemy Kuate, Kulkarni, Chanda, Kulkarni, Veena S., Kumar, G. Anil, Kumar, Kaushalendra, Kumar, Ravi B., Kwan, Gene, Lai, Taavi, Lalloo, Ratilal, Lam, Hilton, Lansingh, Van C., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Xiaohong, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., London, Stephanie J., Lotufo, Paulo A., Ma, Jixiang, Ma, Stefan, Machado, Vasco Manuel Pedro, Mainoo, Nana Kwaku, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Mason-Jones, Amanda J., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, De La Cruz Monis, Jonathan, Hernandez, Julio Cesar Montañez, Moore, Ami R., Moradi-Lakeh, Maziar, Mori, Rintaro, Mueller, Ulrich O., Mukaigawara, Mitsuru, Naheed, Aliya, Naidoo, Kovin S., Nand, Devina, Nangia, Vinay, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nieuwenhuijsen, Mark J., Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Park, Jae-Hyun, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pesudovs, Konrad, Petzold, Max, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pope, Dan, Pourmalek, Farshad, Qato, Dima, Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Ur Rahman, Sajjad, Raju, Murugesan, Rana, Saleem M., Refaat, Amany, Ronfani, Luca, Roy, Nobhojit, Pimienta, Tania Georgina Sánchez, Sahraian, Mohammad Ali, Salomon, Joshua A., Sampson, Uchechukwu, Santos, Itamar S., Sawhney, Monika, Sayinzoga, Felix, Schneider, Ione J.C., Schumacher, Austin, Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Shakh-Nazarova, Marina, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stroumpoulis, Konstantino, Sturua, Lela, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tan, Feng, Teixeira, Carolina Maria, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thorne-Lyman, Andrew L., Tirschwell, David L., Towbin, Jeffrey A., Tran, Bach X., Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Undurraga, Eduardo A., Uzun, Selen Begüm, Vallely, Andrew J., Van Gool, Coen H., Vasankari, Tommi J., Vavilala, Monica S., Venketasubramanian, N., Villalpando, Salvador, Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vos, Theo, Waller, Stephen, Wang, Haidong, Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, Wilkinson, James D., Woldeyohannes, Solomon Meseret, Wong, John Q., Wordofa, Muluemebet Abera, Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., Naghavi, Mohsen, Murray, Christopher J.L., Lozano, Rafael, Kassebaum, Nj, Bertozzi-Villa, A, Coggeshall, M, Shackelford, Ka, Steiner, C, Heuton, Kr, Gonzalez-Medina, D, Barber, R, Huynh, C, Dicker, D, Templin, T, Wolock, Tm, Ozgoren, Aa, Abd-Allah, F, Abera, Sf, Achoki, T, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Agardh, Ee, Akena, D, Alasfoor, D, Alemu, Za, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Al Kahbouri, Mj, Alla, F, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis-Guzmán, N, Amankwaa, Aa, Amare, At, Amini, H, Ammar, W, Antonio, Ca, Anwari, P, Arnlöv, J, Arsenijevic, V, Artaman, A, Asad, Mm, Asghar, Rj, Assadi, R, Atkins, L, Badawi, A, Balakrishnan, K, Basu, A, Basu, S, Beardsley, J, Bedi, N, Bekele, T, Bell, Ml, Bernabe, E, Beyene, Tj, Bhutta, Z, Bin Abdulhak, A, Blore, J, Basara, Bb, Bose, D, Breitborde, N, Cárdenas, R, Castañeda-Orjuela, Ca, Castro, Re, Catalá-López, F, Cavlin, A, Chang, Jc, Che, X, Christophi, Ca, Chugh, S, Cirillo, M, Colquhoun, Sm, Cooper, Lt, Cooper, C, da Costa Leite, I, Dandona, L, Dandona, R, Davis, A, Dayama, A, Degenhardt, L, De Leo, D, Del Pozo-Cruz, B, Deribe, K, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Dilmen, U, Ding, El, Dorrington, Re, Driscoll, Tr, Ermakov, Sp, Esteghamati, A, Faraon, Ej, Farzadfar, F, Felicio, Mm, Fereshtehnejad, Sm, de Lima, Gm, Forouzanfar, Mh, França, Eb, Gaffikin, L, Gambashidze, K, Gankpé, Fg, Garcia, Ac, Geleijnse, Jm, Gibney, Kb, Giroud, M, Glaser, El, Goginashvili, K, Gona, P, González-Castell, D, Goto, A, Gouda, Hn, Gugnani, Hc, Gupta, R, Hafezi-Nejad, N, Hamadeh, Rr, Hammami, M, Hankey, Gj, Harb, Hl, Havmoeller, R, Hay, S, Pi, Ib, Hoek, Hw, Hosgood, Hd, Hoy, Dg, Husseini, A, Idrisov, Bt, Innos, K, Inoue, M, Jacobsen, Kh, Jahangir, E, Jee, Sh, Jensen, Pn, Jha, V, Jiang, G, Juel, K, Kabagambe, Ek, Kan, H, Karam, Ne, Karch, A, Karema, Ck, Kaul, A, Kawakami, N, Kazanjan, K, Kazi, D, Kemp, Ag, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khan, Ea, Khang, Yh, Knibbs, L, Kokubo, Y, Kosen, S, Defo, Bk, Kulkarni, C, Kulkarni, V, Kumar, Ga, Kumar, K, Kumar, Rb, Kwan, G, Lai, T, Lalloo, R, Lam, H, Lansingh, Vc, Larsson, A, Lee, Jt, Leigh, J, Leinsalu, M, Leung, R, Li, X, Li, Y, Liang, J, Liang, X, Lim, S, Lin, Hh, Lipshultz, Se, Liu, S, Liu, Y, Lloyd, Bk, London, Sj, Lotufo, Pa, Ma, J, Ma, S, Machado, Vm, Mainoo, Nk, Majdan, M, Mapoma, Cc, Marcenes, W, Marzan, Mb, Mason-Jones, Aj, Mehndiratta, Mm, Mejia-Rodriguez, F, Memish, Za, Mendoza, W, Miller, Tr, Mills, Ej, Mokdad, Ah, Mola, Gl, Monasta, L, de la Cruz Monis, J, Hernandez, Jc, Moore, Ar, Mori, R, Mueller, Uo, Mukaigawara, M, Naheed, A, Naidoo, K, Nand, D, Nangia, V, Nash, D, Nejjari, C, Nelson, Rg, Neupane, Sp, Newton, Cr, Ng, M, Nieuwenhuijsen, Mj, Nisar, Mi, Nolte, S, Norheim, Of, Nyakarahuka, L, Oh, Ih, Ohkubo, T, Olusanya, Bo, Omer, Sb, Opio, Jn, Orisakwe, Oe, Pandian, Jd, Papachristou, C, Park, Jh, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pereira, Dm, Pesudovs, K, Petzold, M, Poenaru, D, Polanczyk, Gv, Polinder, S, Pope, D, Pourmalek, F, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Ur Rahman, S, Raju, M, Rana, Sm, Refaat, A, Ronfani, L, Roy, N, Pimienta, Tg, Sahraian, Ma, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Sayinzoga, F, Schneider, Ij, Schumacher, A, Schwebel, Dc, Seedat, S, Sepanlou, Sg, Servan-Mori, Ee, Shakh-Nazarova, M, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shiue, I, Sigfusdottir, Id, Silberberg, Dh, Silva, Ap, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Sreeramareddy, Ct, Stroumpoulis, K, Sturua, L, Sykes, Bl, Tabb, Km, Talongwa, Rt, Tan, F, Teixeira, Cm, Tenkorang, Ey, Terkawi, A, Thorne-Lyman, Al, Tirschwell, Dl, Towbin, Ja, Tran, Bx, Tsilimbaris, M, Uchendu, U, Ukwaja, Kn, Undurraga, Ea, Uzun, Sb, Vallely, Aj, van Gool, Ch, Vasankari, Tj, Vavilala, M, Venketasubramanian, N, Villalpando, S, Violante, F, Vlassov, Vv, Vos, T, Waller, S, Wang, H, Wang, L, Wang, Sx, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Woldeyohannes, Sm, Wong, Jq, Wordofa, Ma, Xu, G, Yang, Yc, Yano, Y, Yentur, Gk, Yip, P, Yonemoto, N, Yoon, Sj, Younis, Mz, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhao, Y, Zheng, Y, Zhou, M, Zhu, J, Zou, Xn, Lopez, Ad, Naghavi, M, Murray, Cj, Lozano, R, Cell biology, Epidemiology, Public Health, Erasmus MC other, Cardiothoracic Surgery, and Pathology

Subjects
Pediatrics, Time Factors, Nutrition and Disease, hiv-infection, immunodeficiency virus-1 infection, peripartum cardiomyopathy, Poison control, HIV Infections, IMMUNODEFICIENCY VIRUS-1 INFECTION, Socioeconomic Factor, Global Health, 0302 clinical medicine, PERIPARTUM CARDIOMYOPATHY, pregnancy-related mortality, Risk Factors, Pregnancy, Voeding en Ziekte, Cause of Death, Global health, HIV Infection, 030212 general & internal medicine, Pregnancy Complications, Infectious, 10. No inequality, Cause of death, 030219 obstetrics & reproductive medicine, south-africa, Medicine (all), 1. No poverty, WOMEN, PREGNANCY-RELATED MORTALITY, health initiatives, General Medicine, SOUTH-AFRICA, 3. Good health, Maternal Mortality, World Health, CHILD SURVIVAL, Female, Maternal death, women, Human, medicine.medical_specialty, Time Factor, DEATHS, child survival, Article, adult mortality, 03 medical and health sciences, Age Distribution, HEALTH INITIATIVES, SDG 3 - Good Health and Well-being, HIV-INFECTION, ADULT MORTALITY, Injury prevention, medicine, Organizational Objectives, Organizational Objective, Humans, VLAG, Models, Statistical, business.industry, Risk Factor, medicine.disease, deaths, Standardized mortality ratio, Socioeconomic Factors, Relative risk, Pregnancy Complications, Infectiou, business, Demography
Abstract

BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.FUNDING: Bill & Melinda Gates Foundation.

