Aurelio Tobias

Aurelio Tobias
Institute of Environmental Assessment and Water Research | IDAEA · Geosciences

BSc MSc PhD CStat

About

453
Publications
82,802
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17,663
Citations
Introduction
My research activity focuses on environmental epidemiology, studying the health effects of environmental risk exposures; temperature, air pollution, desert dust, and climate change. I have a strong interest in applied statistical and epidemiological methods in environmental health studies. In particular, the application of time-series regression in public health and statistical methods for meta-analysis.

Publications

Publications (453)
Article
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Background: The minimum mortality temperature from J- or U- shaped curves varies across cities with different climates. This variation conveys information on adaptation, but ability to characterize it is limited by the absence of a method to describe uncertainty in estimated minimum mortality temperatures. Methods: We propose an approximate para...
Article
Lockdown measures came into force in Spain from March 14th, two weeks after the start of the SARS-CoV-2 epidemic, to reduce the epidemic curve. Our study aims to describe changes in air pollution levels during the lockdown measures in the city of Barcelona (NE Spain), by studying the time evolution of atmospheric pollutants recorded at the urban ba...
Article
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Background: Desert dust is assumed to have substantial adverse effects on human health. However, the epidemiologic evidence is still inconsistent, mainly because previous studies used different metrics for dust exposure and its corresponding epidemiologic analysis. We aim to provide a standardized approach to the methodology for evaluating the sho...
Article
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Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has re...
Article
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Several methods have been used to assess the seasonality of health outcomes in epidemiological studies. However, little information is available on the methods to study the changes in seasonality before and after adjusting for environmental or other known seasonally varying factors. Such investigations will help us understand the role of these fact...
Article
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Rationale: The associations between ambient coarse particulate matter (PM2.5-10) and daily mortality is not fully understood at a global scale. Objectives: To evaluate the short-term associations between PM2.5-10 and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide. Methods: We collected daily mortal...
Article
(BJOG. 2021;128:1324–1333) Maternal sepsis is the third most common direct cause of maternal mortality worldwide. Low-resource settings are disproportionately affected by maternal sepsis. While sepsis screening and care bundles can reduce the time to initiation of treatment and improve outcomes, the current bundles are not specific to maternal care...
Article
In late March 2018, a large part of the Eastern Mediterranean experienced an extraordinary episode of African dust, one of the most intense in recent years, here referred to as the “Minoan Red” event. The episode mainly affected the Greek island of Crete, where the highest aerosol concentrations over the past 15 yeas were recorded, although impacts...
Book
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The aim of the "Sand and Dust Storms Compendium: Information and Guidance on Assessing and Addressing the Risks" is to provide information and guidance on how to assess and address the risks posed by sand and dust storms and plan actions to combat sand and dust storms. The Compendium brings together information and guidance from a wide range of sou...
Article
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Background Increased mortality risk is associated with short-term temperature variability. However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperatu...
Article
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Vehicular traffic is one of the major sources of air pollution in European cities. This work aims to understand which characteristics of the urban environment could influence mobility-related air pollution, quantify the health impacts of exposure to traffic-derived PM2.5 and NO2 concentrations, and assess the potential health benefits expected from...
Article
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Epidemiological analyses of health risks associated with non-optimal temperature are traditionally based on ground observations from weather stations that offer limited spatial and temporal coverage. Climate reanalysis represents an alternative option that provide complete spatio-temporal exposure coverage, and yet are to be systematically explored...
Article
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Background Numerous studies have quantified the associations between ambient temperature and enteric infections, particularly all-cause enteric infections. However, the temperature sensitivity of enteric infections might be pathogen dependent. Here, we sought to identify pathogen-specific associations between ambient temperature and enteric infecti...
Article
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Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the sam...
Article
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Numerous studies have been conducted worldwide to investigate if an association exists between meteorological factors and the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection incidence. Although research studies provide conflicting results, which can be partially explained by different methods used, some clear trends emerge on...
Preprint
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Background: Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. To date, studies on this topic have indicated conflicting findings and typically focus on a localized area or single country. We evaluated the effect modification of greenspa...
Article
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Background: The association between fine particulate matter (PM2.5) and mortality widely differs between as well as within countries. Differences in PM2.5 composition can play a role in modifying the effect estimates, but there is little evidence about which components have higher impacts on mortality. Methods: We applied a two-stage analysis on...
Article
