ArticleBMC public health2019
Effects of pollution, low temperature and influenza syndrome on the excess mortality risk in winter 2016-2017.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- The Mortality Effect of Apparent Temperature: A Multi-City Study in Asia.International journal of environmental research and public health · 2021Pooled it
- Acute and chronic exposure to air pollution in relation with incidence, prevalence, severity and mortality of COVID-19: a rapid systematic review.Environmental health : a global access science source · 2021Pooled it
- Nitrate ingestion blunts the increase in blood pressure during cool air exposure: a double-blind, placebo-controlled, randomized, crossover trial.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Trial
- The mediating role of acute respiratory infections in temperature-mortality associations in the Czech Republic, 1982-2019.International journal of biometeorology · 2026Article
- Modifying effects of PMScientific reports · 2025Article
- Article
- Article
- Temperature and particulate matter as environmental factors associated with seasonality of influenza incidence - an approach using Earth observation-based modeling in a health insurance cohort study from Baden-Württemberg (Germany).Environmental health : a global access science source · 2022Article
- Roles for Pathogen Interference in Influenza Vaccination, with Implications to Vaccine Effectiveness (VE) and Attribution of Influenza Deaths.Infectious disease reports · 2022Review
- Estimation of Excess All-Cause Mortality Due to COVID-19 in Thailand.Tropical medicine and infectious disease · 2022Article
- Trends in Excess Winter Mortality (EWM) from 1900/01 to 2019/20-Evidence for a Complex System of Multiple Long-Term Trends.International journal of environmental research and public health · 2022Article
- Population-based incidence and prevalence of inflammatory bowel diseases in Milan (Northern Italy), and estimates for Italy.European journal of gastroenterology & hepatology · 2021Article
- The impact of main air pollutants on respiratory emergency department visits and the modification effects of temperature in Beijing, China.Environmental science and pollution research international · 2021Article
- The association between COVID-19 deaths and short-term ambient air pollution/meteorological condition exposure: a retrospective study from Wuhan, China.Air quality, atmosphere, & health · 2021Article
- Evidence-Based Considerations Exploring Relations between SARS-CoV-2 Pandemic and Air Pollution: Involvement of PM2.5-Mediated Up-Regulation of the Viral Receptor ACE-2.International journal of environmental research and public health · 2020Article
- COVID-19-associated cardiovascular morbidity in older adults: a position paper from the Italian Society of Cardiovascular Researches.GeroScience · 2020Review
- Effects of air pollutants on the transmission and severity of respiratory viral infections.Environmental research · 2020Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the winter of 2016-2017, the number of deaths recorded in the north-west Europe was significantly higher than that in previous years. This spike in mortality was attributed principally to an influenza epidemic, but the contribution of air pollution and cold temperature has not been investigated. Information on the combined effect of low temperatures, influenza epidemic, and air pollution on mortality is inadequate. The objective of this study was to estimate the excess mortality in the winter of 2016-2017 in the metropolitan area of Milan, and to evaluate the independent short-term effect of 3 risk factors: low temperatures, the influenza epidemic, and air pollution.
methodsWe used a case-crossover, time-stratified study design. Mortality data were collected on all people aged > 65 years who died of natural causes, due to respiratory diseases or cardiovascular diseases, between December 1, 2016 and February 15, 2017. Environmental data were extracted from the Regional Environmental Protection Agency. The National Surveillance Network provided data on influenza epidemic.
resultsAmong the 7590 natural deaths in people aged > 65 years, 965 (13%) were caused by respiratory conditions, and 2688 (35%) were caused by cardiovascular conditions. There were statistically significant associations between the minimum recorded temperature and deaths due to natural causes (OR = 0.966, 95% CI: 0.944-0.989), and cardiovascular conditions (OR = 0.961, 95% CI: 0.925-0.999). There were also statistically significant association between the influenza epidemic and deaths due to natural causes (OR = 1.198, 95% CI: 1.156-1.241), cardiovascular conditions (OR = 1.153, 95% CI: 1.088-1.223), and respiratory conditions (OR = 1.303, 95% CI: 1.166-1.456). High levels of PM10 (60 and 70 μg/m
conclusionsExcess of mortality in Milan during winter 2016-2017 was associated with influenza epidemic and concomitant environmental exposures, specifically, the combined effect of air pollution and low temperatures. Policies mitigating the effects of environmental risk factors should be implemented to prevent future excess mortality.
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