Yang J, Yin P, Zeng X Y, You J L, Zhao Y F, Wang Z Q, Zhou M G
Division of Science, Education and International Cooperation, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Division of Vital Registry and Mortality Surveillance , National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Nov 10;39(11):1449-1453. doi: 10.3760/cma.j.issn.0254-6450.2018.11.006.
To analyze the deaths attributed to ambient air pollution in China between 2006 and 2016. The data were collected from the project of Global Burden of Disease in 2016 (GBD2016). The Data Integration Model for Air Quality were used to estimate exposure to particulate matter smaller than 2.5 μm in aerodynamic diameter (PM(2.5)). The attributable death number was calculated based on the calculation of population attributable fraction (PAF), and the results were compared by gender, diseases and provinces. An average world population age structure was adopted to calculate age-standardized rates. In 2016, a total of 1 075 000 deaths attributed to ambient air pollution occurred in China, accounting for 11.1% of the total deaths, and 57.6% of the deaths attributed to ambient air pollution were due to ischemic heart disease and stroke. The death number among men was 1.7 times higher than that in women, Compared with 2006, the proportion of ambient air pollution related deaths in total deaths decreased by 6.8%; the age- standardized death rate attributed to ambient air pollution decreased by 26.5% and the decrease rate of lower respiratory infections (37.6%) and chronic obstructive pulmonary disease (42.1%) were greater than ischemic heart disease (5.3%). The age-standardized rate of death attributed to ambient air pollution decreased both in men and in women, but the decrease rate was higher in women (34.8%) than that in men (20.4%). The PAFs varied among provinces, it was highest in Tianjin (13.9%), lowest in Tibet (6.1%), and it was relatively higher in Beijing, Hebei, Shandong, Henan and the three provinces in the northeast and relatively lower in Hong Kong, Macao, Fujian and Hainan etc.. The age-standardized rate of death attributed to ambient air pollution was highest in Xinjiang (120.1/100 000) and lowest in Hong Kong (30.9/100 000), and it was relatively higher in Qinghai, Guizhou, Henan and relatively lower in Macao, Shanghai and Fujian, etc.. Compared with 2006, the PAFs of 17 provinces decreased, the decrease rate ranged from 4.1% to 16.8%, whereas the PAF of Jilin (5.0%) and Heilongjiang (8.1%) increased, and the PAFs of other 14 provinces showed no significant change. The attributable age-standardized death rate decreased in all provinces with the decrease rate ranging from 11.9% (Heilongjiang) to 43.2% (Fujian), and the decrease rate was relatively higher in Guangdong, Zhejiang and Guizhou, and lower in the three provinces in the northeast, Hubei and Hebei . In 2016, the disease burden attributable to PM(2.5) in China was heavy, but mitigated compared with 2006. The gender and area specific distributions of deaths attributed to ambient air pollution were observed.
分析2006年至2016年间中国因环境空气污染导致的死亡情况。数据来自2016年全球疾病负担项目（GBD2016）。采用空气质量数据整合模型估算空气动力学直径小于2.5μm的颗粒物（PM2.5）暴露情况。基于人群归因分数（PAF）计算归因死亡数，并按性别、疾病和省份进行结果比较。采用世界平均人口年龄结构计算年龄标准化率。2016年，中国共有107.5万人死于环境空气污染，占总死亡人数的11.1%，其中57.6%的环境空气污染所致死亡归因于缺血性心脏病和中风。男性死亡人数是女性的1.7倍。与2006年相比，环境空气污染相关死亡占总死亡的比例下降了6.8%；环境空气污染归因年龄标准化死亡率下降了26.5%，下呼吸道感染（37.6%）和慢性阻塞性肺疾病（42.1%）的下降幅度大于缺血性心脏病（5.3%）。环境空气污染归因年龄标准化死亡率在男性和女性中均下降，但女性下降幅度（34.8%）高于男性（20.4%）。PAF在各省份间存在差异，天津最高（13.9%），西藏最低（6.1%），北京、河北、山东、河南及东北三省相对较高，香港、澳门、福建和海南等相对较低。环境空气污染归因年龄标准化死亡率新疆最高（120.1/10万），香港最低（30.9/10万），青海、贵州、河南相对较高，澳门、上海和福建等相对较低。与2006年相比，17个省份的PAF下降，下降幅度为4.1%至16.8%，而吉林（5.0%）和黑龙江（8.1%）的PAF上升，其他14个省份的PAF无显著变化。所有省份的归因年龄标准化死亡率均下降，下降幅度从黑龙江的11.9%至福建的43.2%不等，广东、浙江和贵州下降幅度相对较大，东北三省、湖北和河北下降幅度较小。2016年，中国PM2.5所致疾病负担较重，但与2006年相比有所减轻。观察到环境空气污染所致死亡的性别和地区特异性分布。