Published
2016

20. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author

Vasiliki Stathopoulou, Kiran Thapa, Vesper Hichilombwe Chisumpa, Azeem Majeed, Hjalte Holm Andersen, Devasahayam J. Christopher, Alireza Mohammadi, John J. McGrath, Konstantin Kazanjan, Naohiro Yonemoto, Guoqing Hu, Yousef Khader, Suzanne Barker-Collo, Frida Namnyak Ngalesoni, Jennifer O Lam, Laetitia Huiart, Xiaofeng Liang, Amanuel Tesfay Gebremedhin, Lalit Dandona, Felix Masiye, Joseph R Fitchett, Derrick A Bennett, Rosana E. Norman, Theo Vos, Tuomo J. Meretoja, Rahman Shiri, Melvin Barrientos Marzan, Charles R. Newton, Kelly Cercy, Masoud Vaezghasemi, Elena Alvarez Martin, Christopher Troeger, Ismael R. Campos-Nonato, Amany H Refaat, Ruben Castro, Amiran Gamkrelidze, Michael R. Phillips, Samath D Dharmaratne, Reed J D Sorensen, Roderick J. Hay, Johan Ärnlöv, Ivo Rakovac, Alexandra Brazinova, Nancy Fullman, Sara Sheikhbahaei, Liliana G Ciobanu, Nader Jahanmehr, Yuming Guo, Luigi Naldi, Rana Jawad Asghar, Tsegaye Tewelde Gebrehiwot, Corine Karema, Biju Abraham, Rynaz H S Rabiee, Emerito Jose A. Faraon, Philimon Gona, Jonathan I. Silverberg, Alexandria Brown, Kovin Naidoo, Suleman Atique, Yun Jin Kim, Benn Sartorius, Hwashin Hyun Shin, George Mugambage Ruhago, Adugnaw Berhane, Tesfaye Tekle, Abdur Rahman Khan, Vipin Gupta, Nima Hafezi-Nejad, Héctor Gómez-Dantés, Jun She, Ted R. Miller, Tolesa Bekele, Yohannes Kinfu, Srinivas Murthy, Alaa Badawi, Mahfuzar Rahman, Raghib Ali, Robert G. Weintraub, Nicholas Steel, Khalid A Altirkawi, Muhammad Imran Nisar, Man Mohan Mehndiratta, Thomas N. Williams, Adrian Davis, Usha Ram, Nobuyuki Horita, Qingyang Xiao, Bishal Gyawali, Burcu Kucuk Bicer, Eun-Kee Park, Subas Neupane, Mohammad Tavakkoli, Lorenzo Monasta, Roman Topor-Madry, Marc-Alain Widdowson, James Leigh, Padukudru Anand Mahesh, Stephen M. Amrock, Stefan Ma, Virendra Singh, Amir Kasaeian, Mahdi Mahdavi, Shahrzad Bazargan-Hejazi, Kim Moesgaard Iburg, Vafa Rahimi-Movaghar, Julio Cesar Campuzano, Maria Dolores Sanchez-Niño, Jean B. Nachega, Hamid Asayesh, Pratik Pinal Doshi, Charles Shey Wiysonge, Peter J. Hotez, Ying Jiang, Girma Temam Shifa, Warren D. Lo, Francis Apolinary Mhimbira, Joan B. Soriano, Ritul Kamal, Young-Ho Khang, Isaac Akinkunmi Adedeji, Daniel C Casey, Adeladza Kofi Amegah, Demewoz Haile, Tomi Akinyemiju, Andrew L. Thorne-Lyman, Achala Upendra Jayatilleke, Rajeev Gupta, Rosario Cárdenas, Peter W. Gething, Ami R. Moore, Marie Ng, Maigeng Zhou, Ferrán Catalá-López, Anders Larsson, Ratilal Lalloo, Panniyammakal Jeemon, Bach Xuan Tran, Chigozie Jesse Uneke, Marina Shakh-Nazarova, Jamie Hancock, Yohannes Adama Melaku, Jasvinder A. Singh, Isabela M. Benseñor, Shafiu Mohammed, Rajiv Chowdhury, Hedyeh Ebrahimi, Yoshihiro Kokubo, Belinda K Lloyd, Samir Bhatt, Geoffrey Buckle, Tissa Wijeratne, Giuseppe Remuzzi, Robert W Aldridge, Luca Ronfani, Raj Kumar Verma, Jagdish Khubchandani, Irma Khonelidze, Ai Koyanagi, Teshome Gebre, Michael Kutz, Om Prakash Singh, Ana Maria Nogales Vasconcelos, Margaret Lind, Svetlana Popova, Hmwe H Kyu, Tom Achoki, Laith J. Abu-Raddad, Zacharie Tsala Dimbuene, Henock Yebyo, Mehdi Yaseri, Max Petzold, Sungho Won, Semaw Ferede Abera, Devina Nand, Rafael Tabarés-Seisdedos, Abdishakur M. Abdulle, Yingfeng Zheng, Soewarta Kosen, Aleksandra Barac, Mahboubeh Parsaeian, Yuichiro Yano, Charles D.A. Wolfe, Simon I. Hay, Luke D. Knibbs, Balem Demtsu Betsu, Solomon Abrha Damtew, Ileana Heredia-Pi, Boris Bikbov, Bemnet Amare Tedla, Daniel Kim, Ulrich O Mueller, Khurshid Alam, Andrew H. Kemp, Austin Carter, Chuanhua Yu, Ibrahim A Khalil, João Mário Pedro, Atsushi Goto, Arsène Kouablan Adou, Scott B. Patten, Nicola Low, Julio Cesar Montañez Hernandez, Heidi J. Larson, Worku Tefera, Sanjay Zodpey, Kalpana Balakrishnan, Hsing-Yi Chang, Jacqueline Castillo Rivas, Donal Bisanzio, Hilda L Harb, Meghan D. Mooney, John N Newton, Vasiliy Victorovich Vlassov, Marcella Montico, Mojde Mirarefin, Vinay Nangia, Edgar P. Simard, Ben Schöttker, Michael Brainin, Ziad A. Memish, Rafael Lozano, Damian G Hoy, Gebre Yitayih Abyu, Alexis J Handal, Saleem M Rana, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Iqbal R. F. Elyazar, Oluremi N Ajala, Christopher J L Murray, Chioma Ezinne Chibueze, Rupert R A Bourne, Euripide Frinel G Arthur Avokpaho, Andreas A Kudom, Hilton Lam, Aman Yesuf Endries, Farshad Pourmalek, Andre Pascal Kengne, Gholamreza Roshandel, Chandrashekhar T Sreeramareddy, Bolajoko O. Olusanya, Tommi Vasankari, Zahid A Butt, Alemseged Aregay Gebru, Samer Hamidi, Soraya Seedat, Xie Rachel Kulikoff, Maziar Moradi-Lakeh, Gelin Xu, Shireen Sindi, Ruoyan Tobe-Gai, Haidong Wang, Johanna M. Geleijnse, Rajesh Kumar Rai, Ryan M Barber, André Karch, Ione Jayce Ceola Schneider, Hebe N. Gouda, Sibhatu Biadgilign, Erika Ota, Kerrie E. Doyle, Olalekan A. Uthman, Jed D. Blore, Walid Ammar, Guohong Jiang, Carlos A Castañeda-Orjuela, Ibrahim Abubakar, Konstantinos Stroumpoulis, Megan Coggeshall, Charles N Mock, Ronan A Lyons, Jose Martinez-Raga, Thomas Fürst, Ambuj Roy, Mustafa Z. Younis, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Lidia Morawska, Noore Alam, Paul S. F. Yip, Grant Nguyen, Randah R. Hamadeh, Victor Aboyans, Miloje Savic, Ketevan Gambashidze, Graeme J. Hankey, David M. Pereira, Cho-il Kim, Peter A. Meaney, Haidong Kan, Sameer Vali Gopalani, Murugesan Raju, Saeid Shahraz, Ibrahim Abdelmageem Mohamed Ginawi, Kenji Shibuya, Raimundas Lunevicius, Sun Ha Jee, Prashant Singh, Atte Meretoja, Suzanne Polinder, Alex Reynolds, Joseph Mikesell, David O. Carpenter, Carla Sofia e Sa Farinha, Miguel Angel Alegretti, Nataliya Foigt, Naris Silpakit, Amare Deribew, Gessessew Bugssa Hailu, Mohammed Magdy Abd El Razek, Reza Assadi, Yichong Li, Georgina A. V. Murphy, Babak Eshrati, Rintaro Mori, Scott Weichenthal, Andre Keren, Van C. Lansingh, Kebede Deribe, Bulat Idrisov, François Alla, Maaya Kita, Ala'a Alkerwi, Maia Kereselidze, Yanping Wang, Rajesh Sharma, Florian Fischer, Foluke Adetola Ojelabi, Maya S Fraser, Kingsley N. Ukwaja, H. Dean Hosgood, Puja Rao, Deena Alasfoor, Muhammad Muhammad Saleh, Bryan L. Sykes, Juan Sanabria, Ronny Westerman, Julian David Pillay, Cassandra Szoeke, Umar Bacha, Edward J Mills, Manisha Dubey, Aliya Naheed, Al Artaman, Jiabin Shen, Michael Burch, Reza Malekzadeh, Hans W. Hoek, David C. Schwebel, Alireza Esteghamati, Seok Jun Yoon, Leilei Duan, Matthew M Coates, Arnav Agarwal, Soumya Swaminathan, Quyen Nguyen, Hye-Youn Park, Peter Nguhiu, Bereket Yakob, Patrick Liu, Elisabeth Barboza França, Tigist Assefa Bayou, Azmeraw T. Amare, Farshad Farzadfar, Tariku Jibat, Jost B. Jonas, Kaja Abbas, Thomas Truelsen, Maryam S. Farvid, Louisa Degenhardt, George A. Mensah, Till Bärnighausen, Ivy Shuie, Jee-Young Jasmine Choi, Amitava Banerjee, Zubair Kabir, Ingrid Wolfe, Patrick Martial Nkamedjie Pete, Preet K Dhillon, Kathryn H. Jacobsen, Sadaf G. Sepanlou, Gagandeep Kang, Aminu K. Bello, Bineyam Taye, Mohsen Naghavi, Chhabi Lal Ranabhat, Walter Mendoza, M. Patrice Lindsay, Sergey K Vladimirov, Tesfaye Setegn, Angel J Paternina Caicedo, Eric L. Ding, Narayanaswamy Venketasubramanian, Stephen S Lim, Barthelemy Kuate Defo, Alan D. Lopez, G Anil Kumar, João C. Fernandes, In-Hwan Oh, Rasmus Havmoeller, Amanuel Alemu Abajobir, Pengpeng Ye, Gabrielle deVeber, Espen Bjertness, Hao Zhang, Ali H. Mokdad, Yogeshwar Kalkonde, Peter Memiah, Rodrigo Sarmiento-Suarez, Konrad Pesudovs, Yong Zhao, Joseph Friedman, Abdullah Sulieman Terkawi, Hadi Danawi, André Faro, Kevin N. Sheth, Abera Kenay Tura, Sajjad Ur Rahman, Sergey Soshnikov, Ajit Kumar Yadav, Michelle L. Bell, Nelson Alvis-Guzman, Miia Kivipelto, Pieter de Jager, Yongmei Li, Giancarlo Logroscino, Sivadasanpillai Harikrishnan, Talha Farid, Zewdie Aderaw Alemu, Alemayehu Amberbir, Niveen M E Abu-Rmeileh, Beatriz Paulina Ayala Quintanilla, Parvaiz A Koul, Edson Serván-Mori, Anil Kaul, Cheng Huang, Kalkidan Hassen Abate, Hsiang Huang, Foad Abd-Allah, Marek Majdan, Sait Mentes Birlik, Jung-Chen Chang, Rahul Gupta, Luciano A. Sposato, Sergey Petrovich Ermakov, Ejaz Ahmad Khan, Yibeltal Tebekaw Bayou, Christian Lycke Ellingsen, Ole Frithjof Norheim, Zulfiqar A Bhutta, Hajo Zeeb, Norberto Perico, Jun Zhu, Bruno F. Sunguya, Parthasarathi Ganguly, Fisaha Haile Tesfay, Min-Jeong Shin, Ashish Awasthi, Felix Akpojene Ogbo, Alan J Thomson, Mostafa Qorbani, Ye Jin, Don C. Des Jarlais, Itamar S. Santos, Juanita A. Haagsma, Anwar Rafay, Jacob Olusegun Olusanya, José Neves, Gregory M Anderson, Amador Goodridge, Bolanle F Banigbe, David Rojas-Rueda, Pedro R. Olivares, Rakhi Dandona, Stefanos Tyrovolas, Peter Njenga Keiyoro, Stein Emil Vollset, Andrea Werdecker, Mohamed Hsairi, Chandrasekharan Nair Kesavachandran, Jeanne Françoise Kayibanda, Alemayehu B. Mekonnen, Addisu Shunu Beyene, Lela Sturua, Inga Dora Sigfusdottir, Amber Sligar, Maysaa El Sayed Zaki, Shiwei Liu, Melkamu Dedefo Gishu, Chantal Huynh, Lope H Barrero, Linhong Wang, Neeraj