Seasonal analysis of the short-term effects of air pollution on daily mortality in Northeast Asia.

The constituents and concentrations of pollutants, individual exposures, and biologic responses to air pollution may vary by season and meteorological conditions. However, evidence regarding seasonality of the acute effects of air pollution on mortality is limited and inconsistent. Herein, we examined seasonal patterns in the short-term associations of particulate matter (PM) smaller than 10μm (PM) with daily mortality in 29 cities of three northeast Asian countries. Stratified time-series models were used to determine whether season altered the effect of PM on mortality. This effect was first quantified within each season and at each location using a time-series model, after which city-specific estimates were pooled using a hierarchical Bayesian model. In all data sets, 3,675,348 non-accidental deaths were registered from 1993 to 2009. In Japan, a 10μg/m increase in PM was significantly associated with increases in non-accidental mortality of 0.44% (95% confidence interval [CI]: 0.03%, 0.8%) in spring and 0.42% (0.02%, 0.82%) in fall. In South Korea, a 10μg/m increase in PM was significantly associated with increases in non-accidental mortality of 0.51% (0.01%, 1.01%) in summer and 0.45% (0.03%, 0.87%) in fall, in cardiovascular disease mortality of 0.96% (0.29%, 1.63%) in fall, and in respiratory disease mortality of 1.57% (0.40%, 2.75%) in fall. In China, a 10μg/m increase in PM was associated with increases in non-accidental mortality of 0.33% (0.01%, 0.66%) in summer and 0.41% (0.09%, 0.73%) in winter, in cardiovascular disease mortality of 0.41% (0.08%, 0.74%) in spring and 0.33% (0.02%, 0.64%) in winter, and in respiratory diseases mortality of 0.78% (0.27%, 1.30%) in winter. Our analyses suggest that the acute effect of particulate air pollution could vary seasonally and geographically.