Temporal trends in respiratory mortality and short-term effects of air pollutants in Shenyang, China

Xiaoxia Xue,Jianping Chen,Xuelian Li,Baijun Sun,Baosen Zhou

doi:10.1007/s11356-018-1270-5

Abstract

Short-term exposures to air pollution are associated with acute effects on respiratory health. This study aimed to describe 10-year temporal trends in respiratory mortality in the urban areas of Shenyang, China, according to gender and age and estimate the effects of air pollution on respiratory diseases (ICD-10J00-J99) and lung cancer (ICD-10 C33-C34) using a case-crossover design. During the study period 2013–2015, the exposure-response relationship between ambient air pollutants and mortality data was fitted by a quasi-Poisson model. Age-standardized mortality rates for a combined number of respiratory diseases and for lung cancer declined in Shenyang; however, death counts increased with aging. Deaths from respiratory diseases increased by 4.7% (95% CI, 0.00–9.9), and lung cancer mortality increased by 6.5% (95% CI, 1.2–12.0), both associated with a 10 μg/m3 increase in exposure to particulate matter < 2.5 μg in diameter (PM2.5). Moreover, males in Shenyang’s urban areas were more susceptible to the acute effects of PM2.5 and SO2 exposure; people aged ≥ 65 years had a high susceptibility to ozone, and those aged < 65 years were more susceptible to other air pollutants. These results provided an updated estimate of the short-term effects of air pollution in Shenyang. Since population aging is also associated with increasing mortality from respiratory diseases and lung cancer, reinforcing air quality control measures and health-promoting behaviors is urgent and necessary in Shenyang.

Highlights

Over the recent decades, the air quality in China has worsened due to rapid economic development, accelerated urbanization, and industrialization (Zhang and Cao 2015)
The daily mean temperature is negatively correlated with air pollutants except for ozone; the largest correlation coefficient was found in SO2 with − 0.767
We have found positive associations between daily concentrations of air pollutants and mortality from respiratory diseases and lung cancer in Shenyang, China

Summary

Introduction

The air quality in China has worsened due to rapid economic development, accelerated urbanization, and industrialization (Zhang and Cao 2015). Because of the regional or seasonal heterogeneity, the urban air in northern China was generally more polluted than that in the south mainly due to the coal smoke. Associations between exposure to air pollution and mortality were observed in epidemiological studies in Shenyang (Ma et al 2011; Zhang et al 2011). Updated air pollution epidemiological study on all pollutants of interest, especially on PM2.5 in Shenyang city, is still very limited. Rapid population aging is occurring in Shenyang city. The fraction of population aged ≥ 65 years in Shenyang’s urban areas has increased by 13% since 2013, compared with only 9% in 2005. To better understand the association between air pollutants and mortality in Shenyang, especially in different age or gender groups, we evaluated 10year temporal changes in respiratory mortality and lung cancer mortality, and we examined the association between air pollutant exposure and daily respiratory death in Shenyang from 2013 to 2015 using a case-crossover analysis

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