Bedi, Masood Ali Shaikh, Ricky Leung, Mehdi Javanbakht, Alemayehu Hailu, Kimani M Harun, Ubai Alsharif, Richard C. Franklin, Zoubida Zaidi, Hassan Magdy Abd El Razek, Masako Horino, Karzan Abdulmuhsin Mohammad, Diego Augusto Santos Silva, Marcello Tonelli, Juan Jesus Carrero, Cyrus Cooper, Rajaa Al-Raddadi, Juan Liang, Leslie Cornaby, Awoke Misganaw, Norito Kawakami, Carl Abelardo T. Antonio, Daniel J. Weiss, Abhishek Singh, Vivekanand Jha, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Gizachew Assefa Tessema, Alem Mehari, Wagner Marcenes, Chabila C Mapoma, Ababi Zergaw Giref, Farhad Pishgar, Khassoum Diallo, Nicholas J K Breitborde, Emmanuel A. Ameh, Justin Beardsley, Ademola Lukman Adelekan, Joshua A. Salomon, Mamo Wubshet, Diego De Leo, Daniel Pope, Elisabete Weiderpass, Gregory A. Roth, Niranjan Kissoon, Kaire Innos, João Vasco Santos, Rajesh Sagar, Bradford D. Gessner, Akindele Olupelumi Adebiyi, John J Huang, Dharmesh Kumar Lal, Samantha M. Colquhoun, Eduardo Bernabé, Nadia Akseer, Maheswar Satpathy, Fotis Topouzis, Health Services Management & Organisation (HSMO), Public Health, Psychiatry, Neurology, Wang, Haidong, Bhutta, Zulfiqar A, Coates, Matthew M, Coggeshall, M, Ciobanu, Liliana G, Murray, Christopher JL, Coggeshall, Megan, Dandona, Lalit, Diallo, Khassoum, Franca, Elisabeth Barboza, Fraser, Maya, Fullman, Nancy, Gething, Peter W, Hay, Simon I, Kinfu, Yohanne, Kita, Maaya, Kulikoff, Xie Rachel, Larson, Heidi J, Liang, Juan, Liang, Xiaofeng, Lind, Margaret, Lopez, Alan D, Lozano, Rafael, Mensah, George A, Mikesell, Joseph B, Mokdad, Ali H, Mooney, Meghan D, Nguyen, Grant, Rakovac, Ivo, Salomon, Joshua A, Silpakit, Nari, Sligar, Amber, Sorensen, Reed J D, Vos, Theo, Zhu, Jun, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abera, Semaw Ferede, Aboyans, Victor, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen M E, Abyu, Gebre Yitayih, Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsène Kouablan, Agarwal, Arnav, Ajala, Oluremi N, Akinyemiju, Tomi F, Akseer, Nadia, Alam, Khurshid, Alam, Noore K M, Alasfoor, Deena, Aldridge, Robert William, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Ali, Raghib, Alkerwi, Ala'A, Alla, Françoi, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ameh, Emmanuel A, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Gregory M, Antonio, Carl Abelardo T, Ärnlöv, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Assadi, Reza, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Banigbe, Bolanle F, Barac, Aleksandra, Barber, Ryan M, Barker-Collo, Suzanne L, Bärnighausen, Till, Barrero, Lope H, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Berhane, Adugnaw, Bernabé, Eduardo, Betsu, Balem Demtsu, Bhatt, Samir, Biadgilign, Sibhatu, Bikbov, Bori, Birlik, Sait Mente, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D, Bourne, Rupert R A, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brown, Alexandria, Buckle, Geoffrey Colin, Burch, Michael, Butt, Zahid A, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesu, Carter, Austin, Casey, Daniel C, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Castro, Ruben Estanislao, Catalá-López, Ferrán, Cercy, Kelly, Chang, Hsing-Yi, Chang, Jung-Chen, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesuda, Colquhoun, Samantha M, Cooper, Cyru, Cornaby, Leslie, Damtew, Solomon Abrha, Danawi, Hadi, Dandona, Rakhi, das Neves, José, Davis, Adrian C, de Jager, Pieter, De Leo, Diego, Degenhardt, Louisa, Deribe, Kebede, Deribew, Amare, Jarlais, Don C De, Deveber, Gabrielle A, Dharmaratne, Samath D, Dhillon, Preet K, Ding, Eric L, Doshi, Pratik Pinal, Doyle, Kerrie E, Duan, Leilei, Dubey, Manisha, Ebrahimi, Hedyeh, Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Faraon, Emerito Jose Aquino, Farid, Talha A, Farinha, Carla Sofia e Sa, Faro, André, Farvid, Maryam S, Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C, Fischer, Florian, Fitchett, Joseph R A, Foigt, Nataliya, Franklin, Richard C, Friedman, Joseph, Fürst, Thoma, Gambashidze, Ketevan, Gamkrelidze, Amiran, Ganguly, Parthasarathi, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Geleijnse, Johanna M, Gessner, Bradford D, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Gishu, Melkamu Dedefo, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Gouda, Hebe N, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gyawali, Bishal, Haagsma, Juanita A, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hancock, Jamie, Handal, Alexis J, Hankey, Graeme J, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Harun, Kimani M, Havmoeller, Rasmu, Hay, Roderick J, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hotez, Peter J, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Huang, Cheng, Huang, John J, Huang, Hsiang, Huiart, Laetitia, Iburg, Kim Moesgaard, Idrisov, Bulat T, Innos, Kaire, Jacobsen, Kathryn H, Jahanmehr, Nader, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Kang, Gagandeep, Karch, André, Karema, Corine Kakizi, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Françoise, Kazanjan, Konstantin, Keiyoro, Peter Njenga, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khubchandani, Jagdish, Kim, Cho-il, Kim, Daniel, Kim, Yun Jin, Kissoon, Niranjan, Kivipelto, Miia, Knibbs, Luke D, Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A, Kumar, G Anil, Kyu, Hmwe H, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lam, Jennifer O, Lansingh, Van C, Larsson, Ander, Leigh, Jame, Leung, Ricky, Li, Yichong, Li, Yongmei, Lindsay, M Patrice, Liu, Patrick Y, Liu, Shiwei, Lloyd, Belinda K, Lo, Warren D, Logroscino, Giancarlo, Low, Nicola, Lunevicius, Raimunda, Lyons, Ronan A, Ma, Stefan, Razek, Hassan Magdy Abd El, Razek, Mohammed Magdy Abd El, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C, Marcenes, Wagner, Martinez-Raga, Jose, Marzan, Melvin Barriento, Masiye, Felix, Mcgrath, John J, Meaney, Peter A, Mehari, Alem, Mehndiratta, Man Mohan, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J, Mhimbira, Francis Apolinary, Miller, Ted R, Mills, Edward J, Mirarefin, Mojde, Misganaw, Awoke, Mock, Charles N, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Monasta, Lorenzo, Hernandez, Julio Cesar Montañez, Montico, Marcella, Moore, Ami R, Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich O, Murphy, Georgina A V, Murthy, Sriniva, Nachega, Jean B, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Neupane, Suba, Newton, Charles R, Newton, John N, Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Norheim, Ole F, Norman, Rosana E, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Oren, Eyal, Ota, Erika, Pa, Mahesh, Park, Eun-Kee, Park, Hye-Youn, Parsaeian, Mahboubeh, Caicedo, Angel J Paternina, Patten, Scott B, Pedro, João Mário, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Qorbani, Mostafa, Rabiee, Rynaz H S, Rafay, Anwar, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Raju, Murugesan, Ram, Usha, Rana, Saleem M, Ranabhat, Chhabi Lal, Rao, Puja, Refaat, Amany H, Remuzzi, Giuseppe, Resnikoff, Serge, Reynolds, Alex, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Roy, Ambuj, Ruhago, George Mugambage, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Sanchez-Niño, Maria Dolore, Santos, Itamar S, Santos, João Vasco, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Setegn, Tesfaye, Shahraz, Saeid, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Sheth, Kevin N, Shibuya, Kenji, Shin, Hwashin Hyun, Shin, Min-Jeong, Shiri, Rahman, Shuie, Ivy, Sigfusdottir, Inga Dora, Silva, Diego Augusto Santo, Silverberg, Jonathan, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Singh, Virendra, Soriano, Joan B, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Steel, Nichola, Stroumpoulis, Konstantino, Sturua, Lela, Sunguya, Bruno F, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tavakkoli, Mohammad, Taye, Bineyam, Tedla, Bemnet Amare, Tefera, Worku Mekonnen, Tekle, Tesfaye, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tesfay, Fisaha Haile, Tessema, Gizachew Assefa, Thapa, Kiran, Thomson, Alan J, Thorne-Lyman, Andrew L, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thoma, Dimbuene, Zacharie Tsala, Tura, Abera Kenay, Tyrovolas, Stefano, Ukwaja, Kingsley N, Uneke, Chigozie Jesse, Uthman, Olalekan A, Vaezghasemi, Masoud, Vasankari, Tommi, Vasconcelos, Ana Maria Nogale, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wang, Linhong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Widdowson, Marc-Alain, Wijeratne, Tissa, Williams, Thomas Neil, Wiysonge, Charles Shey, Wolfe, Charles D A, Wolfe, Ingrid, Won, Sungho, Wubshet, Mamo, Xiao, Qingyang, Xu, Gelin, Yadav, Ajit Kumar, Yakob, Bereket, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yebyo, Henock Gebremedhin, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zeeb, Hajo, Zhang, Hao, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zodpey, Sanjay, and Murray, Christopher J L

