{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T18:31:44Z","timestamp":1775154704423,"version":"3.50.1"},"reference-count":35,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100001306","name":"Health Protection Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001306","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,4,26]]},"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To quantitatively assess time-series studies of daily nitrogen dioxide (NO\n                      <jats:sub>2<\/jats:sub>\n                      ) and mortality and hospital admissions which also controlled for particulate matter (PM) to determine whether or to what extent the NO\n                      <jats:sub>2<\/jats:sub>\n                      associations are independent of PM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Time-series studies\u2014published in peer-reviewed journals worldwide, up to May 2011\u2014that reported both single-pollutant and two-pollutant model estimates for NO\n                      <jats:sub>2<\/jats:sub>\n                      and PM were ascertained from bibliographic databases (PubMed, EMBASE and Web of Science) and reviews. Random-effects summary estimates were calculated globally and stratified by different geographical regions, and effect modification was investigated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Mortality and hospital admissions for various cardiovascular or respiratory diseases in different age groups in the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      60 eligible studies were identified, and meta-analysis was conducted on 23 outcomes. Two-pollutant model study estimates generally showed that the NO\n                      <jats:sub>2<\/jats:sub>\n                      associations were independent of PM mass. For all-cause mortality, a 10\u2005\u00b5g\/m\n                      <jats:sup>3<\/jats:sup>\n                      increase in 24-hour NO\n                      <jats:sub>2<\/jats:sub>\n                      was associated with a 0.78% (95% CI 0.47% to 1.09%) increase in the risk of death, which reduced to 0.60% (0.33% to 0.87%) after control for PM. Heterogeneity between geographical region-specific estimates was removed by control for PM (I\n                      <jats:sup>2<\/jats:sup>\n                      from 66.9% to 0%). Estimates of PM and daily mortality assembled from the same studies were greatly attenuated after control for NO\n                      <jats:sub>2<\/jats:sub>\n                      : from 0.51% (0.29% to 0.74%) to 0.18% (\u22120.11% to 0.47%) per 10\u2005\u00b5g\/m\n                      <jats:sup>3<\/jats:sup>\n                      PM\n                      <jats:sub>10<\/jats:sub>\n                      and 0.74% (0.34% to 1.14%) to 0.54% (\u22120.25% to 1.34%) for PM\n                      <jats:sub>2.5<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The association between short-term exposure to NO\n                      <jats:sub>2<\/jats:sub>\n                      and adverse health outcomes is largely independent of PM mass. Further studies should attempt to investigate whether this is a generic PM effect or whether it is modified by the source and physicochemical characteristics of PM. This finding strengthens the argument for NO\n                      <jats:sub>2<\/jats:sub>\n                      having a causal role in health effects.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-010751","type":"journal-article","created":{"date-parts":[[2016,7,21]],"date-time":"2016-07-21T21:53:31Z","timestamp":1469138011000},"page":"e010751","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":75,"title":["Distinguishing the associations between daily mortality and hospital admissions and nitrogen dioxide from those of particulate matter: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"6","author":[{"given":"I C","family":"Mills","sequence":"first","affiliation":[{"name":"Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R W","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H R","family":"Anderson","sequence":"additional","affiliation":[{"name":"Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK"},{"name":"MRC-PHE Centre for Environment and Health, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R L","family":"Maynard","sequence":"additional","affiliation":[{"name":"University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D P","family":"Strachan","sequence":"additional","affiliation":[{"name":"Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,7,21]]},"reference":[{"key":"2025121510173509000_6.7.e010751.1","first-page":"39","article-title":"Particulate air pollution and daily mortality: a synthesis","volume":"19","author":"Schwartz","year":"1991","journal-title":"Public Health Rev"},{"key":"2025121510173509000_6.7.e010751.2","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1006\/enrs.1994.1005","article-title":"Air pollution and daily mortality: a review and meta-analysis","volume":"64","author":"Schwartz","year":"1994","journal-title":"Environ Res"},{"key":"2025121510173509000_6.7.e010751.3","doi-asserted-by":"publisher","DOI":"10.1080\/10473289.1996.10467528"},{"key":"2025121510173509000_6.7.e010751.4","first-page":"49","article-title":"Human health risks of airborne particles: historical perspective","volume-title":"Air pollution in the 21st century\u2014priority issues and policy. 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