{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:01:05Z","timestamp":1792083665351,"version":"4.4.0"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>The association between short-term exposure to air pollution and mortality has been widely documented worldwide; however, few studies have applied causal modeling approaches to account for unmeasured confounders that vary across time and space.<\/jats:p><\/jats:sec>Objective<\/jats:title>To estimate the association between short-term changes in fine particulate matter (PM2.5<\/jats:sub>) and nitrogen dioxide (NO2<\/jats:sub>) concentrations and changes in daily all-cause mortality rates using a causal modeling approach.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study used air pollution and mortality data from Jiangsu, China; California; central-southern Italy; and Germany with interactive fixed-effects models to control for both measured and unmeasured spatiotemporal confounders. A total of 8\u202f963\u202f352 deaths in these 4 regions from January 1, 2015, to December 31, 2019, were included in the study. Data were analyzed from June 1, 2021, to October 30, 2023.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Day-to-day changes in county- or municipality-level mean PM2.5<\/jats:sub> and NO2<\/jats:sub> concentrations.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Day-to-day changes in county- or municipality-level all-cause mortality rates.<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 8\u202f963\u202f352 deaths in the 4 study regions, a 10-\u03bcg\/m3<\/jats:sup> increase in daily PM2.5<\/jats:sub> concentration was associated with an increase in daily all-cause deaths per 100 000 people of 0.01 (95% CI, 0.001-0.01) in Jiangsu, 0.03 (95% CI, 0.004-0.05) in California, 0.10 (95% CI, 0.07-0.14) in central-southern Italy, and 0.04 (95% CI, 0.02- 0.05) in Germany. The corresponding increases in mortality rates for a 10-\u03bcg\/m3<\/jats:sup> increase in NO2<\/jats:sub> concentration were 0.04 (95% CI, 0.03-0.05) in Jiangsu, 0.03 (95% CI, 0.01-0.04) in California, 0.10 (95% CI, 0.05-0.15) in central-southern Italy, and 0.05 (95% CI, 0.04-0.06) in Germany. Significant effect modifications by age were observed in all regions, by sex in Germany (eg, 0.05 [95% CI, 0.03-0.06] for females in the single-pollutant model of PM2.5<\/jats:sub>), and by urbanicity in Jiangsu (0.07 [95% CI, 0.04-0.10] for rural counties in the 2-pollutant model of NO2<\/jats:sub>).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The findings of this cross-sectional study contribute to the growing body of evidence that increases in short-term exposures to PM2.5<\/jats:sub> and NO2<\/jats:sub> may be associated with increases in all-cause mortality rates. The interactive fixed-effects model, which controls for unmeasured spatial and temporal confounders, including unmeasured time-varying confounders in different spatial units, can be used to estimate associations between changes in short-term exposure to air pollution and changes in health outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.54607","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T16:31:07Z","timestamp":1709310667000},"page":"e2354607","source":"Crossref","is-referenced-by-count":27,"title":["Short-Term Exposure to Fine Particulate Matter and Nitrogen Dioxide and Mortality in 4 Countries"],"prefix":"10.1001","volume":"7","author":[{"given":"Yiqun","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut"},{"name":"Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, 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