Subjects
Pediatrics, Nutrition and Disease, Global Health, Communicable Disease, 0302 clinical medicine, Voeding en Ziekte, Infant Mortality, Compensation law of mortality, Global health, Medicine, LIFE EXPECTANCY, 030212 general & internal medicine, DEVELOPING-COUNTRIES, 10. No inequality, Medicine(all), NEWBORN BABIES, Medicine (all), Mortality rate, 1. No poverty, DEATH, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, 11 Medical And Health Sciences, Stillbirth, 3. Good health, Child Mortality, SURVIVAL, CHILD-MORTALITY, HEALTH, Life Sciences & Biomedicine, DEVELOPMENT GOAL 4, Human, INTERVENTIONS, medicine.medical_specialty, RJ, INTEGRATED APPROACH, Developing country, Communicable Diseases, neonatal, 03 medical and health sciences, Medicine, General & Internal, 030225 pediatrics, General & Internal Medicine, Life Science, Humans, Global Burden of Disease Study, VLAG, Estimation, Science & Technology, business.industry, Klinisk medicin, Infant, GBD 2015 Child Mortality Collaborators, Infant mortality, Malaria, Child mortality, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Life expectancy, Clinical Medicine, RG, business, Demography
Abstract

BACKGROUND: Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. METHODS: Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980-2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age-sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS: Globally, 5·8 million (95% uncertainty interval [UI] 5·7-6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7-53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3-43·6) to 2·6 million (2·6-2·7) neonatal deaths and 47·0% (35·1-57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6-3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. INTERPRETATION: Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. FUNDING: Bill & Melinda Gates Foundation. Erratum: Department of Error, The Lancet,Volume 389, Issue 10064, 2017, Page e1. DOI: 10.1016/S0140-6736(16)32608-3

Published
2016

21. Tracking National and Regional Spatial-Temporal Mortality Risk Associated with NO2 Concentrations in Canada: A Bayesian Hierarchical Two-Level Model

Author

Rick Burnett, Dave Stieb, Hwashin Hyun Shin, Glen Takahara, and Barry Jessiman

Subjects
Bayes' theorem, Geography, Mortality data, Physiology (medical), Statistics, Bayesian probability, Credible interval, Bayesian hierarchical modeling, Safety, Risk, Reliability and Quality, Random effects model, Warm season, Air quality index, Demography
Abstract

The association between daily variations in urban air quality and mortality has been well documented using time series statistical methods. This approach assumes a constant association over time. We develop a space-time dynamic model that relaxes this assumption, thus more directly examining the hypothesis that improvements in air quality translate into improvements in public health. We postulate a Bayesian hierarchical two-level model to estimate annual mortality risks at regional and national levels and to track both risk and heterogeneity of risk within and between regions over time. We illustrate our methods using daily nitrogen dioxide concentrations (NO2) and nonaccidental mortality data collected for 1984-2004 in 24 Canadian cities. Estimates of risk and heterogeneity are compared by cause of mortality (cardio-pulmonary [CP] versus non-CP) and season, respectively. Over the entire period, the NO2 risk for CP mortality was slightly lower but with a narrower credible interval than that for non-CP mortality, mainly due to an unusually low risk for a single year (1998). Warm season NO2 risk was higher than cold season risk for both CP and non-CP mortality. For 21 years overall there were no significant differences detected among the four regional NO2 risks. We found overall that there was no strong evidence for time trends in NO2 risk at national or regional levels. However, an increasing linear time trend in the annual between-region heterogeneities was detected, which suggests the differences in risk among the four regions are getting larger, and further studies are necessary to understand the increasing heterogeneity.

Published
2011

22. A Temporal, Multicity Model to Estimate the Effects of Short-Term Exposure to Ambient Air Pollution on Health

Author

Tim Ramsay, Richard T. Burnett, Mark S. Goldberg, Jeffrey R. Brook, Barry Jessiman, David M. Stieb, Hwashin Hyun Shin, and Orly Brion

Subjects
Canada, medicine.medical_specialty, spatial-temporal model, 010504 meteorology & atmospheric sciences, Health Status, Health, Toxicology and Mutagenesis, air pollution, Poisson generalized additive model, Air pollution, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Air pollutants, Environmental protection, Environmental health, 11. Sustainability, medicine, Humans, Air quality index, 0105 earth and related environmental sciences, Air Pollutants, Ambient air pollution, Research, Public health, public health, Public Health, Environmental and Occupational Health, Environmental Exposure, Environmental exposure, Models, Theoretical, simulation, mortality, Term (time), 13. Climate action, Environmental science
Abstract

Background Countries worldwide are expending significant resources to improve air quality partly to improve the health of their citizens. Are these societal expenditures improving public health? Objectives We consider these issues by tracking the risk of death associated with outdoor air pollution over both space and time in Canadian cities. Materials and methods We propose two multi-year estimators that use current plus several previous years of data to estimate current year risk. The estimators are derived from sequential time series analyses using moving time windows. To evaluate the statistical properties of the proposed methods, a simulation study with three scenarios of changing risk was conducted based on 12 Canadian cities from 1981 to 2000. Then an optimal estimator was applied to 24 of Canada’s largest cities over the 17-year period from 1984 to 2000. Results The annual average daily concentrations of ozone appeared to be increasing over the time period, whereas those of nitrogen dioxide were decreasing. However, the proposed method returns different time trends in public health risks. Evidence for some monotonic increasing trends in the annual risks is weak for O3 (p = 0.3870) but somewhat stronger for NO2 (p = 0.1082). In particular, an increasing time trend becomes apparent when excluding year 1998, which reveals lower risk than proximal years, even though concentrations of NO2 were decreasing. The simulation results validate our two proposed methods, producing estimates close to the preassigned values. Conclusions Despite decreasing ambient concentrations, public health risks related to NO2 appear to be increasing. Further investigations are necessary to understand why the concentrations and adverse effects of NO2 show opposite time trends.

Published
2008

23. A Natural Intervention Study: Closure Of The Oakville Oil Refinery

Author

Marc Smith-Doiron, Lisa Marie Kauri, Ling Liu, Robert Dales, Dave Stieb, Branka Jovic, Hwashin Hyun Shin, and Wesley S. Burr

Subjects
Waste management, Oil refinery, Closure (topology), General Earth and Planetary Sciences, Environmental science, Intervention studies, Natural (archaeology), General Environmental Science
Published
2015

25. Meta-Analysis Methods to Estimate the Shape and Uncertainty in the Association Between Long-Term Exposure to Ambient Fine Particulate Matter and Cause-Specific Mortality Over the Global Concentration Range

Author

Hwashin Hyun, Shin, Aaron J, Cohen, C Arden, Pope, Majid, Ezzati, Stephen S, Lim, Bryan J, Hubbell, and Richard T, Burnett

Abstract

Estimates of excess mortality associated with exposure to ambient concentrations of fine particulate matter have been obtained from either a single cohort study or pooling information from a small number of studies. However, standard frequentist methods of pooling are known to underestimate statistical uncertainty in the true risk distribution when the number of studies pooled is small. Alternatively, Bayesian pooling methods using noninformative priors yield unrealistically large amounts of uncertainty in this case. We present a new hybrid frequentist-bayesian framework for meta-analysis that incorporates features of both frequentist and Bayesian approaches, yielding estimated uncertainty distributions that are more useful for burden estimation. We also present an example of mortality risk due to long-term exposure to ambient fine particulate matter obtained from a small number of cohort studies conducted in the United States and Europe. We compare our new risk uncertainty distribution to that obtained by the integrated exposure-response (IER) model used in the Global Burden of Disease 2010 project for which risk was modeled over the entire global concentration range. We suggest a method to incorporate our new risk uncertainty distribution based on the relatively low concentrations observed in the United States and western Europe into the IER model, thus extending risk estimation to the global concentration range.

