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Table 1 Descriptive information for all included studies, categorized by the combination of risk factor exposures

From: Synergistic health effects of air pollution, temperature, and pollen exposure: a systematic review of epidemiological evidence

Study Type Location Duration Outcome Population Pollutants Measured Pollen Measured Temperature Measurement
Air pollution, heat, and pollen (n = 6)
 Respiratory
  Hebbern 2015 [47] Time series 10 Canadian cities Apr 1994- Mar 2007 Asthma hospital admissions Not reported CO, O3, NO2, SO2, PM10, PM2.5 Weed, tree, grass Daily Mean
  Makra 2015 [48] Time series Szeged, Hungary 1999–2007 Asthma emergency room visits 0–14 years; 15–64 years; 65+ years (n = 936 asthma ER visits) CO, NO, NO2, SO2, O3, PM10 Ambrosia, maple, alder, mugwort, birch, hemp, hornbeam, goosefoot, hazel, ash, walnut, mulberry, pine, plantain, platan, grasses, poplar, oak, dock, willow, yew, linden, elm, nettle Daily Mean, daily maximum, daily minimum, daily range
  Matyasovszky 2011 [49] Time series Szeged, Hungary 1999–2007 Respiratory hospital admissions All ages; 15–64 years; 65+ years (n = 133,464 hospital admission) CO, NO, NO2, SO2, O3, PM10 Ambrosia, maple, alder, mugwort, birch, hemp, hornbeam, goosefoot, hazel, ash, walnut, mulberry, pine, plantain, platan, grasses, poplar, oak, dock, willow, yew, linden, elm, nettle Daily mean, maximum, minimum, range
  Mazenq 2017 [50] Nested case control Southeastern France Jan 2013-Dec 2013 Asthma emergency room visits 3–18 years (n = 1182 asthma ER visits) PM10, PM2.5 cypress, birch, ash, grass, urticaceae Daily average
  Mireku 2009 [51] Retrospective time series Detroit, MI Jan 2004- Dec 2005 Asthma emergency room visits 1–18 years (n = 25,401 asthma ER visits) PM2.5, PM10, SO2, O3 Total Daily average
  Witonsky 2019 [52] Retrospective cohort Bronx, NY Jan 2001- Dec 2008 Asthma emergency room visits and hospitalizations All ages (n = 42,065 asthma ER visits; n = 1664 asthma-related hospitalizations) NOx, O3, SO2 Grass, weed, tree, Daily average
Air pollution and temperature (n = 39)
 Multiple health endpoints
  Analitis 2014 [53] Ecological time series 9 European cities 1990–2004 All natural, cardiovascular, and respiratory mortality 0–64, 65–74, 75–84, and 85+ years (n not reported) SO2, PM10, NO2, O3, CO   3-h average
  Analitis 2018 [54] Ecological time series 9 European cities 2004–2010 All natural, cardiovascular, and respiratory mortality All ages; 15–64, 65–74, 75+ years (n not reported) PM10, O3, NO2   Daily mean
  Breitner 2014 [55] Time series Bavaria, Germany 1990–2006 Non accidental, cardiovascular, respiratory mortality < 85, 85+ years (n = 338,631 deaths) PM10, O3   Daily mean
  Cheng 2012 [56] Time series Shanghai, China 2001–2004 Non-accidental, cardiovascular, respiratory mortality All ages (n = 173,911 deaths) PM10, O3, SO2, NO2   Daily minimum, maximum, mean
  Li 2011 [57] Time Series Tianjin, China 2007–2009 Cardiovascular, respiratory, cardiopulmonary, stroke and IDH, Non accidental mortality All ages; < 65, 65+ years (n = 111,087 deaths) PM10, SO2, NO2   Daily mean
  Li 2015 [58] Time Series Guangzhou, China 2003–2011 Non accidental mortality, cardiovascular mortality, respiratory mortality < 65, 65+ years (n = 213,737 deaths) PM10   Daily mean
  Lokys 2018 [59] Time series 28 districts, Germany 2001–2011 Cardiovascular and respiratory hospital admissions Not reported NO2, SO2, O3, PM10   Daily mean
 All-cause or non-accidental only
  Burkart 2013 [60] Time Series Berlin and Lisbon 1998–2010 All cause mortality Age not reported (n = 698,586 deaths) PM10, O3   Hourly mean