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Background More than half of the working population in Latin American and Caribbean (LAC) countries is engaged in informal employment. The few previous studies indicate that this employment condition could have negative consequences for workers’ health. The aim of the present study was to estimate the association between self-perceived health and i...
Article
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Background Ambient temperature may contribute to seasonality of mortality; in particular, a warming climate is likely to influence the seasonality of mortality. However, few studies have investigated seasonality of mortality under a warming climate. Methods Daily mean temperature, daily counts for all-cause, circulatory, and respiratory mortality,...
Article
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Objectives Recreational physical activity is an integral part of our society, and the injuries caused by sports activities are a concern for public health. We studied the effect of outdoor ambient temperature on hospital emergency department visits caused by sports injuries in Madrid, Spain, and accounted for its seasonal changes. Methods We used...
Article
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There is conflicting evidence on the influence of weather on COVID-19 transmission. Our aim is to estimate weather-dependent signatures in the early phase of the pandemic, while controlling for socio-economic factors and non-pharmaceutical interventions. We identify a modest non-linear association between mean temperature and the effective reproduc...
Article
Background The evidence on the association between ultrafine (UFP) particles and mortality is still inconsistent. Moreover, health effects of specific UFP sources have not been explored. We assessed the impact of UFP sources on daily mortality in Barcelona, Helsinki, London, and Zurich. Methods UFP sources were previously identified and quantified...
Article
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What this study adds The minimum mortality temperature (MMT) is an important indicator of the relationship between temperature and mortality. It indicates the adaptability to climate, but little is known about its geographical changes in the global distribution. This article investigates the geographic differences of the MMT on a global scale and s...
Article
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Background Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2·5 and mortality across various regions of...
Article
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Background Although seasonal variations in mortality have been recognized for millennia, the role of temperature remains unclear. We aimed to assess seasonal variation in mortality and to examine the contribution of temperature. Methods We compiled daily data on all-cause, cardiovascular and respiratory mortality, temperature and indicators on loc...
Article
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Background: Minimum mortality temperature (MMT) is an important indicator to assess the temperature-mortality association, indicating long-term adaptation to local climate. Limited evidence about the geographical variability of the MMT is available at a global scale. Methods: We collected data from 658 communities in 43 countries under different...
Article
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The nonpharmaceutical interventions (NPIs) on COVID-19 can impact current and future dynamics of respiratory syncytial virus infections (RSV). In Tokyo, RSV activity declined by 97.9% (95%CI: 94.8% - 99.2%) during NPIs. A longer period of NPIs could expand susceptible populations, enhancing the potential for larger RSV outbreaks after NPIs ends.
Article
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Background: The increased risk of mortality during periods of high and low temperatures has been well established. However, most of the studies used daily counts of deaths or hospitalisations as health outcomes, although they are the ones at the top of the health impact pyramid reflecting only a limited proportion of patients with the most severe c...
Article
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Background Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and f...
Article
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Background: There is strong evidence concerning the impact of heat stress on mortality, particularly from high temperatures. However, few studies to our knowledge emphasize the importance of hot nights, which may prevent necessary nocturnal rest. Objectives: In this study, we use hot-night duration and excess to predict daily cause-specific mortal...
Article
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Objective: To evaluate whether the implementation of the FAST-M complex intervention was feasible and improved the recognition and management of maternal sepsis in a low-resource setting. Design: A before and after design. Setting: Fifteen government healthcare facilities in Malawi. Population: Women suspected of having maternal sepsis. Met...
Article
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The preventive and cautionary measures taken by the UAE and Abu Dhabi governments to reduce the spread of the coronavirus disease (COVID-19) and promote social distancing have led to a reduction of mobility and a modification of economic and social activities. This paper provides statistical analysis of the air quality data monitored by the Environ...
Preprint
Full-text available
Background: More than half of the working population in Latin American and Caribbean (LAC) countries is engaged in informal employment. The few previous studies indicate that this employment condition could have negative consequences for workers' health. The aim of the present study was to estimate the association between self-perceived health and...
Article
Full-text available
Background: Miscarriage, defined as the spontaneous loss of a pregnancy before 24 weeks' gestation, is common with approximately 25% of women experiencing a miscarriage in their lifetime. An estimated 15% of pregnancies end in miscarriage. Miscarriage can lead to serious morbidity, including haemorrhage, infection, and even death, particularly in...
Article
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Air temperature has been the most commonly used exposure metric in assessing relationships between thermal stress and mortality. Lack of the high-quality meteorological station data necessary to adequately characterize the thermal environment has been one of the main limitations for the use of more complex thermal indices. Global climate reanalyses...