Published
2015

26. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Soumya Swaminathan, Berrak Bora Basara, Niveen M E Abu-Rmeileh, Shams Eldin Ali Hassan Khalifa, Nadim E. Karam, Jongmin Lee, Roberto Tchio Talongwa, Inga Dora Sigfusdottir, Yang Yang, Stein Emil Vollset, Joseph R. Masci, Daniel Dicker, Maysaa El Sayed Zaki, Shiwei Liu, Valentina Arsić Arsenijević, Ting Wu Chuang, Linhong Wang, Xiao Rong Wang, Bryan K. Phillips, Don C. Des Jarlais, Vasco Manuel Pedro Machado, Vasiliki Stathopoulou, David Phillips, Luke Nyakarahuka, Leslie T. Cooper, Sandra Nolte, Charles R. Newton, Christina Papachristou, Stephen G. Waller, Carlos Magis-Rodriguez, D. Allen Roberts, Elisabete Weiderpass, Aliya Naheed, Andre Keren, Amanda J. Mason-Jones, Karen J. Courville, Ted R. Miller, Kinnari S. Murthy, Bolajoko O. Olusanya, Tommi Vasankari, Kyle J Foreman, Gabriel Alcalá-Cerra, Yousef Khader, Lorenzo Monasta, Austine Olufemi Adeyemo, Rakhi Dandona, Sanjay Basu, Samir Soneji, Rana J. Asghar, Yohannes Adama Melaku, Rafael Alfonso-Cristancho, John Q. Wong, Yoshihiro Kokubo, Young-Ho Khang, Dhruv S. Kazi, Tom Achoki, Homie Razavi, Uche S. Uchendu, Ashish Bhalla, Ferrán Catalá-López, Peggy Pei-Chia Chiang, Kim Moesgaard Iburg, Kaire Innos, Nicholas J K Breitborde, Zacharie Tsala Dimbuene, Elena Alvarez, Vafa Rahimi-Movaghar, Qing Lan, Simon I. Hay, Kaushalendra Kumar, Ubai Alsharif, Scott B. Patten, Gelin Xu, Theo Vos, Kalpana Balakrishnan, Raghib Ali, Marcella Montico, Andrea P. Silva, Robert G. Weintraub, Timothy M. Wolock, Mohammad Ali Sahraian, Heidi J. Larson, Kingsley N. Ukwaja, Saad B. Omer, Scott Weichenthal, D. Alex Quistberg, Justin Beardsley, Chandrashekhar T Sreeramareddy, Jennifer H MacLachlan, Hsien-Ho Lin, H. Dean Hosgood, Karzan Abdulmuhsin Mohammad, Ryan M Barber, Ibrahim Abubakar, Irma Khonelidze, Ileana B. Heredia Pi, Cyrus Cooper, Hilton Lam, Urbano Fra Paleo, Joshua A. Salomon, Ricky Leung, Farshad Pourmalek, Robert G. Nelson, Konstantinos Stroumpoulis, Megan Coggeshall, Mazin J. Al Kahbouri, Richard G. Ellenbogen, Hwashin Hyun Shin, Ida Kankindi, Guohong Jiang, Yanping Wang, Daniel Obadare Fijabi, Carlos A Castañeda-Orjuela, Chakib Nejjari, Diego De Leo, Rashmi Gupta, Gene F. Kwan, Johanna M. Geleijnse, Kenji Shibuya, Hassan Amini, Nsanzimana Sabin, Benjamin C Cowie, Karen M. Tabb, Chanda Kulkarni, Jed D. Blore, Amado D Quezada, Norito Kawakami, Walid Ammar, Van C. Lansingh, François Alla, Seyed-Mohammad Fereshtehnejad, Yichong Li, Vineet K. Chadha, Jasvinder A. Singh, Agnes Binagwaho, Andrew L. Thorne-Lyman, Denis Nash, Palwasha Anwari, Mohammad T Mashal, Kim Yun Jin, Steven E. Lipshultz, Veena S. Kulkarni, Amitava Banerjee, Naohiro Yonemoto, James D. Wilkinson, Aslam Pervaiz, Emilie Agardh, Barthelemy Kuate Defo, Alan D. Lopez, Carl Abelardo T. Antonio, Abraham D. Flaxman, Boris I. Pavlin, Karen Sliwa, Dima M. Qato, G Anil Kumar, Lynne Gaffikin, K.M. Venkat Narayan, Luca Ronfani, Kazem Rahimi, Vivekanand Jha, Gokalp Kadri Yentur, Wagner Marcenes, Giuseppe Remuzzi, Anwar Rafay, Anand Dayama, Robert Quentin Reilly, Alaa Badawi, Selen Begüm Uzun, James Leigh, Vinay Nangia, Ivy Shiue, J Brown, Nobhojit Roy, Genesis May J. Samonte, Edward J Mills, Soewarta Kosen, Atsushi Goto, Sajjad Ur Rahman, Jose C. Adsuar, Semaw Ferede Abera, Jefferson Traebert, Amiran Gamkrelidze, Andrew H. Kemp, Vasiliy Victorovich Vlassov, André Karch, Edgar P. Simard, Aref A. Bin Abdulhak, Samath D Dharmaratne, Ione Jayce Ceola Schneider, Andre Pascal Kengne, Corine Karema, Harish Chander Gugnani, Reza Assadi, Glen Mola, Paulo A. Lotufo, Christopher J L Murray, Rajeev Gupta, Philimon Gona, Mustafa Z. Younis, Herbert C. Duber, Mitchell T. Wallin, Arjun Lakshmana Balaji, Max Petzold, Francesco Saverio Violante, Monika Sawhney, Kovin Naidoo, Mercedes Colomar, Chuanhua Yu, Mitsuru Mukaigawara, Emerito Jose A. Faraon, Jung-Chen Chang, A Artaman, Muhammad Imran Nisar, Dickens Akena, Xiao Nong Zou, Knud Juel, Mohammed I. Albittar, Mohammad Yahya Saeedi, Sergey Petrovich Ermakov, Ole Frithjof Norheim, Graeme J. Hankey, Jerry Puthenpurakal Abraham, Mouhanad Hammami, Zulfiqar A Bhutta, Rintaro Mori, Maia Kereselidze, Josep Maria Haro, Emily Dansereau, Michael Brainin, Elizabeth Glaser, Ziad A. Memish, Anders Larsson, Solomon Meseret Woldeyohannes, Azmeraw T. Amare, Louisa Degenhardt, Yuichiro Yano, Luke D. Knibbs, Sadaf G. Sepanlou, Hilda L Harb, In-Hwan Oh, Katherine B Gibney, Abdullah Sulieman Terkawi, Adansi A. Amankwaa, Nicholas Graetz, Fortuné Gbètoho Gankpé, Vincent Nowaseb, David M. Pereira, Alan J Thomson, Miguel Angel Alegretti, Rupak Shivakoti, Adnan M. Durrani, Dipan Bose, Saleem M Rana, Mohammad Taghi Hedayati, Mohsen Naghavi, Vegard Skirbekk, Walter Mendoza, Ali H. Mokdad, Soraya Seedat, Zewdie Aderaw Alemu, Edson Serván-Mori, Anil Kaul, Foad Abd-Allah, Paul S. F. Yip, Marek Majdan, Peter A. Meaney, Kebede Deribe, Paul N. Jensen, Fabiola Mejía-Rodríguez, Bradford D. Gessner, Ami R. Moore, Marie Ng, Maigeng Zhou, Mohammad H. Forouzanfar, John J Huang, Tim Driscoll, Samia Alhabib, Jun Zhu, Michael H. Criqui, Eduardo Bernabé, Lalit Dandona, Miltiadis K. Tsilimbaris, Borja del Pozo-Cruz, Johan Ärnlöv, Luigi Naldi, Tariku Jibat Beyene, Rasmus Havmoeller, Bongani M. Mayosi, Konrad Pesudovs, Richard A. White, Ejaz Ahmad Khan, Orish Ebere Orisakwe, Graça Maria Ferreira De Lima, Yang Liu, Haidong Wang, Yongmei Li, Bryan L. Sykes, Ronny Westerman, Vinod K. Paul, Angel J Paternina Caicedo, Abigail C. McKay, Eric L. Ding, Narayanaswamy Venketasubramanian, Uur Dilmen, Stephen S Lim, Andrew Vallely, Alireza Esteghamati, Seok Jun Yoon, John Hornberger, Kathryn H. Jacobsen, Yong Zhao, Thomas D. Fleming, Nelson Alvis-Guzman, Damian G Hoy, Hebe N. Gouda, Mall Leinsalu, Elizabeth Johnson, Wilkister N. Moturi, Bach Xuan Tran, Donald H. Silberberg, Yingfeng Zheng, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Ibrahim Abdelmageem Mohamed Ginawi, Bulat Idrisov, Man Mohan Mehndiratta, Thomas N. Williams, Jeffrey A. Towbin, Caterina Guinovart, Jeyaraj D Pandian, Panniyammakal Jeemon, Taavi Lai, Haidong Kan, Tasara T. Mazorodze, Murugesan Raju, Randah R. Hamadeh, Neil Pearce, Melvin Barrientos Marzan, Nima Hafezi-Nejad, John Nelson Opio, Deena Alasfoor, Peter J. Hotez, Jonas Minet Kinge, Peter J. Allen, Eric Y. Tenkorang, Sudan Prasad Neupane, Laith J. Abu-Raddad, Katrina F Ortblad, Arsène Kouablan Adou, Farshad Farzadfar, Sergey Soshnikov, Neeraj Bhala, Sara Sheikhbahaei, Kyle R. Heuton, Michelle L. Bell, Yohannes Kinfu, Takayoshi Ohkubo, Belinda K Lloyd, R. Kumar, Jan Hendrik Richardus, Benjamin O. Anderson, Cell biology, Epidemiology, Public Health, Erasmus MC other, Pathology, Cardiothoracic Surgery, Murray, Christopher J.L, Ortblad, Katrina F., Guinovart, Caterina, Lim, Stephen S., Wolock, Timothy M., Roberts, D. Allen, Dansereau, Emily A., Graetz, Nichola, Barber, Ryan M., Brown, Jonathan C., Wang, Haidong, Duber, Herbert C., Naghavi, Mohsen, Dicker, Daniel, Dandona, Lalit, Salomon, Joshua A., Heuton, Kyle R., Foreman, Kyle, Phillips, David E., Fleming, Thomas D., Flaxman, Abraham D., Phillips, Bryan K., Johnson, Elizabeth K., Coggeshall, Megan S., Abd-Allah, Foad, Abera, Semaw Ferede, Abraham, Jerry P., Abubakar, Ibrahim, Abu-Raddad, Laith J., Abu-Rmeileh, Niveen Me, Achoki, Tom, Adeyemo, Austine Olufemi, Adou, Arsène Kouablan, Adsuar, José C., Agardh, Emilie Elisabet, Akena, Dicken, Al Kahbouri, Mazin J., Alasfoor, Deena, Albittar, Mohammed I., Alcalá-Cerra, Gabriel, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Alla, Francoi, Allen, Peter J., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Amini, Hassan, Ammar, Walid, Anderson, Benjamin O., Antonio, Carl Abelardo T., Anwari, Palwasha, Ärnlöv, Johan, Arsic Arsenijevic, Valentina S., Artaman, Ali, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Basu, Sanjay, Beardsley, Justin, Bekele, Tolesa, Bell, Michelle L., Bernabe, Eduardo, Beyene, Tariku Jibat, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A., Bin Abdulhak, Aref, Binagwaho, Agne, Blore, Jed D., Bora Basara, Berrak, Bose, Dipan, Brainin, Michael, Breitborde, Nichola, Castañeda-Orjuela, Carlos A., Catalá-López, Ferrán, Chadha, Vineet K., Chang, Jung-Chen, Chiang, Peggy Pei-Chia, Chuang, Ting-Wu, Colomar, Mercede, Cooper, Leslie Trumbull, Cooper, Cyru, Courville, Karen J., Cowie, Benjamin C., Criqui, Michael H., Dandona, Rakhi, Dayama, Anand, De Leo, Diego, Degenhardt, Louisa, Del Pozo-Cruz, Borja, Deribe, Kebede, Des Jarlais, Don C., Dessalegn, Muluken, Dharmaratne, Samath D., Dilmen, Uur, Ding, Eric L., Driscoll, Tim R., Durrani, Adnan M., Ellenbogen, Richard G., Ermakov, Sergey Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fijabi, Daniel Obadare, Forouzanfar, Mohammad H., Paleo, Urbano Fra., Gaffikin, Lynne, Gamkrelidze, Amiran, Gankpé, Fortuné Gbètoho, Geleijnse, Johanna M., Gessner, Bradford D., Gibney, Katherine B., Ginawi, Ibrahim Abdelmageem Mohamed, Glaser, Elizabeth L., Gona, Philimon, Goto, Atsushi, Gouda, Hebe N., Gugnani, Harish Chander, Gupta, Rajeev, Gupta, Rahul, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Haro, Josep Maria, Havmoeller, Rasmu, Hay, Simon I., Hedayati, Mohammad T., Heredia Pi, Ileana B., Hoek, Hans W., Hornberger, John C., Hosgood, H. Dean, Hotez, Peter J., Hoy, Damian G., Huang, John J., Iburg, Kim M., Idrisov, Bulat T., Innos, Kaire, Jacobsen, Kathryn H., Jeemon, Panniyammakal, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kan, Haidong, Kankindi, Ida, Karam, Nadim E., Karch, André, Karema, Corine Kakizi, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz Ahmed, Khang, Young-Ho, Khonelidze, Irma, Kinfu, Yohanne, Kinge, Jonas M., Knibbs, Luke, Kokubo, Yoshihiro, Kosen, S., Kuate Defo, Barthelemy, Kulkarni, Veena S., Kulkarni, Chanda, Kumar, Kaushalendra, Kumar, Ravi B., Kumar, G. Anil, Kwan, Gene F., Lai, Taavi, Lakshmana Balaji, Arjun, Lam, Hilton, Lan, Qing, Lansingh, Van C., Larson, Heidi J., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Yichong, Li, Yongmei, De Lima, Graça Maria Ferreira, Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Machado, Vasco Manuel Pedro, Maclachlan, Jennifer H., Magis-Rodriguez, Carlo, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Masci, Joseph R., Mashal, Mohammad Taufiq, Mason-Jones, Amanda J., Mayosi, Bongani M., Mazorodze, Tasara T., Mckay, Abigail Cecilia, Meaney, Peter A., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mohammad, Karzan Abdulmuhsin, Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, Montico, Marcella, Moore, Ami R., Mori, Rintaro, Moturi, Wilkister Nyaora, Mukaigawara, Mitsuru, Murthy, Kinnari S., Naheed, Aliya, Naidoo, Kovin S., Naldi, Luigi, Nangia, Vinay, Narayan, K.M. Venkat, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nowaseb, Vincent, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pervaiz, Aslam, Pesudovs, Konrad, Petzold, Max, Pourmalek, Farshad, Qato, Dima, Quezada, Amado D., Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rana, Saleem M., Razavi, Homie, Reilly, Robert Quentin, Remuzzi, Giuseppe, Richardus, Jan Hendrik, Ronfani, Luca, Roy, Nobhojit, Sabin, Nsanzimana, Saeedi, Mohammad Yahya, Sahraian, Mohammad Ali, Samonte, Genesis May J., Sawhney, Monika, Schneider, Ione J.C., Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Shivakoti, Rupak, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Simard, Edgar P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soneji, Samir, Soshnikov, Sergey S., Sreeramareddy, Chandrashekhar T., Stathopoulou, Vasiliki Kalliopi, Stroumpoulis, Konstantino, Swaminathan, Soumya, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thomson, Alan J., Thorne-Lyman, Andrew L., Towbin, Jeffrey A., Traebert, Jefferson, Tran, Bach X., Tsala Dimbuene, Zacharie, Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Uzun, Selen Begüm, Vallely, Andrew J., Vasankari, Tommi J., Venketasubramanian, N., Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Waller, Stephen, Wallin, Mitchell T., Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, White, Richard A., Wilkinson, James D., Williams, Thomas Neil, Woldeyohannes, Solomon Meseret, Wong, John Q., Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa, Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., and Vos, Theo

Subjects
Gerontology, SEVERE FEBRILE ILLNESS, Male, verbal autopsy, Nutrition and Disease, Cost effectiveness, MILLENNIUM DEVELOPMENT GOALS, HIV Infections, active antiretroviral therapy, Global Health, COST-EFFECTIVENESS, 0302 clinical medicine, Voeding en Ziekte, Global health, HIV Infection, 030212 general & internal medicine, 0303 health sciences, ACTIVE ANTIRETROVIRAL THERAPY, Incidence (epidemiology), Medicine (all), Incidence, General Medicine, Millennium Development Goals, 3. Good health, middle-income countries, projection package, World Health, VERBAL AUTOPSY, Female, Human, Tuberculosis, Tuberculosi, PROJECTION PACKAGE, prospective cohort, Epidemic, millennium development goals, 03 medical and health sciences, Age Distribution, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, MIDDLE-INCOME COUNTRIES, medicine, Organizational Objective, Humans, Organizational Objectives, FEMALE SEX WORKERS, Mortality, Sex Distribution, Epidemics, cost-effectiveness, female sex workers, 030304 developmental biology, VLAG, business.industry, plasmodium-falciparum malaria, PLASMODIUM-FALCIPARUM MALARIA, medicine.disease, Verbal autopsy, Malaria, PROSPECTIVE COHORT, severe febrile illness, business, Demography
Abstract

BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets.FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990.INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action.FUNDING: Bill & Melinda Gates Foundation.

