Antonio GasparriniLondon School of Hygiene and Tropical Medicine | LSHTM · Department of Public Health Environments and Society
Antonio Gasparrini
BSc Mbiol MSc PhD
About
479
Publications
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Introduction
Education
December 2009 - October 2011
January 2006 - April 2010
January 2005 - December 2005
Publications
Publications (479)
Distributed lag non-linear models (DLNMs) represent a modeling framework to flexibly describe associations showing potentially non-linear and delayed effects in time series data. This methodology rests on the definition of a crossbasis, a bi-dimensional functional space expressed by the combination of two sets of basis functions, which specify the...
In this paper, we formalize the application of multivariate meta-analysis and meta-regression to synthesize estimates of multi-parameter associations obtained from different studies. This modelling approach extends the standard two-stage analysis used to combine results across different sub-groups or populations. The most straightforward applicatio...
Recent investigations have reported a decline in the heat-related mortality risk during the last decades. However, these studies are frequently based on modelling approaches that do not fully characterize the complex temperature-mortality relationship, and are limited to single cities or countries.
To assess the temporal variation in heat-mortality...
Although studies have provided estimates of premature deaths attributable to either heat or cold in selected countries, none has so far offered a systematic assessment across the whole temperature range in populations exposed to different climates. We aimed to quantify the total mortality burden attributable to non-optimum ambient temperature, and...
Distributed lag non-linear models (DLNMs) are a modelling tool for describing potentially non-linear and delayed dependencies. Here, we illustrate an extension of the DLNM framework through the use of penalized splines within generalized additive models (GAM). This extension offers built-in model selection procedures and the possibility of accommod...
Background
Fine particulate matter (PM 2.5 ) occurs within a mixture of other pollutant gases that interact and impact its composition and toxicity. To characterize the local toxicity of PM 2.5 , it is useful to have an index that accounts for the whole pollutant mix, including gaseous pollutants. We consider a recently proposed pollutant mixture c...
Objectives
To assess the short term temporal variations in suicide risk related to the day of the week and national holidays in multiple countries.
Design
Multicountry, two stage, time series design.
Setting
Data from 740 locations in 26 countries and territories, with overlapping periods between 1971 and 2019, collected from the Multi-city Multi...
Background
Evidence for long-term mortality risks of PM 2.5 comes mostly from large administrative studies with incomplete individual information and limited exposure definitions. Here we assess PM 2.5 -mortality associations in the UK Biobank cohort using detailed information on confounders and exposure.
Methods
We reconstructed detailed exposure...
Background
Land-use and land-cover change (LULCC) can substantially affect climate through biogeochemical and biogeophysical effects. Here, we examine the future temperature–mortality impact for two contrasting LULCC scenarios in a background climate of low greenhouse gas concentrations. The first LULCC scenario implies a globally sustainable land...
Background
We quantify the mortality burden and economic loss attributable to nonoptimal temperatures for cold and heat in the Central and South American countries in the Multi-City Multi-Country (MCC) Collaborative Research Network.
Methods
We collected data for 66 locations from 13 countries in Central and South America to estimate location-spec...
Objective
To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality.
Design
Two stage time series analysis.
Setting
645 locations across 34 countries or regions.
Population
Daily mortality data, comprising a total of 109 954 744 all cause, 3...
Background
The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in mult...
Background
Throughout the Syrian conflict, the Syrian government has intentionally attacked health facilities, violating International Humanitarian Law. Previous studies have qualitatively described health system disruptions following attacks on healthcare or established associations between armed conflict and health service utilisation, but there...
Background
Heterogeneity in temperature-mortality relationships across locations may partly result from differences in the demographic structure of populations and their cause-specific vulnerabilities. Here we conduct the largest epidemiological study to date on the association between ambient temperature and mortality by age and cause using data f...
Recent advances in data science and urban environmental health research utilise large-scale databases (100s–1000s of cities) to explore the complex interplay of urban characteristics such as city form and size, climate, mobility, exposure, and environmental health impacts. Cities are still hotspots of air pollution and noise, suffer urban heat isla...
