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Effect modification by maximum temperature of the association between PM2.5 and short-term cardiorespiratory mortality and emergency room visits in Lima, Peru, 2010–2016

Abstract

Background

The health effects of fine particulate matter (PM2.5) may be worse at higher temperatures.

Objective

To investigate temperature’s effect on PM2.5-mortality/morbidity associations in Lima, Peru.

Methods

Time-series regressions relating PM2.5 and temperature to mortality and emergency room (ER) visits during 2010–2016. Daily PM2.5 levels (assigned to 40 Lima districts) and daily maximum temperature (Lima-wide) were estimated based on ground monitors, remote sensing, and modeling. We analyzed all-cause, cardiovascular (ICD codes I00-I99), and respiratory (ICD codes J00-J99) mortality, and cardiovascular and respiratory causes for ER visits.

Results

The average PM2.5 concentration was 20.9 µg/m3 (IQR 17.5–23.5). The mean daily maximum temperature was 23.8 °C (IQR 20.8–26.9). PM2.5’s effect on all-cause, respiratory, and circulatory disease mortality was significantly (p < 0.05) stronger at temperatures above the maximum temperature median. The rate ratios per increase of 10 µg/m3 of PM2.5 for all cause, respiratory, and circulatory mortality respectively were 1.03 (1.00–1.06), 1.04 (0.98–1.10), and 1.04 (0.98–1.10) at temperatures below the median, vs. 1.08 (1.04–1.12), 1.11 (1.03–1.19), and 1.14 (1.05–1.25) when temperatures were above the median. Results were analogous for ER visits for respiratory but not circulatory disease.

Significance

Results strengthen the evidence that air pollution may be more dangerous when temperatures are higher.

Impact

Our data contribute to a growing body of literature which indicates that the damaging effects of PM2.5 may be worse at higher temperature, adding new evidence from Lima, Peru.

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Fig. 1: Lima districts and the hospitals in the study.
Fig. 2: Rate ratios for 10 μg/m3 increase in PM2.5 exposure for mortality and morbidity.
Fig. 3: Spline curve for the association of PM2.5 with respiratory (ER) visits, Lima 2010-2016.
Fig. 4: Spline curve for the association of PM2.5 with circulatory hospital (ER) visits, Lima 2010-2016.

References

  1. 1.

    Chen F, Fan Z, Qiao Z, Cui Y, Zhang M, Zhao X, et al. Does temperature modify the effect of PM10 on mortality? A systematic review and meta-analysis. Environ Pollut. 2017;224:326–35.

    Article  CAS  Google Scholar 

  2. 2.

    Karagulian F, Belis CA, Dora CFC, Prüss-Ustün AM, Bonjour S, Adair-Rohani H, et al. Contributions to cities’ ambient particulate matter (PM): a systematic review of local source contributions at global level. Atmos Environ. 2015;120:475–83.

    Article  CAS  Google Scholar 

  3. 3.

    Gouveia N, Kephart JL, Dronova I, McClure L, Granados JT, Betancourt RM, et al. Ambient fine particulate matter in Latin American cities: Levels, population exposure, and associated urban factors. Sci Tot Env. 2021;772:145035.

    Article  CAS  Google Scholar 

  4. 4.

    Chen K, Wolf K, Breitner S, Gasparrini A, Stafoggia M, Samoli E, et al. Two-way effect modifications of air pollution and air temperature on total natural and cardiovascular mortality in eight European urban areas. Environ Int. 2018;116:186–96.

    Article  CAS  Google Scholar 

  5. 5.

    Liu C, Chen R, Sera F, Vicedo-Cabrera AM, Guo Y, Tong S, et al. Ambient Particulate Air Pollution and Daily Mortality in 652 Cities. N. Engl J Med. 2019;381:705–15.

    Article  CAS  Google Scholar 

  6. 6.

    Anenberg SC, Haines S, Wang E, Nassikas N, Kinney PL. Synergistic health effects of air pollution, temperature, and pollen exposure: a systematic review of epidemiological evidence. Environ Health. 2020;19:130.