Published
2014

27. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Karen Sliwa, Xiaofeng Liang, Vivekanand Jha, Dorairaj Prabhakaran, Rakhi Dandona, Gonghuan Yang, Xuan Che, Soewarta Kosen, Sergei Petrovich Ermakov, Ted R. Miller, Samath D Dharmaratne, Philimon Gona, Sergey Soshnikov, Atsushi Goto, Costas A. Christophi, Zacharie Tsala Dimbuene, Elena Alvarez, Yanping Wang, Peggy Pei-Chia Chiang, Mohammad H. Forouzanfar, Giancarlo Logroscino, Massimo Cirillo, Knud Juel, Johanna M. Geleijnse, Stefan Ma, Samaya Ismayilova, Karen Fern Greenwell, Michelle L. Bell, Saad B. Omer, Ademola Lukman Adelekan, Joshua A. Salomon, Dhruv S. Kazi, Jed D. Blore, Walid Ammar, Carly E Levitz, Kovin Naidoo, Solveig A. Cunningham, Stephen G. Waller, Anand Dayama, James D. Wilkinson, Vasiliki Stathopoulou, Meghan D. Mooney, Mall Leinsalu, Jonathan R. Carapetis, Paul S. F. Yip, Anders Larsson, Abbas Ali Mahdi, Hideaki Toyoshima, Guohong Jiang, Xia Wan, Chuanhua Yu, Soufiane Boufous, Ivy Shiue, Bulat Idrisov, Qing Lan, Chelsea A. Liddell, Austin E Schumacher, Valeria Caso, Nigel Bruce, Paulo A. Lotufo, Ibrahim Abubakar, Roberto Tchio Talongwa, Luke Nyakarahuka, Edward J Mills, Iuri da Costa Leite, Semaw Ferede Abera, Ana C. Garcia, Ayse Abbasoglu Ozgoren, Matthew M Coates, Konstantinos Stroumpoulis, Bradford D. Gessner, Kebede Deribe, Tommi Vasankari, Logan Sandar, Kenji Shibuya, Karen M. Tabb, Troy Jacobs, Christopher J L Murray, Chakib Nejjari, Katherine T. Lofgren, Melvin Barrientos Marzan, Haidong Wang, Joanna Moschandreas, Raimundas Lunevicius, Nataliya Foigt, Rashmi Gupta, Ziad A. Memish, Victoria Pillay-van Wyk, Randah R. Hamadeh, Azmeraw T. Amare, Lalit Dandona, Uchechukwu K.A. Sampson, Monika Sawhney, Vasiliy Victorovich Vlassov, Farhad Islami, Palwasha Anwari, Mustafa Z. Younis, Amitava Banerjee, Ruben Castro, David O. Carpenter, Karzan Abdulmuhsin Mohammad, Taavi Lai, Yousef Khader, Sara Sheikhbahaei, Atte Meretoja, Zanfina Ademi, Ivo Rakovac, Yang Yang, Hilda L Harb, Daniel Pope, Jun She, Yichong Li, Andrew L. Thorne-Lyman, Adrian Davis, Stein Emil Vollset, Andre Pascal Kengne, Henry Apfel, Mark J. Nieuwenhuijsen, John J. McGrath, Yoshihiro Kokubo, Jonas Minet Kinge, Elisabete Weiderpass, Rajiv Chowdhury, Damian G Hoy, Jürgen C Schmidt, Seyed-Mohammad Fereshtehnejad, Harish Chander Gugnani, Hywel C Williams, Karen Edmond, Peter J. Allen, Marina Shakh-Nazarova, Tom Achoki, Edmond K. Kabagambe, Naohiro Yonemoto, Jun Zhu, Simon I. Hay, Karen J. Courville, Ketevan Goginashvili, Theo Vos, Kim Yun Jin, Kawkab Shishani, Lorenzo Monasta, H. Dean Hosgood, Uʇur Dilmen, Marcella Montico, Shankuan Zhu, Ami R. Moore, Marie Ng, Maigeng Zhou, Hebe N. Gouda, Linh N Bui, Sanjay Basu, Mouhanad Hammami, Mohammad T Mashal, Bryan K. Phillips, Marissa Iannarone, Ronan A Lyons, Young-Ho Khang, Robert G. Weintraub, Luca Ronfani, Daniel Kim, Alanur Çavlin, Ferrán Catalá-López, Ronny Westerman, Maia Kereselidze, Itamar S. Santos, Reza Assadi, Hwashin Hyun Shin, Carolina Maria Teixeira, Berrak Bora Basara, David Rojas-Rueda, Abdullah Sulieman Terkawi, Adansi A. Amankwaa, Nicholas J K Breitborde, Gokalp Kadri Yentur, Kaushalendra Kumar, Daniel Obadare Fijabi, Neeraj Bedi, Robert Quentin Reilly, Ana Maria Nogales Vasconcelos, Scott Weichenthal, Mark A. Green, Selen Begüm Uzun, Mukesh Dherani, Shams Eldin Ali Hassan Khalifa, Majed Asad, Jasvinder A. Singh, Angel J Paternina Caicedo, Eric L. Ding, Jost B. Jonas, Tolesa Bekele, Alan J Thomson, Steven E. Lipshultz, Rosario Cárdenas, Sajjad Ur Rahman, George A. Mensah, Jongmin Lee, Inga Dora Sigfusdottir, Mohammad Yahya Saeedi, Magdalena M. Muszyńska, Ulrich O Mueller, Stephen S Lim, Barthelemy Kuate Defo, Alan D. Lopez, Luciano A. Sposato, G Anil Kumar, Farshad Pourmalek, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shiwei Liu, K.M. Venkat Narayan, William Msemburi, Ting Wu Chuang, Zewdie Aderaw Alemu, Saleem M Rana, Mohammad Taghi Hedayati, Mohsen Naghavi, Vegard Skirbekk, Walter Mendoza, Ali H. Mokdad, Yohannes Kinfu, Jean de Dieu Ngirabega, Takayoshi Ohkubo, Parfait Uwaliraye, Tasara T. Mazorodze, Farshad Farzadfar, Rob E. Dorrington, Mohammad A. AlMazroa, R. Kumar, Lesley Rushton, Wang, H, Liddell, Ca, Coates, Mm, Mooney, Md, Levitz, Ce, Schumacher, Ae, Apfel, H, Iannarone, M, Phillips, B, Lofgren, Kt, Sandar, L, Dorrington, Re, Rakovac, I, Jacobs, Ta, Liang, X, Zhou, M, Zhu, J, Yang, G, Wang, Y, Liu, S, Li, Y, Ozgoren, Aa, Abera, Sf, Abubakar, I, Achoki, T, Adelekan, A, Ademi, Z, Alemu, Za, Allen, Pj, Almazroa, Ma, Alvarez, E, Amankwaa, Aa, Amare, At, Ammar, W, Anwari, P, Cunningham, Sa, Asad, Mm, Assadi, R, Banerjee, A, Basu, S, Bedi, N, Bekele, T, Bell, Ml, Bhutta, Z, Blore, J, Basara, Bb, Boufous, S, Breitborde, N, Bruce, Ng, Bui, Ln, Carapetis, Jr, Cárdenas, R, Carpenter, Do, Caso, V, Castro, Re, Catalá Lopéz, F, Cavlin, A, Che, X, Chiang, Pp, Chowdhury, R, Christophi, Ca, Chuang, Tw, Cirillo, Massimo, da Costa Leite, I, Courville, Kj, Dandona, L, Dandona, R, Davis, A, Dayama, A, Deribe, K, Dharmaratne, Sd, Dherani, Mk, Dilmen, U, Ding, El, Edmond, Km, Ermakov, Sp, Farzadfar, F, Fereshtehnejad, Sm, Fijabi, Do, Foigt, N, Forouzanfar, Mh, Garcia, Ac, Geleijnse, Jm, Gessner, Bd, Goginashvili, K, Gona, P, Goto, A, Gouda, Hn, Green, Ma, Greenwell, Kf, Gugnani, Hc, Gupta, R, Hamadeh, Rr, Hammami, M, Harb, Hl, Hay, S, Hedayati, Mt, Hosgood, Hd, Hoy, Dg, Idrisov, Bt, Islami, F, Ismayilova, S, Jha, V, Jiang, G, Jonas, Jb, Juel, K, Kabagambe, Ek, Kazi, D, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khang, Yh, Kim, D, Kinfu, Y, Kinge, Jm, Kokubo, Y, Kosen, S, Defo, Bk, Kumar, Ga, Kumar, K, Kumar, Rb, Lai, T, Lan, Q, Larsson, A, Lee, Jt, Leinsalu, M, Lim, S, Lipshultz, Se, Logroscino, G, Lotufo, Pa, Lunevicius, R, Lyons, Ra, Ma, S, Mahdi, Aa, Marzan, Mb, Mashal, Mt, Mazorodze, Tt, Mcgrath, Jj, Memish, Za, Mendoza, W, Mensah, Ga, Meretoja, A, Miller, Tr, Mills, Ej, Mohammad, Ka, Mokdad, Ah, Monasta, L, Montico, M, Moore, Ar, Moschandreas, J, Msemburi, Wt, Mueller, Uo, Muszynska, Mm, Naghavi, M, Naidoo, K, Narayan, Kv, Nejjari, C, Ng, M, de Dieu Ngirabega, J, Nieuwenhuijsen, Mj, Nyakarahuka, L, Ohkubo, T, Omer, Sb, Caicedo, Aj, Wyk, Vp, Pope, D, Prabhakaran, D, Rahman, Su, Rana, Sm, Reilly, Rq, Rojas Rueda, D, Ronfani, L, Rushton, L, Saeedi, My, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Schmidt, Jc, Shakh Nazarova, M, She, J, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shishani, K, Shiue, I, Sigfusdottir, Id, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Stathopoulou, Vk, Stroumpoulis, K, Tabb, Km, Talongwa, Rt, Teixeira, Cm, Terkawi, A, Thomson, Aj, Thorne Lyman, Al, Toyoshima, H, Dimbuene, Zt, Uwaliraye, P, Uzun, Sb, Vasankari, Tj, Vasconcelos, Am, Vlassov, Vv, Vollset, Se, Vos, T, Waller, S, Wan, X, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Williams, Hc, Yang, Yc, Yentur, Gk, Yip, P, Yonemoto, N, Younis, M, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhu, S, Lopez, Ad, and Murray, C. J.