Conference Paper
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More than a year since its emergence, there is conflicting evidence on the potential influence of weather conditions on SARS-CoV-2 transmission dynamics. We used a two-stage ecological modelling approach to estimate weather-dependent signatures in SARS-CoV-2 transmission in the early phase of the pandemic, using a dataset of 3 million COVID-19 case...
Article
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Background: Epidemiological evidence on short-term association between ambient carbon monoxide (CO) and mortality is inconclusive and limited to single cities, regions, or countries. Generalisation of results from previous studies is hindered by potential publication bias and different modelling approaches. We therefore assessed the association be...
Article
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Background: Epidemiological evidence on short-term association between ambient carbon monoxide (CO) and mortality is inconclusive and limited to single cities, regions, or countries. Generalisation of results from previous studies is hindered by potential publication bias and different modelling approaches. We therefore assessed the association bet...
Article
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Background Previous studies investigating the relationship of influenza with acute myocardial infarction (AMI) have not distinguished between AMI types 1 and 2. Influenza and cold temperature can explain the increased incidence of AMI during winter but, because they are closely related in temperate regions, their relative contribution is unknown....
Article
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Objective To evaluate the short term associations between nitrogen dioxide (NO 2 ) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. Design Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. Setting 398 cit...
Article
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Background The use of obstetric early warning systems (OEWS) are recommended as an adjunct to reduce maternal morbidity and mortality. The aim of this review was to document the variation in OEWS trigger thresholds and the quality of information included within accompanying escalation protocols. Methods A review of OEWS charts and escalation polic...
Article
Biomass burning (BB) including forest, bush, prescribed fires, agricultural fires, residential wood combustion, and power generation has long been known to affect climate, air quality and human health. With this work we supply a systematic review on the health effects of BB emissions in the framework of the WHO activities on air pollution. We perfo...
Article
The transmission of coronaviruses can be affected by several factors, including the climate. Due to the rapid spread of COVID-19 and the urgent need for rapid responses to contain the pandemic, it is essential to understand the role that weather conditions on the transmission of SARS-CoV-2. We evaluate the influence of meteorological factors on the...
Article
Background Scarce data are available on what variables affect the risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the development of symptomatic COVID-19, and, particularly, the relationship with viral load. We aimed to analyse data from linked index cases of COVID-19 and their contacts to explore factors assoc...
Article
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Background Globally too many mothers and babies die during childbirth; 98% of maternal deaths are avoidable. Skilled clinicians can reduce these deaths; however, there is a world-wide shortage of maternity healthcare workers. Malawi has enough to deliver 20% of its maternity care. A motivating work environment is important for healthcare worker ret...
Article
Background: Climate change is a severe public health challenge. Understanding to what extent fatal and non-fatal consequences of specific diseases are associated with temperature may help to improve the effectiveness of preventive public health efforts. This study examines the effects of temperature on deaths and hospital admissions by cardiovascul...
Article
Background: Postpartum haemorrhage (PPH), defined as a blood loss of 500 mL or more after birth, is the leading cause of maternal death worldwide. The World Health Organization (WHO) recommends that all women giving birth should receive a prophylactic uterotonic agent. Despite the routine administration of a uterotonic agent for prevention, PPH re...
Article
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Background Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions.
Article
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The occurrence of local high-pollution episodes in densely populated urban areas, which have huge fleets of vehicles, is currently one of the most worrying problems associated with air pollution worldwide. Such episodes are produced under specific meteorological conditions, which favour the sudden increase of levels of air pollutants. This study ha...
Article
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Objectives To assess if there is any association between hyperemesis gravidarum (HG), psychological morbidity and infant bonding and to quantify any psychosocial consequences of HG. Design Two-point prospective case–control, multicentre survey study with antenatal and postnatal data collection. Setting Three London hospitals. Participants Pregna...
Article
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Objective: Report maternal, fetal and neonatal complications associated with single intrauterine fetal death (sIUFD) in monochorionic twin pregnancies. Design: Prospective observational study. Setting: UK. Population: 81 monochorionic twin pregnancies with sIUFD after 14 weeks gestation, irrespective of cause. Methods: UKOSS reporters subm...
Article
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Background: Data analysis and visualization is an essential tool for exploring and communicating findings in medical research, especially in epidemiological surveillance. Results: Data on COVID-19 diagnosed cases and mortality, from January 1st, 2020, onwards is collected automatically from the European Centre for Disease Prevention and Control...
Article
Background: The risk of infection and death by COVID-19 could be associated with a heterogeneous distribution at a small area level of environmental, socioeconomic and demographic factors. Our objective was to investigate, at a small area level, whether long-term exposure to air pollutants increased the risk of COVID-19 incidence and death in Cata...