Abstract 13699: Cardiovascular Health Impact of Air Pollution Control in Beijing and Urban China: Projections From the Cardiovascular Disease Policy Model-China

Abstract

Background: Air pollution ranks the 4th among risk factors responsible for China’s avoidable disease burden. We projected the potential cardiovascular health benefits achievable with sustained air quality improvement in Beijing and all of urban China. Methods: Coronary heart disease (CHD) and stroke mortality and life years gained were projected in adults aged 35-84 years in Beijing and urban China using the Cardiovascular Disease Policy Model-China. We simulated two air quality improvement scenarios from 2015-2030, each achieved gradually over 10 years: 1) the 2008 Beijing Olympics fine particle matter (PM2.5) level of 55 μg/m3, and 2) the World Health Organization (WHO) recommendation of 10 μg/m3. For comparison, we simulated a 50% reduction in active and secondhand smoking and reduction of systolic hypertension to 140 mmHg, each over 5 years. Relative risks of CHD, stroke and all-cause mortality associated with long term PM2.5 exposure were obtained from a meta-analysis of observational studies. Systolic blood pressure and smoking relative risks were estimated from China Multi-provincial Cohort Study. Results: PM2.5 reduction to 2008 Olympic levels in Beijing would reduce stroke deaths by 2.7%, CHD deaths by 7.2% over 2015-2030 and would gain life-years on the order of about a third of that projected for a 50% smoking reduction, and a fourth of that projected for systolic hypertension control (Table). However, achieving more aggressive WHO PM2.5 goal would yield greater life year gains than either tobacco or systolic blood pressure control. Achieving 2008 Olympics levels in urban China would prevent 304,000 stroke deaths, 619,000 CHD deaths, and gain 4.2 million life years over 2015-2030. Conclusions: Air pollution is a leading cardiovascular risk factor in Beijing and all urban China. We projected that lowering air pollution to Beijing Olympics level could prevent about 900,000 cardiovascular deaths and gain about 4.2 million life years in urban China by 2030.