Subjects
trends, Pediatrics, medicine.medical_specialty, Nutrition and Disease, democracy, Developing country, coverage, VDP::Medisinske fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, millennium development goals, Global Health, survival, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Voeding en Ziekte, Infant Mortality, Global health, Humans, Organizational Objectives, Medicine, 030212 general & internal medicine, 10. No inequality, VLAG, business.industry, Mortality rate, Infant, Newborn, 1. No poverty, Infant, health, General Medicine, Millennium Development Goals, Infant mortality, maternal education, 3. Good health, Secular variation, Child mortality, Socioeconomic Factors, income countries, Child, Preschool, Child Mortality, developing-countries, VDP::Midical sciences: 700::Health sciences: 800::Epidemiology, medical and dental statistics: 803, International development, business, Demography, child-mortality
Abstract

Summary Background Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. Methods We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. Findings We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990–2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. Interpretation Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. Funding Bill & Melinda Gates Foundation, US Agency for International Development.

Published
2014

28. Correction to Lancet HIV 2016; 3: e361–87

Author

Kerrie E. Doyle, Olalekan A. Uthman, Laxmikant Chavan, Azmeraw T. Amare, Rasmus Havmoeller, Maryam S. Farvid, Louisa Degenhardt, Mohamed Hsairi, Kimani M Harun, Zoubida Zaidi, Hassan Magdy Abd El Razek, Masako Horino, Rajesh Sagar, Bradford D. Gessner, Bongani M. Mayosi, Konrad Pesudovs, Man Mohan Mehndiratta, Sadaf G. Sepanlou, Akindele Olupelumi Adebiyi, Hye Youn Park, Alexandria Brown, Charles Shey Wiysonge, Bach Xuan Tran, Haidong Kan, Ajit Kumar Yadav, Arsène Kouablan Adou, Karzan Abdulmuhsin Mohammad, In-Hwan Oh, Juan Jesus Carrero, Pratik Pinal Doshi, Panniyammakal Jeemon, Teshome Gebre, Abdullah Sulieman Terkawi, Vasiliki Stathopoulou, Hsing-Yi Chang, Bulat Idrisov, Azeem Majeed, Yoshihiro Kokubo, Zahid A Butt, Yuichiro Yano, Nataliya Foigt, Naris Silpakit, Rajesh Kumar Rai, Rajaa Mohammad, Alireza Esteghamati, Seok Jun Yoon, Kathryn H. Jacobsen, Carl Abelardo T. Antonio, Sibhatu Biadgilign, Ruoyan Tobe-Gai, Balem Demtsu Betsu, Haidong Wang, Samir Soneji, Devasahayam J. Christopher, Ileana Heredia-Pi, Boris Bikbov, John Q. Wong, Yun Jin Kim, Giancarlo Logroscino, Raimundas Lunevicius, Eesh Bhatia, Kazem Rahimi, Sajjad Ur Rahman, Henock Yebyo, Mehdi Yaseri, Rodrigo Sarmiento-Suarez, Yong Zhao, Joseph Friedman, André Faro, Nelson Alvis-Guzman, Yongmei Li, Bemnet Amare Tedla, Wanqing Chen, Shafiu Mohammed, Vivekanand Jha, Achala Upendra Jayatilleke, Guoqing Hu, Yousef Khader, Rafael Alfonso-Cristancho, Girma Temam Shifa, Suzanne Polinder, Bryan L. Sykes, Kaja Abbas, Nadia Akseer, Rakhi Dandona, Aleksandra Barac, Simon I. Hay, Scott B. Patten, Jiabin Shen, Donal Bisanzio, Hilda L Harb, Gizachew Assefa Tessema, Wagner Marcenes, Chabila C Mapoma, Miia Kivipelto, Hsiang Huang, Jung-Chen Chang, P. V. Rao, Amanda J. Mason-Jones, Bolajoko O. Olusanya, Hilton Lam, Amare Deribew, Saleem M Rana, Mohammad Taghi Hedayati, Khurshid Alam, Reza Malekzadeh, Mohamed Magdy Abd El Razek, Mojde Mirarefin, Juan Sanabria, Umar Bacha, Rashmi Gupta, Laith J. Abu-Raddad, Amanuel Tesfay Gebremedhin, Felix Masiye, Maurice Giroud, Palwasha Anwari, Sergey Petrovich Ermakov, Ole Frithjof Norheim, Zulfiqar A Bhutta, Rosario Cárdenas, John J Huang, Alaa Badawi, Edward J Mills, Guohong Jiang, Matthew M Coates, Martin McKee, Jacqueline Castillo Rivas, Norito Kawakami, Chandrashekhar T Sreeramareddy, Mohammad Tavakkoli, Pieter de Jager, Hajo Zeeb, Tim Driscoll, James Leigh, Mohammad Yahya Saeedi, Gelin Xu, Rana J. Asghar, Koranteng Adofo, Sivadasanpillai Harikrishnan, Zewdie Aderaw Alemu, Roberto Tchio Talongwa, Jeanne Françoise Kayibanda, Tuomo J. Meretoja, Alemseged Aregay Gebru, Yuantao Hao, Bereket Yakob, Melvin Barrientos Marzan, Jose Martinez-Raga, Rosana E. Norman, Gebre Yitayih Abyu, Anders Larsson, Dayane Gabriele Alves Silveira, Sasa Rajsic, Elena Alvarez, Nikolaos Tsilimparis, Kenji Shibuya, Alexandra Brazinova, Nader Jahanmehr, Solomon Abreha Damtew, Ambuj Roy, Elisabete Weiderpass, Derrick A Bennett, Holly Hagan, Julio Cesar Campuzano, Shifalika Goenka, Gudlavalleti V S Murthy, Mirriam Chibalabala, Mostafa Qorbani, Peter Njenga Keiyoro, Stein Emil Vollset, Andrea Werdecker, Sanjay Zodpey, Alemayehu B. Mekonnen, Addisu Shunu Beyene, Stephen M. Amrock, Soewarta Kosen, Haseeb Nawaz, Tukur Dahiru, Gessessew Bugssa Hailu, Atsushi Goto, Abdur Rahman Khan, Vipin Gupta, Nima Hafezi-Nejad, Parvaiz A Koul, John Nelson Opio, Jun She, Michael Brainin, Luke Nyakarahuka, Edson Serván-Mori, Dimitris Karletsos, Chandrasekharan Nair Kesavachandran, Van C. Lansingh, Ala'a Alkerwi, Elizabeth Glaser, Ziad A. Memish, Sinead Langan, Usha Ram, Alicia Aleman, Brighton Murimira, Jae-Hyun Park, Foluke Adetola Ojelabi, Anil Kaul, Foad Abd-Allah, Aman Yesuf Endries, Erika Ota, Mark Drew Crosland Guimarães, Rajesh Sharma, Mahdi Mahdavi, Andre Pascal Kengne, Joan B. Soriano, Soumya Swaminathan, Ritul Kamal, Quyen Nguyen, Felix Akpojene Ogbo, Alan J Thomson, Don C. Des Jarlais, Sara Sheikhbahaei, Al Artaman, Chigozie Jesse Uneke, Tsegaye Tewelde Ghiwot, Maya S Fraser, Veena S. Kulkarni, Corine Karema, Samer Hamidi, Randah R. Hamadeh, Marek Majdan, Sait Mentes Birlik, Mihajlo Jakovljevic, Kingsley N. Ukwaja, Jeffrey A. Towbin, Tariku Jibat, Julian David Pillay, Suleman Atique, Raghib Ali, Shicheng Yu, Carlos A. Castañeda-Orjuela, Nobuyuki Horita, Graeme J. Hankey, Prashant Singh, Mouhanad Hammami, Nicholas Steel, Yohannes Kinfu, Hao Zhang, Niveen M E Abu-Rmeileh, François Alla, Johanna M. Geleijnse, Nancy Fullman, Rintaro Mori, Ying Jiang, Semaw Ferede Abera, Atte Meretoja, Katherine Pearson, Robert G. Weintraub, Zubair Kabir, Juanita A. Haagsma, Muhammad Imran Nisar, Benn Sartorius, Lalit Dandona, Amir Kasaeian, Andrew H. Kemp, Melkamu Dedefo Gishu, Ferrán Catalá-López, Deena Alasfoor, Isaac Akinkunmi Adedeji, Hwashin Hyun Shin, Peter Memiah, Muhammad Muhammad Saleh, Mahfuzar Rahman, Yohannes Adama Melaku, Barthelemy Kuate Defo, Alan D. Lopez, Meghan D. Mooney, Inga Dora Sigfusdottir, Walid Ammar, Vegard Skirbekk, David M. Prokop, Edgar P. Simard, Jagdish Khubchandani, Fortuné Gbètoho Gankpé, Arindam Basu, Roman Topor-Madry, Walter Mendoza, Amador Goodridge, G Anil Kumar, Jean de Dieu Ngirabega, Amanuel Alemu Abajobir, João C. Fernandes, Michael Burch, Gholamreza Roshandel, Leo Zoeckler, Ai Koyanagi, Emmanuel Peprah, Maysaa El Sayed Zaki, Shiwei Liu, Shireen Sindi, Adam Trickey, Ali H. Mokdad, William Msemburi, James D. Wilkinson, Rafael Tabarés-Seisdedos, Sungho Won, Abdishakur M. Abdulle, Ted R. Miller, Oluremi N Ajala, Karen Sliwa, Linhong Wang, Awoke Misganaw Temesgen, Jasvinder A. Singh, Kaire Innos, Fisaha Haile Tesfay, Steven E. Lipshultz, Belinda Lloyd, Burcu Kucuk Bicer, Vasiliy Victorovich Vlassov, Maziar Moradi-Lakeh, Abera Kenay Tura, Adeladza Kofi Amegah, Peggy Pei-Chia Chiang, Charles D.A. Wolfe, Ulrich O Mueller, Francis Apolinary Mhimbira, Nicholas J K Breitborde, Monika Sawhney, Eyal Oren, Kim Moesgaard Iburg, Vafa Rahimi-Movaghar, Tomi Akinyemiju, Tissa Wijeratne, Giuseppe Remuzzi, Alemayehu Amberbir, Itamar S. Santos, Ibrahim A Khalil, Aliya Naheed, Anwar Rafay, Beatriz Paulina Ayala Quintanilla, Saleh F. Aldhahri, Jacob Olusegun Olusanya, André Karch, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Ronny Westerman, Vinod K. Paul, Dietrich Plass, David Rojas-Rueda, Reza Assadi, Tigist Assefa Bayou, Vinay Nangia, Ayalnesh Zemene Yalew, Eric L. Ding, Justin Beardsley, Veena R. Iyer, Stephen S Lim, Bineyam Taye, Till Bärnighausen, Ademola Lukman Adelekan, Joshua A. Salomon, Chakib Nejjari, Josep Maria Haro, Diego De Leo, Faris Lami, Sameer Vali Gopalani, Om P. Singh, Farshad Farzadfar, Kalkidan Hassen Abate, Ejaz Ahmad Khan, Yibeltal Tebekaw Bayou, Norberto Perico, Bruno F. Sunguya, Narayanaswamy Venketasubramanian, Ashish Awasthi, Lorenzo Monasta, David O Soti, Hamid Asayesh, Young-Ho Khang, Thomas Fürst, Hmwe H Kyu, Heidi J. Larson, Amber Sligar, Mahesh Anand Padukudru, Ricky Leung, Reed J D Sorensen, Farshad Pourmalek, Liliana G Ciobanu, Luigi Naldi, Kiran Thapa, Vesper Hichilombwe Chisumpa, Yousef M. Elshrek, Naohiro Yonemoto, Frida Namnyak Ngalesoni, Jennifer O Lam, Neeraj Bedi, Masood Ali Shaikh, Iqbal R. F. Elyazar, Soraya Seedat, Mehdi Javanbakht, Paul S. F. Yip, Grant Nguyen, Peter A. Meaney, Joseph Mikesell, Kebede Deribe, Johan Ärnlöv, Emmanuela Gakidou, Robert W Aldridge, Joseph Robert Ander Fitchett, José das Neves, Ubai Alsharif, Diego Augusto Santos Silva, Cyrus Cooper, H. Dean Hosgood, Seyed-Mohammad Fereshtehnejad, Liesl Zühlke, Dharmesh Kumar Lal, Tim M. Wolock, David M. Pereira, Carla Sofia e Sa Farinha, Miguel Angel Alegretti, Babak Eshrati, Paulo A. Lotufo, Salem Al-Raddadi, Christopher J L Murray, Austin Carter, Rajeev Gupta, Jee-Young Jasmine Choi, Mustafa Z. Younis, Michael R. Phillips, Snehal Patil, Samath D Dharmaratne, Robert P. Dellavalle, George Mugambage Ruhago, Tesfaye Tekle, Shahrzad Bazargan-Hejazi, Peter W. Gething, Isabela M. Benseñor, Zacharie Tsala Dimbuene, Max Petzold, Chuanhua Yu, Ziyad Al-Aly, Ibrahim Abubakar, Noore Alam, Aletta E. Schutte, Andrew L. Thorne-Lyman, Denis Nash, Luca Ronfani, Manisha Dubey, Lydia S. Atkins, Hans W. Hoek, David C. Schwebel, Jost B. Jonas, Carla Makhlouf, Sergey K Vladimirov, Damian G Hoy, Euripide Frinel G Arthur Avokpaho, Florian Fischer, and Imad D A Faghmous

