Mortality risks due to long-term ambient sulphur dioxide exposure: large variability of relative risk in the literature
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URBAN AIR QUALITY, CLIMATE AND POLLUTION: FROM MEASUREMENT TO MODELING APPLICATIONS
Mortality risks due to long-term ambient sulphur dioxide exposure: large variability of relative risk in the literature Yumi Kobayashi 1 & Jane M. Santos 1 & José Geraldo Mill 2 & Neyval C. Reis Júnior 1 & Willian L. Andreão 3 & Taciana T. de A. Albuquerque 1,3 & Richard M. Stuetz 4 Received: 7 October 2019 / Accepted: 24 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Several studies have been published about the potential health effects due to long-term exposure to sulphur dioxide (SO2) and the relative risks (RRs) for different causes of mortality. Broad differences in the RR values are found, however. In this study, we performed an analysis of these studies aiming finding potential explanations for the high variability of the RR reported. The RRs for stratified subgroups were also analysed to identify more susceptible subgroups. A total of 14 studies were identified. Some of them related strong associations between mortality and long-term ambient SO2 exposure, while others found insignificant or no associations to the same mortality indexes. The mean RR values ranged from 0.95 to 1.14 for mortality due to all causes, 0.99 to 3.05 for lung cancer, 0.87 to 1.3 for respiratory diseases, 0.96 to 1.14 cardiovascular diseases and 0.97 to 1.05 for cardiopulmonary diseases mortality. Among the factors that may affect the RR estimations, only the size of studied population and the spatial scales used in exposure assessment showed notable influences. The female population was found to be more susceptible to longterm SO2 exposure. For other stratified subgroups including age, smoking status and income levels, no obvious relationship with RR was observed. Keywords Relative risk . Mortality . Sulphur dioxide . Health effects . Review
Introduction Ambient air pollution has long been recognized to be associated with various types of adverse effects to human health (WHO 2006). However, the degree of human health effects of each pollutant is still not very clear. Among the pollutants, Responsible editor: Philippe Garrigues * Jane M. Santos [email protected] 1
Department of Environmental Engineering, Universidade Federal do Espírito Santo, Vitória 29060-970, Brazil
2
Department of Physiological Sciences, Universidade Federal do Espírito Santo, Vitória 29060-970, Brazil
3
Department of Sanitary and Environmental Engineering, Universidade Federal de Minas Gerais, Belo Horizonte 31270-010, Brazil
4
School of Civil and Environmental Engineering, University of New South Wales, Sydney, New South Wales 2052, Australia
fine particulate matter (PM2.5; ≤ 2.5 μm in aerodynamic diameter) has been the focus of health impact studies. The PM2.5 concentration is higher in many parts of the world, and their adverse effects were confirmed in several cohort studies (Pope et al. 2002, 2004, 2019; Laden et al. 2006; Krewski et al. 2009; Katanoda et al. 2011; Crouse et al. 2012; Lepeule et al. 2012; Cesaroni et al. 20
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