Abstract
BackgroundAmbient air pollution has posed negative effects on human health. Individual-level factors may modify this effect, but previous studies have controversial conclusions, and evidence is lacking especially in developing countries. This study aims to examine the modifying effects of sex, age, and education level of individuals on the associated between daily mortality and air pollutants, including particulate matter < 10 μm in aerodynamic diameter (PM10), sulfur dioxide (SO2), and nitrogen dioxide (NO2).MethodsTime-series analysis was conducted to investigate the acute effects of the air pollution on daily mortality from January 2002 to December 2010 in Wuhan, China. Generalized Additive Models (GAM) were used to examine the association stratified by sex for non-accidental, cardiovascular, and respiratory mortality. For non-accidental mortality, stratified analysis was also conducted by age and educational level.ResultsOutdoor air pollution was associated with daily non-accidental and cardiovascular mortality. An increase of 10 μg/m3 in a 2-day average concentration of PM10, SO2, and NO2 was corresponding to the increase in non-accidental mortality of 0.29% (95%CI: 0.06–0.53%), 1.22% (95%CI: 0.77–1.67%) and 1.60% (95%CI: 1.00–2.19%), respectively. The effects of air pollution were faster in females than males. The magnitude of the estimates was higher for females with low education, aged 65–75 years for PM10 and < 65 years for SO2. To be more specific, we observed that per 10 μg/m3 increase in SO2 was association with increases in non-accidental mortality of 2.03% (95%CI: 1.38–2.67) for all females and 3.10% (95%CI: 2.05–4.16) for females with low education.ConclusionFemales and people with low-education are more susceptible to the effect of air pollution, which would provide a sound scientific basis for determination of air pollution standards.
Highlights
Ambient air pollution has posed negative effects on human health
Our study found higher effects of NO2 on respiratory mortality in females than in males, with per 10 μg/m3 increase associated with a 3.84% increase in respiratory mortality for females
We examined susceptibilities to air pollution stratified by education and found higher effects were observed in the lower education category for non-accidental mortality, though the differences were insignificant
Summary
Ambient air pollution has posed negative effects on human health. Individual-level factors may modify this effect, but previous studies have controversial conclusions, and evidence is lacking especially in developing countries. Numerous epidemiological studies have shown exposure to air pollution closely associated with several adverse health outcomes, such as increased total mortality, cause-specific mortality, hospitalizations, and morbidity of asthma and lung cancer [1,2,3,4,5]. Such effect could be modified by individual-level factors including sex, age, and socioeconomic status (SES) [6,7,8,9,10,11,12,13]. Few studies have been previously conducted in China, where ambient air pollution has been regarded as the fourth leading risk factor for disability-adjusted life-years (DALYs) [20]
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