  Chen 2018a [61] Time series 8 European cities 1999–2013 Non accidental mortality 0–74, 75+ years (n = 742,526 deaths) PM2.5, PM10, O3   Daily mean
  Chen 2018b [62] Time Series 8 European cities; 86 US Cities 1999–2013; 1987–2000 Non accidental mortality All ages (n not reported) PM10, NO2, O3   Daily mean
  Dear 2005 [63] Time series 12 French cities Aug-03 All cause mortality All ages (n not reported) O3   24 h Minimum, maximum
  Filleul 2006 [64] Time series 9 French cities Aug-03 All cause mortality All ages (n not reported) O3   Daily maximum
  Jhun 2014 [65] Time series 97 cities 1987–2000 Non accidental mortality 0–99 years (n not reported) O3   Daily high
  Kim 2015 [66] Time series 7 South Korean cities Jan 2000-Dec 2009 Daily non accidental deaths < 65, 65+ years (n = 828,787 deaths) PM10   Daily mean
  Liu 2016 [67] Time Series 20 US communities 1987–2000 Non accidental mortality Not reported O3   Daily mean
  Meng 2012 [68] Time series 8 Chinese cities 2001–2008 Non accidental mortality Not reported PM10   Daily mean
  Moolgavkar 2003 [69] Time Series Cook County, IL & LA County, CA 1987–1995 Non accidental mortality All ages; 65+ years (n not reported) O3, SO2, NO2, CO, PM   Daily minimum, median, maximum
  Park 2011 [70] Time series Seoul, South Korea Jun 1999- Dec 2007 Non accidental mortality All ages; 65–74, 75–84, 85+ years (n = 291,665 deaths) PM10, NO2, SO2, CO, O3   Daily mean, minimum, maximum
  Pattenden 2010 [71] Time series 15 conurbations in England and Wales 1993–2003 All cause mortality 0–64, 65–74, 75–84, 85+ years (n not reported) O3, PM10   Two day Mean
  Peng 2013 [72] Time series 23 European Cities; 12 Canadian Cities; 86 US cities Canada 1987–1996; Europe 1990–1997; US 1987–1996 Non accidental mortality All ages; < 75, 75+ years (n not reported) NO2, SO2, O3, PM10   Daily mean
  Rainham 2005 [73] Time series Toronto, Canada 1981–1999 Non Trauma mortality Not reported CO, NO2, SO2, O3, PM2.5   Daily mean
Scortichini 2018 [74] Time series 25 Italian cities 2006–2010 Mortality from natural causes 35+ years (n = 187,743 deaths) O3, PM10   Daily mean
  Shaposhnikov 2014 [75] Time series Moscow, Russia 2006–2009, 2010 Non accidental mortality All ages; < 65, 65+ years (n = 10,860 deaths) O3, PM10   Daily mean
  Stafoggia 2008 [76] Case crossover 9 Italian cities 1997–2004 Mortality from natural causes 35+ years (n = 321,024 deaths) PM10   Daily mean, apparent
  Sun 2015 [77] Time Series Hong Kong 1999–2011 Mortality from natural causes Age not reported (n = 456,317 deaths) PM2.5, NO2, SO2, O3   Daily mean
  Vanos 2015 [78] Time series 12 Canadian cities 1981–2008 Non accidental mortality Not reported O3, NO2, PM2.5, SO2   Daily mean
  Wilson 2014 [79] Time Series 95 US cities 1987–2000 Mortality Not reported O3   Daily mean
  Zhang 2006 [80] Time series Shanghai, China Jan 2001- Dec 2004 Non accidental mortality All ages; 0–4, 5–44, 45–64, 65+ years (n = 173,911 deaths) O3, PM10, SO2, NO2   Daily mean
 Respiratory only
  Ding 2017 [81] Case crossover Taiwan 2000–2013 COPD mortality 40–64, 65–79, 80+ years (n not reported) PM2.5, O3, SO2   Daily mean, maximum, minimum
  Jo 2017 [82] Time series Busan, South Korea 2007–2010 Hospital admissions for respiratory disease 0–15,16–64, 65+ years (n not reported) PM2.5, PM10   Daily average, minimum, maximum, range
  Kunikullaya 2017 [83] Retrospective ecological time series Bangalore, India One year Asthma-related emergency room visits and hospitalizations > 18 years (n not reported) SO2, NO2, PM10, PM2.5   Daily mean
  Lam 2016 [84] Time series Hong Kong 2004–2011 Asthma hospitalizations < 5, 5–14, 15–59, 60+ years (n = 56,112 asthma admission) PM10, SO2, NO2, O3   Daily mean
