{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:44:32Z","timestamp":1792611872662,"version":"4.5.0"},"reference-count":27,"publisher":"BMJ","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>\n              To evaluate the short term associations between nitrogen dioxide (NO\n              <jats:sub>2<\/jats:sub>\n              ) and total, cardiovascular, and respiratory mortality across multiple countries\/regions worldwide, using a uniform analytical protocol.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design<\/jats:title>\n            <jats:p>Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>398 cities in 22 low to high income countries\/regions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main outcome measures<\/jats:title>\n            <jats:p>Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>\n              On average, a 10 \u03bcg\/m\n              <jats:sup>3<\/jats:sup>\n              increase in NO\n              <jats:sub>2<\/jats:sub>\n              concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter \u226410 \u03bcm or \u22642.5 \u03bcm (PM\n              <jats:sub>10<\/jats:sub>\n              and PM\n              <jats:sub>2.5<\/jats:sub>\n              , respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO\n              <jats:sub>2<\/jats:sub>\n              concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>\n              This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO\n              <jats:sub>2<\/jats:sub>\n              and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO\n              <jats:sub>2<\/jats:sub>\n              .\n            <\/jats:p>\n          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