This study investigated the association of short-term exposure to PM10, PM2.5, NO2, O3, and CO with daily all-cause, cardiovascular, ischemic heart disease (IHD), cerebrovascular, and respiratory deaths in Mashhad, a tourist megacity in Iran (2014–2018). A distributed-lag-day, nonlinear model (DLNM) and generalized additive model (GAM) based on the quasi-Poisson distribution were used to explore the exposure-lag-day-response associations. The average (± standard deviation) concentrations of PM10, PM2.5, NO2, O3, and CO were 67.1 (± 35.5), 29.6 (± 14.2), 57.3 (± 24.1), 55.9 (± 16.9), and 1907.6 (± 1362.7) μg/m3, respectively. NO2 was associated with IHD mortality in lag-days 0 to 0–7, and lag-day 1. The relative risks (RRs) for a 10 μg/m3 increase in NO2 ranged from 1.01 (95% CI 0.93, 1.11) at lag-day 0 to 1.04 (95% CI 0.94, 1.16) and 1.03 (95% CI 0.93, 1.14) for lag-day 0–1 (cumulative) and lag-day 1 (non-cumulative), respectively. For all-cause mortality, cumulative exposure to PM2.5 for lag-day 0–7 (1.07, 95% CI 1.00, 1.15) and non-cumulative exposure to NO2 at lag-day 6 (1.02, 95% CI 1.00, 1.03) were significant. Exposure to PM10 (per 10 μg/m3) was significantly associated with respiratory mortality at several lag-days. Adjusting for Ramadan did not significantly affect the results. PM10 had significant associations with respiratory mortality of people > 65 years old, and men for several lag-days. For IHD, NO2 affected older people, and men and women over different lag-days. Results of multi-pollutant models were similar to the single-pollutant model outcomes. In conclusion, NO2 and PM10 had more significant relationships with adverse health outcomes than the other pollutants.

中文翻译：

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中东某旅游城市空气污染短期暴露与死亡率的相关性

本研究调查了马什哈德 (Mashhad) 的短期 PM10、PM2.5、NO2、O3 和 CO 与日常全因、心血管、缺血性心脏病 (IHD)、脑血管和呼吸系统死亡之间的关联。伊朗（2014-2018）。基于准泊松分布的分布式滞后日非线性模型 (DLNM) 和广义加性模型 (GAM) 用于探索暴露滞后日反应关联。PM10、PM2.5、NO2、O3和CO的平均（±标准差）浓度分别为67.1（±35.5）、29.6（±14.2）、57.3（±24.1）、55.9（±16.9）和1907.6（±） 1362.7) μg/m3，分别为。NO2 与滞后 0 至 0-7 天和滞后 1 天的 IHD 死亡率相关。 NO2 增加 10 μg/m3 的相对风险 (RR) 范围为 1.01 (95% CI 0.93, 1.11) 在滞后-第 0 天到 1.04 (95% CI 0.94, 1.16) 和 1。03 (95% CI 0.93, 1.14) 分别用于滞后第 0-1 天（累积）和滞后第 1 天（非累积）。对于全因死亡率，延迟第 0-7 天 PM2.5 的累积暴露（1.07，95% CI 1.00，1.15）和延迟第 6 天的 NO2 非累积暴露（1.02，95% CI 1.00，1.03 ) 很重要。暴露于 PM10（每 10 μg/m3）与几个滞后日的呼吸系统死亡率显着相关。调整斋月对结果没有显着影响。PM10 与 65 岁以上人群的呼吸系统死亡率显着相关，而男性则存在数个滞后日。对于 IHD，NO2 在不同的滞后天数影响老年人、男性和女性。多污染物模型的结果与单一污染物模型的结果相似。综上所述，