Burden of mortality and years of life lost due to ambient PM pollution in Wuhan, China.

Ambient particulate matter (PM) has been mainly linked with mortality and morbidity when assessing PM-associated health effects. Up-to-date epidemiologic evidence is very sparse regarding the relation between PM and years of life lost (YLL). The present study aimed to estimate the burden of YLL and mortality due to ambient PM pollution. Individual records of all registered deaths and daily data on PM and meteorology during 2009-2012 were obtained in Wuhan, central China. Using a time-series study design, we applied generalized additive model to assess the short-term association of 10-μg/m increase in PM with daily YLL and mortality, adjusting for long-term trend and seasonality, mean temperature, relative humidity, public holiday, and day of the week. A linear-no-threshold dose-response association was observed between daily ambient PM and mortality outcomes. PM pollution along lag 0-1 days was found to be mostly strongly associated with mortality and YLL. The effects of PM on cause-specific mortality and YLL showed generally similar seasonal patterns, with stronger associations consistently occurring in winter and/or autumn. Compared with males and younger persons, females and the elderly suffered more significantly from both increased YLL and mortality due to ambient PM pollution. Stratified analyses by education level (0-6 and 7 + years) demonstrated great mortality impact on both subgroups, whereas only low-educated persons were strongly affected by PM-associated burden of YLL. Our study confirmed that short-term PM exposure was linearly associated with significant increases in both mortality incidence and years of life lost. Given the non-threshold adverse effects on mortality burden, the on-going efforts to reduce particulate air pollution would substantially benefit public health in China.