Research on the health risks of environmental factors and climate change requires epidemiological evidence on associated health risks at a global scale. Multi-center studies offer an excellent framework for this purpose, but they present various methodological and logistical problems. This contribution illustrates the experience of the Multi-Countr...
Weather and climate patterns play an intrinsic role in societal health, yet a comprehensive synthesis of specific hazard–mortality causes does not currently exist. Country-level health burdens are thus highly uncertain, but harnessing collective expert knowledge can reduce this uncertainty, and help assess diverse mortality causes beyond what is ex...
The rising humid heat is regarded as a severe threat to human survivability, but the proper integration of humid heat into heat-health alerts is still being explored. Using state-of-the-art epidemiological and climatological datasets, we examined the association between multiple heat stress indicators (HSIs) and daily human mortality in 739 cities...
The development of innovative tools for real-time monitoring and forecasting of environmental health impacts is central to effective public health interventions and resource allocation strategies. Though a need for such generic tools has been previously echoed by public health planners and regional authorities responsible for issuing anticipatory a...
Background Wildfire activity is an important source of tropospheric ozone (O 3) pollution. However, no study to date has systematically examined the associations of wildfire-related O 3 exposure with mortality globally.
Exposure to high and low ambient temperatures increases the risk of neonatal mortality, but the contribution of climate change to temperature-related neonatal deaths is unknown. We use Demographic and Health Survey (DHS) data (n = 40,073) from 29 low- and middle-income countries to estimate the temperature-related burden of neonatal deaths between...
Background
The association between nonoptimal temperatures and cardiovascular mortality risk is recognized. However, a comprehensive global assessment of this burden is lacking.
Objectives
The goal of this study was to assess global cardiovascular mortality burden attributable to nonoptimal temperatures and investigate spatiotemporal trends.
Meth...
Background
As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art accoun...
Extreme weather and coronavirus-type pandemics are both leading global health concerns. Until now, no study has quantified the compound health consequences of the co-occurrence of them. We estimate the mortality attributable to extreme heat and cold events, which dominate the UK health burden from weather hazards, in England and Wales in the period...
Background
The regional disparity of heatwave-related mortality over a long period has not been sufficiently assessed across the globe, impeding the localisation of adaptation planning and risk management towards climate change. We quantified the global mortality burden associated with heatwaves at a spatial resolution of 0.5°×0.5° and the temporal...
BACKGROUND:
Extreme temperatures contribute significantly to global mortality. While previous studies on temperature and stroke-specific outcomes presented conflicting results, these studies were predominantly limited to single-city or single-country analyses. Their findings are difficult to synthesize due to variations in methodologies and exposur...
Assessing the association between temperature frequency and mortality can provide insights into human adaptation to local ambient temperatures. We collected daily time-series data on mortality and temperature from 757 locations in 43 countries during 1979–2020. We used a two-stage time series design to assess the association between temperature fre...
Background. Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has a higher effect. Objectives. We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality. Methods. We collected data on total, card...
Background
Model-estimated air pollution exposure products have been widely used in epidemiological studies to assess the health risks of particulate matter with diameters of ≤2.5 µm (PM2.5). However, few studies have assessed the disparities in health effects between model-estimated and station-observed PM2.5 exposures.
Methods
We collected daily...
Introduction
In Kenya, non-communicable diseases (NCDs) are estimated to account for almost one-third of all deaths and this is likely to rise by over 50% in the next 10 years. The Primary Health Integrated Care for Chronic Conditions (PIC4C) project aims to strengthen primary care by integrating comprehensive NCD care into existing HIV primary car...
Older adults are generally amongst the most vulnerable to heat and cold. While temperature-related health impacts are projected to increase with global warming, the influence of population aging on these trends remains unclear. Here we show that at 1.5 °C, 2 °C, and 3 °C of global warming, heat-related mortality in 800 locations across 50 countries...
Climate change could lead to high economic costs (i.e., low income and high prices) for individuals. While economic conditions are important determinants of vulnerability to climate change impacts, climate-related epidemiological studies focus primarily on the direct impact of temperature on morbidity and mortality without accounting for climate-in...