    Article  Google Scholar 

  7. 7.

    Tapia V, Steenland K, Vu B, Liu Y, Vásquez V, Gonzales G. PM2.5 exposure on daily cardio-respiratory mortality in Lima, Peru, from 2010 to 2016. Environ Health. 2020a;19:63.

    Article  CAS  Google Scholar 

  8. 8.

    Tapia V, Steenland K, Sarnat SE, Vu B, Liu Y, Sánchez-Ccoyllo O, et al. Time-series analysis of ambient PM(2.5) and cardiorespiratory emergency room visits in Lima, Peru during 2010-2016. J Expo Sci Environ Epidemiol. 2020b;30:680–8.

    Article  CAS  Google Scholar 

  9. 9.

    Vu B, Sánchez O, Bi J, Qingyang Xiao Q, Hansel N, Checkley W, et al. Developing advanced PM2.5 exposure models in Lima, Peru. Remote Sens. 2019;11:641.

    Article  Google Scholar 

  10. 10.

    Sarnat SE, Sarnat JA, Mulholland J, Isakov V, Özkaynak H, Chang HH, et al. Application of alternative spatiotemporal metrics of ambient air pollution exposure in a time-series epidemiological study in Atlanta. J Expo Sci Environ Epidemiol. 2013;23:593–605.

    Article  Google Scholar 

  11. 11.

    Harrell FE Jr, Lee KL, Pollock BG. Regression models in clinical studies: determining relationships between predictors and response. J Natl Cancer Inst. 1988;80:1198–202.

    Article  Google Scholar 

  12. 12.

    Yitshak-Sade M, Bobb J, Schwartz J, Kloog I, Zanobetti A. The association between short and long-term exposure to PM2.5 and temperature and hospital admissions in New England and the synergistic effect of the short-term exposure. Sci Tot Env. 2018;639:868–75.

    Article  CAS  Google Scholar 

  13. 13.

    Hsu W, Hwang S, Kinney P, Lin S. Seasonal and temperature modifications of the association between fine particulate air pollution and cardiovascular hospitalization in New York state. Sci Tot Env. 2017;578:626–32.

    Article  CAS  Google Scholar 

  14. 14.

    Lokotola CL, Wright CY, Wichmann J. Temperature as a modifier of the effects of air pollution on cardiovascular disease hospital admissions in Cape Town, South Africa. Environ Sci Pollut. 2020;27:16677–85.

    Article  CAS  Google Scholar 

  15. 15.

    Bergmann S, Li B, Pilot E, Chen R, Want B, Yang J. Effect modification of the short-term effects of air pollution on morbidity by season: a systematic review and meta-analysis. Sci Tot Env. 2020;716:136985.

    Article  CAS  Google Scholar 

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Acknowledgements

Vilma Tapia and Vanessa Vasquez kindly provided the hospital data on emergency room visits, and the mortality data, as part of our collaborative work on the GeoHealth Hub in Peru. Temperature data came from public information available from SENAMHI (National Meteorology and Hydrology Service of Peru), a Peruvian government agency, while hospital data came from MINSA (Ministry of Health), and we thank both these agencies for their help.

Funding

The present study was founded by the National Institutes of Health (Fogarty Program) [Grant U01TW010107, 1/2 Regional GEOHealth Hub centered in Peru]. NS is supported by the NIEHS-funded HERCULES Center (P30ES019776).

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KS, BV and NS contributed to the writing of the paper. KS conducted the analyses. BV helped with data management.

Corresponding author

Correspondence to Kyle Steenland.

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The authors declare no competing interests.

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Steenland, K., Vu, B. & Scovronick, N. Effect modification by maximum temperature of the association between PM2.5 and short-term cardiorespiratory mortality and emergency room visits in Lima, Peru, 2010–2016. J Expo Sci Environ Epidemiol (2021). https://doi.org/10.1038/s41370-021-00393-7

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Keywords

  • Temperature
  • PM2.5
  • Effect modification
  • Mortality
  • Emergency room visits

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