Aurelio Tobias

Institute of Environmental Assessment and Water Research | IDAEA · Geosciences

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...

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...

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...

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...

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...

Objectives While COVID-19 continues to challenge the world, meteorological variables are thought to impact COVID-19 transmission. Previous studies showed evidence of negative associations between high temperature and absolute humidity on COVID-19 transmission. Our research aims to fill the knowledge gap on the modifying effect of vaccination rates...

There is a body of evidence that ultrafine particles (UFP, those with diameters ≤ 100 nm) might have significant impacts on health. Accordingly, identifying sources of UFP is essential to develop abatement policies. This study focuses on urban Europe, and aims at identifying sources and quantifying their contributions to particle number size distri...

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 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 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...

El ambiente influye de forma directa e indirecta en nuestra salud, por tanto, una relación directa con el dinamismo antropogenético de las sociedades, en el sentido social, cultural, económico y político. El organismo humano y la atmósfera se encuentran en un equilibrio físico y químico en constante intercambio. Todos los seres humanos se ven forza...

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...

Background: We evaluated the comparative effectiveness of all intra-articular injection corticosteroids for treating internal temporomandibular joint (TMJ) disorders. Methods: We searched MEDLINE, CENTRAL, EMBASE, SCOPUS, and LILACS through December 2023. We included randomized clinical trials (RCTs) enrolling patients with symptomatic internal dis...

Background Precipitation could affect the transmission of diarrheal diseases. The diverse precipitation patterns across different climates might influence the degree of diarrheal risk from precipitation. This study determined the associations between precipitation and diarrheal mortality in tropical, temperate, and arid climate regions. Methods Da...

We present a statistical modelling framework for implementing Distributed Lag Models (DLMs), encompassing several extensions of the approach to capture the temporally distributed effect from covariates via regression. We place DLMs in the context of penalised Generalized Additive Models (GAMs) and illustrate that implementation via the R package \t...

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.

Background Biomass burning (BB) is a major source of air pollution and particulate matter (PM) in Southeast Asia. However, the health effects of PM smaller than 10 µm (PM10) originating from BB may differ from those of other sources. This study aimed to estimate the short-term association of PM10 from BB with respiratory and cardiovascular hospital...

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...

In this article, we present a comprehensive compilation of open access daily time-series datasets tailored to assess the temperature-mortality association. The data consists of daily mortality counts and average ambient temperature at various levels of geographic aggregation, including data from four cities, ten regions, and two counties, which hav...

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...

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...

Objectives: This study aims to estimate the short-term preventable mortality and associated economic costs of complying with the World Health Organization (WHO) air quality guidelines (AQGs) limit values for PM10 and PM2.5 in nine major Latin American cities. Methods: We estimated city-specific PM-mortality associations using time-series regressio...

Tropical cyclones bring health risks and can trigger outbreaks of diarrheal diseases in affected populations. There are several reviews that mention the relationship between tropical cyclones and diarrheal diseases. However, there is no dedicated review of the current evidence and extent of research on the association between tropical cyclones and...

Ultrafine particles (UFP, those with diameters ≤ 100 nm), have been reported to potentially penetrate deeply into the respiratory system, translocate through the alveoli, and affect various organs, potentially correlating with increased mortality. The aim of this study is to assess long-term trends (5–11 years) in mostly urban UFP concentrations ba...

The case-crossover design is widely used in environmental epidemiology as an effective alternative to the conventional time-series regression design to estimate short-term associations of environmental exposures with a range of acute events. This tutorial illustrates the implementation of the time-stratified case-crossover design to study aggregate...

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....

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...

Air pollution poses a health hazard in all countries. However, complete data on ambient particulate matter (PM) concentrations are not available in all world regions. Reanalysis data is already a valuable source of exposure data in epidemiological studies examining the relationship between temperature and health. Nevertheless, the performance of re...

Background: The impact of temperature on morbidity remains largely unknown. Moreover, extensive evidence indicates contrasting patterns between temperature-mortality and temperature-morbidity associations. A nationwide comparison of the impact of temperature on mortality and morbidity in more specific subgroups is necessary to strengthen understan...

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...

