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Mortality Related to Air Pollution with the Moscow Heat Wave and Wildfire of 2010

Shaposhnikov, Dmitrya; Revich, Borisa; Bellander, Tomb,c; Bedada, Getahun Berob; Bottai, Matteob; Kharkova, Tatyanad; Kvasha, Ekaterinad; Lezina, Elenae; Lind, Tomasb; Semutnikova, Eugeniae; Pershagen, Göranb,c

doi: 10.1097/EDE.0000000000000090
Air Pollution

Background: Prolonged high temperatures and air pollution from wildfires often occur together, and the two may interact in their effects on mortality. However, there are few data on such possible interactions.

Methods: We analyzed day-to-day variations in the number of deaths in Moscow, Russia, in relation to air pollution levels and temperature during the disastrous heat wave and wildfire of 2010. Corresponding data for the period 2006–2009 were used for comparison. Daily average levels of PM10 and ozone were obtained from several continuous measurement stations. The daily number of nonaccidental deaths from specific causes was extracted from official records. Analyses of interactions considered the main effect of temperature as well as the added effect of prolonged high temperatures and the interaction with PM10.

Results: The major heat wave lasted for 44 days, with 24-hour average temperatures ranging from 24°C to 31°C and PM10 levels exceeding 300 μg/m3 on several days. There were close to 11,000 excess deaths from nonaccidental causes during this period, mainly among those older than 65 years. Increased risks also occurred in younger age groups. The most pronounced effects were for deaths from cardiovascular, respiratory, genitourinary, and nervous system diseases. Continuously increasing risks following prolonged high temperatures were apparent during the first 2 weeks of the heat wave. Interactions between high temperatures and air pollution from wildfires in excess of an additive effect contributed to more than 2000 deaths.

Conclusions: Interactions between high temperatures and wildfire air pollution should be considered in risk assessments regarding health consequences of climate change.

Supplemental Digital Content is available in the text.

From the aInstitute of Economic Forecasting, Russian Academy of Sciences, Moscow, Russia; bInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; cCentre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden; dInstitute of Demography, Higher School of Economics, Moscow, Russia; and eState Environmental Protection Institution Mosecomonitoring, Moscow, Russia.

Supported by grants from the Swedish Research Council FORMAS and the Swedish Environmental Protection Agency.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( This content is not peer-reviewed or copy-edited; it is the sole responsibility of the author.

Editors' note: A commentary on this article appears on page 365.

Correspondence: Göran Pershagen, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-171 77 Stockholm, Sweden. E-mail:

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