Daily exposure to PM_2.5and 1.5 million deaths: A time-stratified case-crossover analysis in the Mexico City Metropolitan Area

Abstract

Background. Satellite-based PM2.5predictions are being used to advance exposure science and air-pollution epidemiology in developed countries; including emerging evidence about the impacts of PM2.5on acute health outcomes beyond the cardiovascular and respiratory systems, and the potential modifying effects from individual-level factors in these associations. Research on these topics is lacking in Latin America. Methods. We used a time-stratified case-crossover study design with 1,479,950 non-accidental deaths from Mexico City Metropolitan Area for the period of 2004-2019. Daily 1x1 km PM2.5(median=23.4 μg/m3; IQR=13.6 μg/m3) estimates from our satellite-based regional model were employed for exposure assessment at the sub-municipality level. Associations between PM2.5with broad-category (organ-system) and cause-specific mortality outcomes were estimated with distributed lag conditional logistic models. We also fit models stratifying by potential individual-level effect modifiers including; age, sex, and individual SES-related characteristics namely: education, health insurance coverage, and job categories. Results. PM2.5exposure was associated with higher total non-accidental, cardiovascular, cerebrovascular, respiratory, and digestive mortality. A 10-μg/m3PM2.5higher cumulative exposure over one week (lag06) was associated with higher cause-specific mortality outcomes including hypertensive disease [2.28% (95%CI: 0.26%—4.33%)], acute ischemic heart disease [1.61% (95%CI: 0.59%—2.64%)], other forms of heart disease [2.39% (95%CI: -0.35%—5.20%)], hemorrhagic stroke [3.63% (95%CI: 0.79%—6.55%)], influenza and pneumonia [4.91% (95%CI: 2.84%—7.02%)], chronic respiratory disease [2.49% (95%CI: 0.71%—4.31%)], diseases of the liver [1.85% (95%CI: 0.31%—3.41%)], and renal failure [3.48% (95%CI: 0.79%—6.24%)]. No differences in effect size of associations were observed between SES strata. Conclusions. Exposure to PM2.5was associated with mortality outcomes beyond the cardiovascular and respiratory systems, including specific death-causes from the digestive and genitourinary systems, with no indications of effect modification by individual SES-related characteristics.

Effect of Air Pollution on the Basal DNA Damage of Mother–Newborn Couples of México City

“…Several studies in recent years evaluated both the mortality and morbidity associated with the effect of pollution in Mexico [ 3 , 4 , 5 ]. The high concentration of pollutants, mainly particulate matter and to a lesser extent ozone, has been associated with an increase in different diseases such as neurodegeneration and with excess mortality from cardiovascular and respiratory failure [ 6 , 7 , 8 , 9 ]. It is important to point out that these results are consistent with reports from other highly polluted cities [ 9 , 10 , 11 , 12 , 13 , 14 ].…”