Mortality burden attributable to PM1 in Zhejiang province, China

Kejia Hu; Yuming Guo; Deyun Hu; Rongguang Du; Xuchao Yang; Jieming Zhong; Fangrong Fei; Feng Chen; Gongbo Chen; Qi Zhao; Jun Yang; Yunquan Zhang; Qian Chen; Tingting Ye; Shanshan Li; Jiaguo Qi

doi:10.1016/j.envint.2018.09.033

Mortality burden attributable to PM₁ in Zhejiang province, China

Environ Int. 2018 Dec;121(Pt 1):515-522. doi: 10.1016/j.envint.2018.09.033. Epub 2018 Oct 3.

Authors

Kejia Hu¹, Yuming Guo², Deyun Hu³, Rongguang Du³, Xuchao Yang⁴, Jieming Zhong⁵, Fangrong Fei⁶, Feng Chen⁷, Gongbo Chen², Qi Zhao², Jun Yang⁸, Yunquan Zhang⁹, Qian Chen¹⁰, Tingting Ye¹⁰, Shanshan Li², Jiaguo Qi¹¹

Affiliations

¹ Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.
² Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.
³ Hangzhou Meteorological Service, Hangzhou 310051, China.
⁴ Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Center for Global Change and Earth Observations, Michigan State University, East Lansing 48823, USA. Electronic address: yangxuchao@zju.edu.cn.
⁵ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China. Electronic address: jmzhong@cdc.zj.cn.
⁶ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
⁷ Zhejiang Institute of Meteorological Sciences, Hangzhou 310008, China.
⁸ Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
⁹ Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China.
¹⁰ Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China.
¹¹ Center for Global Change and Earth Observations, Michigan State University, East Lansing 48823, USA.

PMID: 30292144
DOI: 10.1016/j.envint.2018.09.033

Abstract

Background: Limited evidence is available on the health effects of particulate matter with an aerodynamic diameter of <1 μm (PM₁), mainly due to the lack of its ground measurement worldwide.

Objectives: To identify and examine the mortality risks and mortality burdens associated with PM₁, PM_2.5, and PM₁₀ in Zhejiang province, China.

Methods: We collected daily data regarding all-cause (stratified by age and gender), cardiovascular, stroke, respiratory, and chronic obstructive pulmonary disease (COPD) mortality, and PM₁, PM_2.5, and PM₁₀, from 11 cities in Zhejiang province, China during 2013 and 2017. We used a quasi-Poisson regression model to estimate city-specific associations between mortality and PM concentrations. Then we used a random-effect meta-analysis to pool the provincial estimates. To show the mortality burdens of PM₁, PM_2.5, and PM₁₀, we calculated the mortality fractions and deaths attributable to these PMs.

Results: Daily concentrations of PM₁, PM_2.5, and PM₁₀ ranged between 0-199 μg/m³, 0-218 μg/m³, and 0-254 μg/m³, respectively; Mortality effects were significant in lag 0-2 days. The relative risks for all-cause mortality were 1.0064 (95% CI: 1.0034, 1.0094), 1.0061 (95% CI: 1.0034, 1.0089), and 1.0060 (95% CI: 1.0038, 1.0083) associated with a 10 μg/m³ increase in PM₁, PM_2.5, and PM₁₀, respectively. Age- and gender-stratified analysis shows that elderly people (aged 65+) and females are more sensitive to PMs. The mortality fractions of all-cause mortality were estimated to be 2.39% (95% CI: 1.28, 3.48) attributable to PM₁, 2.53% (95% CI: 1.42, 3.63) attributable to PM_2.5, and 3.08% (95% CI: 1.95, 4.19) attributable to PM₁₀. The ratios of attributable cause-specific deaths for PM₁/PM_2.5, PM₁/PM₁₀, and PM_2.5/PM₁₀ were higher than the ratios of their respective concentrations.

Conclusions: PM₁, PM_2.5 and PM₁₀ are risk factors of all-cause, cardiovascular, stroke, respiratory, and COPD mortality. PM₁ accounts for the vast majority of short-term PM_2.5- and PM₁₀-induced mortality. Our analyses support the notion that smaller size fractions of PM have a more toxic mortality impacts, which suggests to develop strategies to prevent and control PM₁ in China, such as to foster strict regulations for automobile and industrial emissions.

Keywords: Air pollution; China; Mortality; Mortality burden; PM(1); Particulate matter.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Air Pollutants / analysis
Air Pollutants / toxicity*
Cause of Death*
Child
Child, Preschool
China
Cities
Environmental Exposure* / analysis
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Mortality
Particulate Matter / analysis
Particulate Matter / toxicity*
Risk Assessment
Young Adult

Substances

Air Pollutants
Particulate Matter