Subjects
Burden of disease, medicine.medical_specialty, Operations research, Epidemiology, business.industry, Incidence (epidemiology), Immunology, Human immunodeficiency virus (HIV), medicine.disease, medicine.disease_cause, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Virology, Family medicine, Medicine, business
Abstract

© 2016 Elsevier Ltd GBD 2015 HIV Collaborators. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. Lancet HIV 2016; 3: e361–87—In this Article, Kerrie E Doyle and David M Pereira have been added to the list of collaborators and Claudia C Pereira has been removed. These corrections have been made as of Aug 22, 2016.

Published
2016

29. Tracking national and regional spatial-temporal mortality risk associated with NO2 concentrations in Canada: a Bayesian hierarchical two-level model

Author

Hwashin Hyun, Shin, Dave, Stieb, Rick, Burnett, Glen, Takahara, and Barry, Jessiman

Subjects
Risk, Air Pollutants, Canada, Models, Statistical, Air Pollution, Nitrogen Dioxide, Humans, Bayes Theorem, Seasons, Mortality, Environmental Health, Risk Assessment
Abstract

The association between daily variations in urban air quality and mortality has been well documented using time series statistical methods. This approach assumes a constant association over time. We develop a space-time dynamic model that relaxes this assumption, thus more directly examining the hypothesis that improvements in air quality translate into improvements in public health. We postulate a Bayesian hierarchical two-level model to estimate annual mortality risks at regional and national levels and to track both risk and heterogeneity of risk within and between regions over time. We illustrate our methods using daily nitrogen dioxide concentrations (NO2) and nonaccidental mortality data collected for 1984-2004 in 24 Canadian cities. Estimates of risk and heterogeneity are compared by cause of mortality (cardio-pulmonary [CP] versus non-CP) and season, respectively. Over the entire period, the NO2 risk for CP mortality was slightly lower but with a narrower credible interval than that for non-CP mortality, mainly due to an unusually low risk for a single year (1998). Warm season NO2 risk was higher than cold season risk for both CP and non-CP mortality. For 21 years overall there were no significant differences detected among the four regional NO2 risks. We found overall that there was no strong evidence for time trends in NO2 risk at national or regional levels. However, an increasing linear time trend in the annual between-region heterogeneities was detected, which suggests the differences in risk among the four regions are getting larger, and further studies are necessary to understand the increasing heterogeneity.

Published
2011

30. A new multipollutant, no-threshold air quality health index based on short-term associations observed in daily time-series analyses

Author

Richard T. Burnett, Hwashin Hyun Shin, Vanita Economou, Orly Brion, Marc Smith-Doiron, and David M. Stieb

Subjects
medicine.medical_specialty, Canada, Time Factors, Air pollution, Management, Monitoring, Policy and Law, Urban area, medicine.disease_cause, Health index, Air Pollution, medicine, Humans, Waste Management and Disposal, Air quality index, Pollutant, geography, Series (stratigraphy), Air Pollutants, geography.geographical_feature_category, business.industry, Public health, Environmental resource management, Environmental engineering, Term (time), Data Interpretation, Statistical, Environmental science, business, Environmental Health, Algorithms
Abstract

Air quality indices currently in use have been criticized because they do not capture additive effects of multiple pollutants, or reflect the apparent no-threshold concentration-response relationship between air pollution and health. We propose a new air quality health index (AQHI), constructed as the sum of excess mortality risk associated with individual pollutants from a time-series analysis of air pollution and mortality in Canadian cities, adjusted to a 0-10 scale, and calculated hourly on the basis of trailing 3-hr average pollutant concentrations. Extensive sensitivity analyses were conducted using alternative combinations of pollutants from single and multipollutant models. All formulations considered produced frequency distributions of the daily maximum AQHI that were right-skewed, with modal values of 3 or 4, and less than 10% of values at 7 or above on the 10-point scale. In the absence of a gold standard and given the uncertainty in how to best reflect the mix of pollutants, we recommend a formulation based on associations of nitrogen dioxide, ozone, and particulate matter of median aerodynamic diameter less than 2.5 microm with mortality from single-pollutant models. Further sensitivity analyses revealed good agreement of this formulation with others based on alternative sources of coefficients drawn from published studies of mortality and morbidity. These analyses provide evidence that the AQHI represents a valid approach to formulating an index with the objective of allowing people to judge the relative probability of experiencing adverse health effects from day to day. Together with health messages and a graphic display, the AQHI scale appears promising as an air quality risk communication tool.

Published
2008

31. Meta-Analysis Methods to Estimate the Shape and Uncertainty in the Association Between Long-Term Exposure to Ambient Fine Particulate Matter and Cause-Specific Mortality Over the Global Concentration Range.

Author

Hwashin Hyun Shin, Cohen, Aaron J., Pope III, C. Arden, Ezzati, Majid, Lim, Stephen S., Hubbell, Bryan J., and Burnett, Richard T.

Abstract

Estimates of excess mortality associated with exposure to ambient concentrations of fine particulate matter have been obtained from either a single cohort study or pooling information from a small number of studies. However, standard frequentist methods of pooling are known to underestimate statistical uncertainty in the true risk distribution when the number of studies pooled is small. Alternatively, Bayesian pooling methods using noninformative priors yield unrealistically large amounts of uncertainty in this case. We present a new hybrid frequentist-bayesian framework for meta-analysis that incorporates features of both frequentist and Bayesian approaches, yielding estimated uncertainty distributions that are more useful for burden estimation. We also present an example of mortality risk due to long-term exposure to ambient fine particulate matter obtained from a small number of cohort studies conducted in the United States and Europe. We compare our new risk uncertainty distribution to that obtained by the integrated exposure-response (IER) model used in the Global Burden of Disease 2010 project for which risk was modeled over the entire global concentration range. We suggest a method to incorporate our new risk uncertainty distribution based on the relatively low concentrations observed in the United States and western Europe into the IER model, thus extending risk estimation to the global concentration range. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
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32. E-034

Author

Barry Jessiman, Rick Burnett, Hwashin Hyun Shin, Marc Smith-Doiron, Dave Stieb, Orly Brion, and Glen Takahara

Subjects
chemistry.chemical_compound, Ozone, chemistry, Epidemiology, business.industry, Medicine, business, Atmospheric sciences, Warm season
Published
2012

33. CLOSING THE GREEN GAP: THE IMPACT OF ENVIRONMENTAL COMMITMENT AND ADVERTISING BELIEVABILITY.

Author

YEONSHIN KIM, SANGDO OH, SUKKI YOON, and HWASHIN HYUN SHIN

Subjects
*GREEN product advertising, *BRAND name products, *PRODUCT advertising, *GREEN marketing, *BRANDING (Marketing), *BRAND integration
Abstract

We investigated how consumer and message characteristics affect the consistency between message acceptance and purchase intention for green products (viz., green gap). Participants were 231 adults who were approached in various public places in South Korea (e.g., shopping malls). We used 2 mock advertisements with fictitious brand names. Our data showed that participants who were committed to environmentally friendly behaviors, as measured by their past proenvironmental behaviors, displayed a tighter relationship between accepting green advertising messages and intending to purchase green products. Furthermore, the acceptance-intention relationship was even stronger among participants who were strongly committed to environmentally friendly behaviors and who also found the advertising message believable. Our research findings add to the literature on the attitude-behavior relationship by demonstrating that both dispositional and message factors strengthen thought-action connections. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
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34. A New Multipollutant, No-Threshold Air Quality Health Index Based on Short-Term Associations Observed in Daily Time-Series Analyses.

Author

Stieb, David M., Burnett, Richard T., Smith-Doiron, Marc, Brion, Orly, Hwashin Hyun Shin, and Economou, Vanita

Subjects
*POLLUTANTS, *AIR quality, *HEALTH status indicators, *TIME series analysis, *AIR pollution, *NITROGEN dioxide & the environment, *OZONE, *PARTICULATE matter, *AERODYNAMICS
Abstract

Air quality indices currently in use have been criticized because they do not capture additive effects of multiple pollutants, or reflect the apparent no-threshold concentration-response relationship between air pollution and health. We propose a new air quality health index (AQHI), constructed as the sum of excess mortality risk associated with individual pollutants from a time-series analysis of air pollution and mortality in Canadian cities, adjusted to a 0-10 scale, and calculated hourly on the basis of trailing 3-hr average pollutant concentrations. Extensive sensitivity analyses were conducted using alternative combinations of pollutants from single and multipollutant models. All formulations considered produced frequency distributions of the daily maximum AQHI that were right-skewed, with modal values of 3 or 4, and less than 10% of values at 7 or above on the 10-point scale. In the absence of a gold standard and given the uncertainty in how to best reflect the mix of pollutants, we recommend a formulation based on associations of nitrogen dioxide, ozone, and particulate matter of median aerodynamic diameter less than 2.5 μm with mortality from single-pollutant models. Further sensitivity analyses revealed good agreement of this formulation with others based on alternative sources of coefficients drawn from published studies of mortality and morbidity. These analyses provide evidence that the AQHI represents a valid approach to formulating an index with the objective of allowing people to judge the relative probability of experiencing adverse health effects from day to day. Together with health messages and a graphic display, the AQHI scale appears promising as an air quality risk communication tool. [ABSTRACT FROM AUTHOR]

Published
2008
Full Text
View/download PDF

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