Background. Climate change can directly impact temperature-related excess deaths and might subsequently change the seasonal variation in mortality. In this study, we aimed to provide a systematic and comprehensive assessment of potential future changes in the seasonal variation, or seasonality, of mortality across different climate zones.
Methods....
Background. Exposure to cold spells is associated with mortality. However, little is known about the global mortality burden of cold spells.
Methods. A three-stage meta-analytical method was used to estimate the global mortality burden associated with cold spells by means of a time series dataset of 1960 locations across 59 countries (or regions)....
Short-term exposure to ground-level ozone in cities is associated with increased mortality and is expected to worsen with climate and emission changes. However, no study has yet comprehensively assessed future ozone-related acute mortality across diverse geographic areas, various climate scenarios, and using CMIP6 multi-model ensembles, limiting ou...
b>Hintergrund: Es gibt neue Hinweise auf einen Zusammenhang zwischen der Hitzebelastung in der Umgebung und Krankenhauseinweisungen wegen chronisch obstruktiver Lungenerkrankung (COPD). Individuelle und kontextuelle Merkmale können die Anfälligkeit der Bevölkerung für hitzebedingte Krankenhauseinweisungen wegen COPD beeinflussen. Diese Studie quant...
Background
More intense tropical cyclones (TCs) are expected in the future under a warming climate scenario, but little is known about their mortality effect pattern across countries and over decades. We aim to evaluate the TC-specific mortality risks, periods of concern (POC) and characterize the spatiotemporal pattern and exposure-response (ER) r...
b>Hintergrund: Frühere Studien haben einen Zusammenhang zwischen hohen Temperaturen und Krankenhauseinweisungen wegen Asthma festgestellt. Es wurde eine geschlechts- und altersabhängige Anfälligkeit festgestellt. Über die zeitliche Entwicklung dieses Effekts und seine regionale Variation ist jedoch wenig bekannt. Ziel dieser Studie ist es, den Zusa...
Climate change and coronavirus-type pandemics are both major global health threats. Until now, no study has quantified the compound health consequences of the co-occurrence of these crises. We estimate the mortality attributable to short-term heat and cold events, which dominate the UK health burden from weather hazards, in England and Wales in the...
Recent developments in linkage procedures and exposure modelling offer great prospects for cohort analyses on the health risks of environmental factors. However, assigning individual-level exposures to large population-based cohorts poses methodological and practical problems. In this contribution, we illustrate a linkage framework to reconstruct e...
As the climate warms, increasing heat-related health risks are expected, and can be exacerbated by the urban heat island (UHI) effect. UHIs can also offer protection against cold weather, but a clear quantification of their impacts on human health across diverse cities and seasons is still being explored. Here we provide a 500 m resolution assessme...
Background:
The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent.
Objectives:
To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries.
Methods:
We used daily data on all-cause mortality, air temp...
Objective
To investigate potential interactive effects of fine particulate matter (PM 2.5 ) and ozone (O 3 ) on daily mortality at global level.
Design
Two stage time series analysis.
Setting
372 cities across 19 countries and regions.
Population
Daily counts of deaths from all causes, cardiovascular disease, and respiratory disease.
Main outco...
Objective
To evaluate lag-response associations and effect modifications of exposure to floods with risks of all cause, cardiovascular, and respiratory mortality on a global scale.
Design
Time series study.
Setting
761 communities in 35 countries or territories with at least one flood event during the study period.
Participants
Multi-Country Mul...
Childhood anemia constitutes a global public health problem, especially in low- and middle-income countries (LMICs). However, it remains unknown whether global warming has an impact on childhood anemia. Here, we examined the association between annual temperatures and childhood anemia prevalence in sub-Saharan Africa and then projected childhood an...
Background
Heat stroke is a significant cause of mortality in response to high summer temperatures. There is limited evidence on the pattern and magnitude of the association between temperature and heat stroke mortality. We examined this association in Spain, using data from a 27-year follow-up period.
Methods
We used a space-time-stratified case–...
Background:
The protective effect of urban greenery from adverse heat impacts remains inconclusive. Existing inconsistent findings could be attributed to the different estimation techniques used.
Objectives:
We investigated how effect modifications of urban greenery on heat–mortality associations vary when using different greenery measurements ref...