Short-Term PM2.5 Exposure and Cause-Specific Mortality in China: A Multicounty Time-Series Analysis

Abstract

Efforts to understand the acute effects of PM2.5 concentration at low levels on health have a great deal of multiple centers epidemiologic research in developed countries. In order to identify how short-term exposed to PM2.5 can harm human health, it is crucial to estimate the exposure-response relationships at higher exposure. People in China have been exposed to particularly higher levels and few studies conducted in China showed different magnitudes of PM2.5 acute effect. Considering the severe pollution situation and the inconsistent effects, it is worth initiating more in-depth studies to understand of the acute effects of PM2.5 in China. Appling a county-specific quasi-Poisson regression in 59 counties over China Mainland, we estimated PM2.5 effects on death of all nature cause and 11 specific causes during 2013 to 2015. Then we pooled the county-specific results across China using a random effects meta-analysis. We found a 10 μg/m3 increment in PM2.5 at lag 0-1 day was significantly associated with a 0.14% (95% CI, 0.03–0.25) increase in the risk of all nature cause, a 0. 30% (0.01–0.58) increase in stroke, a 0.28% increase (0.07–0.50) in respiratory disease, a 0.29% (0.03–0.55) increase in chronic lower respiratory disease, and a 0.30% (0.03–0.56) increase in COPD. Associations for respiratory causes of death were larger than for cardiovascular causes, while the magnitudes were less than that reported in developed counties. These findings complemented evidence related to exposure-mortality relationships at the higher end of PM2.5 exposure as well as benefited to arrange strategies of health protection targeted to sensitive disease.