Years of Life Lost (YLL) Due to Short-Term Exposure to Ambient Air Pollution in China: A Systematic Review and Meta-Analysis.

Yang Ni,Wang Song,Ying Bian,Yu Bai,Guoxing Li,Qiang Zeng,Tao Liu

doi:10.3390/ijerph182111467

Abstract

(1) Background: Years of life lost (YLL) as a surrogate of health is important for supporting ambient air pollution related policy decisions. However, there has been little comprehensive evaluation of the short-term impact of air pollution on cause-specific YLL, especially in China. Hence in this study, we selected China as sentinel region in order to conduct a meta-analysis to evaluate disease-specific YLL due to all the main ambient air pollutants. (2) Methods: A meta-analysis was conducted to evaluate disease-specific YLL due to the main ambient air pollutants in China, and 19 studies were included. We conducted methodological quality and risk of bias assessment for each included study as well as for heterogeneity and publication bias. Subgroup analysis and sensitivity analysis were also performed. (3) Results: Meta-analysis indicated that increases in PM2.5, PM10, SO2 and NO2 were associated with 1.99–5.84 years increase in YLL from non-accidental diseases. The increase in YLL to cardiovascular disease (CVD) was associated with PM10 and NO2, and the increase in YLL to respiratory diseases (RD) was associated with PM10. (4) Conclusions: Ambient air pollution was observed to be associated with several cause-specific YLL, increasing especially for elderly people and females.

Highlights

As the largest developing country in the world, China has experienced a rapid economic growth in recent decades
The definition of the research question of this systematic review and meta-analysis is as follows: “Is short-term exposure to ambient air pollution associated with changes in years of life lost (YLL)?” All papers were identified in four English databases (PubMed, EMBASE, Web of science and MEDLINE) and two Chinese databases (China National Knowledge Infrastructure and Wanfang Data) by using the combinations of ambient air pollution terms, YLL terms and location terms up to 10 April 2020
Our analysis focused on the associations of short-term exposure to the main ambient air pollutants with the cause-specific YLL for the entire population

Summary

Introduction

As the largest developing country in the world, China has experienced a rapid economic growth in recent decades. Along with this, China is facing a problem of serious ambient air pollution caused by energy consumption from coal combustion, as well as increasing industrial waste and motor vehicle use, which make it a country with one of the most serious levels of air pollution in the world [1,2]. China is at the most important stage of ambient air pollution control and more and more synthetically epidemiologic evidence is needed to support ambient air pollution related policy-making [3]. Previous comprehensive epidemiologic studies in China have linked ambient air pollution with increased mortality from all of kinds of disease [4,5,6]. The approach, using mortality as a surrogate of human health, gives equal weight to each death and may fail to consider the effects of the death age [7], so is less sensitive in assessing the premature death, which is a major factor to be considered in policy-making and resource allocation [8].

Methods

Results

Discussion

Conclusion