Exposure to heat poses a major threat to high-risk populations by substantially contributing to increased mortality and morbidity. Heat-related mortality has been a significant concern since the summer of 2003, when Europe experienced a heatwave, leading to an excess of more than 70,000 deaths during the summer months, with 3,166 of those occurring...

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...

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 AND AIM:The association between desert dust and daily mortality has been investigated previously in East Asia, but with a different analytical approach and methods for quantifying dust exposure, rendering it difficult to compare results with other regions. We conducted a study to examine the association using the European Union (EU) Refe...

Background: Various rainfall conditions could promote the transmission of diarrhoeal diseases by affecting the pathogen concentration in the environment. Given the diversity of rainfall patterns across different climates, this study explored the associations between rainfall and diarrhoeal mortality in tropical, temperate, and arid regions. Metho...

Background The global spatiotemporal pattern of mortality risk and burden attributable to tropical cyclones is unclear. We aimed to evaluate the global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019. Methods The wind speed associated with cyclones from 1980 to 2019 was estimated globally through a parametr...

Background: Epidemiological evidence on the health risks of sulfur dioxide (SO2) is more limited compared with other pollutants, and doubts remain on several aspects, such as the form of the exposure-response relationship, the potential role of copollutants, as well as the actual risk at low concentrations and possible temporal variation in risks....

In July 2022, Spain experienced an excessive heat episode during which many cities broke temperature records. According to the Spanish Meteorological Agency, it has been the warmest month in Spain ever, at least since 1961. We estimated the mortality attributable to heat using the observed daily mortality by the Spanish daily mortality surveillance...

Desert dust and sandstorms are recurring environmental phenomena that are reported to produce serious health risks worldwide. This scoping review was conducted to identify the most likely health effects of desert dust and sandstorms and the methods used to characterize desert dust exposure from the existing epidemiological literature. We systematic...

Background: Heat and cold are established environmental risk factors for human health. However, mapping the related health burden is a difficult task due to the complexity of the associations and the differences in vulnerability and demographic distributions. In this study, we did a comprehensive mortality impact assessment due to heat and cold in...

Objective This study aims to determine the contribution of comorbidities to excess psychogenic nonepileptic seizures (PNES) mortality. Methods A retrospective cohort study was conducted of tertiary epilepsy outpatients from St. Vincent's Hospital Melbourne, Australia with an 8:1 comparison cohort, matched by age, sex, and socioeconomic status (SES...

Background: Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. Objectives: We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest...

Background Although adaptation to continuously rising ambient temperatures is an emerging topic and has been widely studied at a global scale, detailed analysis of the joint indicators for long-term adaptation in Spain are scarce. This study aims to explore temporal variations of the minimum mortality temperature and mortality burden from heat and...

Background: Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. Methods: We used unified data...

Background and aim Short-term associations between air pollution and mortality have been well reported in Japan, but the historical changes in mortality risk remain unknown. We examined temporal changes in the mortality risks associated with short-term exposure to four criteria air pollutants in selected Japanese cities. Methods We collected daily...

Risk estimators for COVID-19 propagation based on the incidence rate of new cases can be misleading as they usually fail to account for the fraction of population immunized by infection or vaccination.This misconception yields different incidence rates, as we illustrate using the daily number of COVID-19 reported cases in Spain during the pre-vacci...

Background Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortali...

Human health is linked to climatic factors in complex ways, and climate change can have profound direct and indirect impacts on the health status of any given region. Susceptibility to climate change is modulated by biological, ecological and socio-political factors such as age, gender, geographic location, socio-economic status, occupation, health...

Background and aim The associations between COVID-19 transmission and meteorological factors are scientifically debated. Several studies have been conducted worldwide, with inconsistent findings. However, often these studies had methodological issues, e.g., did not exclude important confounding factors, or had limited geographic or temporal resolut...

The data presented in this article is part in essence of a more extensive dataset aimed at evaluating patterns of change in the temperature–mortality relationship on population health in the city of Valencia, Spain on population health in the city of Valencia, Spain. The complete dataset was used in the framework of the European multi-city project...

Background: Preterm birth is the leading cause of death in newborns and children. Tocolytic drugs aim to delay preterm birth by suppressing uterine contractions to allow time for administration of corticosteroids for fetal lung maturation, magnesium sulphate for neuroprotection, and transport to a facility with appropriate neonatal care facilities...