  Mirabelli 2016 [85] Retrospective cross sectional United States 2006–2010 Asthma symptoms 18+ years (n = 50,356 respondents) PM2.5, O3   Average daily mean
  Qiu 2018 [86] Time series Chengdu, China Jan 2015- Dec 2016 COPD hospital admissions All ages; < 60, 60–70, 70–80, 80+ years (n = 54,966 COPD admission) PM10, PM2.5, NO2, SO2, CO, O3   Daily mean
  Winquist 2014 [87] Time Series Atlanta, GA 16 years Asthma emergency department visits 5–17 years (n not reported) CO, NO2, SO2, O3, PM2.5   Daily minimum, maximum,
 Cardiovascular only
  Lee 2018 [88] Case crossover Seoul, South Korea 2008–2014 Migraine emergency room visits All ages; < 40, 40–64, 65+ years (n = 18,921 ER visits) PM2.5, PM10, NO2, SO2, O3, CO   Hourly mean
  Luo 2017 [89] Time series 3 Chinese cities 2008–2011 Cardiovascular mortality All ages; < 65, 65+ years (n = 290,593 deaths) PM10, NO2, SO2   Daily minimum, maximum, mean
  Ren 2008 [90] Time Series 95 US cities 1987–2000 Cardiovascular mortality < 65, 65–74, 75+ years (n = nearly 4 million cardiovascular deaths) O3   Daily maximum
  Ren 2009 [91] Time series 95 US cities 1987–2000 Cardiovascular mortality < 65, 65–74, 74+ years (n= > 4.3 million cardiovascular deaths) O3   Daily maximum
Air pollution and pollen (n = 10)
 Respiratory
  Anderson 1998 [92] Time series London Apr 1987- Feb 1992 Asthma emergency admissions All ages; 0–14, 15–64, 65+ years (n not reported) O3, NO2, Black smoke, SO2 Birch, Grass, Oak Mean 24 h
  Cakmak 2012 [93] Time series 11 Canadian cities Apr 1994-Mar 2007 Asthma hospital admissions Not reported CO, PM2.5, PM10, NO2, SO2 Tree, Weed Mean 24 h
  Chen 2016 [94] Time-series case-crossover Adelaide, South Australia Jul 2003- Jun 2013 Asthma hospital admissions 0–17, 18+ years (n = 36,024admissions) PM2.5, NO2, PM10 Ash tree, birch, cypress, eucalyptus, fruit tree, olive tree, pinus, plane tree, she-oak, wattle, chenopodiaceae, compositae, plantain, polygonaceae, salvation jane, grass Daily average
  Cirera 2012 [95] Time series Cartagena, Spain Jan 1995- Dec 1998 COPD and asthma emergency room visits, Age not reported (n = 1617 asthma and 2322 COPD ER visits) SO2, NO2, TSP, O3 Poaceae, Urticaceae Hourly mean
  Galan 2003 [96] Time series Madrid, Spain 1995–1998 Asthma emergency department visits Age not reported (n = 4827 asthma attacks) SO2, PM10, NO2, O3, CO Olea europaea, Plantago sp., Poaceae, Urticaceae Daily mean
  Gleason 2014 [97] Time-stratified case-crossover New Jersey April - Sept 2004–2007 Asthma emergency department visits 3–17 years (n = 21,854 asthma ED visits) O3, PM Tree, grass, weed, ragweed Daily mean
  Goodman 2017 [98] Time series New York City 1999–2009 Asthma hospital Admissions < 6, 6–18, 19–49, 50+ years (n = 295,497 asthma admission) O3, PM Tree, weed, total Daily average, maximum, minimum
  Krmpotic 2011 [99] Time series Zagreb, Croatia Jan 2004- Dec 2006 Asthma hospital admissions > 18 years (n = 4125 asthma admissions) NO2, CO, PM10 Alder, Hazel, Birch, Hornbeam, Oak, Grasses, Ragweed Daily minimum, maximum, mean
  Ross 2002 [100] Prospective Cohort East Moline, IL 7 months Peak Expiratory flow rates, respiratory symptoms, frequency of asthma attacks, asthma medication use 5–49 years (n = 59 people) O3, PM, SO2 Grass, Ragweed, Total Daily mean, Maximum
 Cardiovascular
  Stieb 2000 [101] Time series Saint John, Canada Jul 1992- Jun 1994, Jul 1994- Mar 1996 Cardiorespiratory emergency department visits Age not reported (n = 19,821) CO, H2S, NO2, O3, SO2, TRS Ascomycetes, basidiomycetes, deuteromycetes, ferns, grass, tree, weed Daily average
Heat and pollen (n = 1)
 Silverberg 2015 [102] Cohort Study United States 2006 Pediatric hay fever 0–17 years (n = 91,642) Total Monthly mean