The quantitative assessment of the public excess disease burden advanced by inhalable particulate matter under different air quality standard targets in Tianjin, China.

Currently, the quantitative assessment of the public excess risk for the update of the air quality guidelines only considered the mortality and morbidity without disease burden indicators. To provide evidences for the update of air quality guidelines and the policy analysis of air control, a simple framework to identify the excess disease burden of PM was used in this study. Daily data on PM, meteorological factors, and deaths were collected in this 10-year (2001-2010) time series study in Tianjin, China. The excess disease burden advanced by PM was assessed when the PM levels exceeded the expected levels. Generalized additive model was used to estimate the associations of PM with mortality and years of life lost (YLL). Our study found that the exposure of PM was associated with the increasing of mortality and YLL in different diseases. The excess deaths and YLL of different diseases advanced by PM when the PM levels exceeded the expected levels were high and showed a decreasing trend from 2001 to 2010. The annual deaths and YLL standardized per million population advanced by PM when the annual PM levels exceeded the China national ambient air quality secondary standard targets (70 μg/m) and WHO guideline (20 μg/m) were 126 persons, 2670 person years and 260 persons, 5449 person years, respectively. This study may provide a simple framework to identify the excess disease burden of PM and provide basic and intuitive evidences to update the air quality guidelines. Furthermore, these findings may also provide decisionmakers with intuitive quantitative information for policymaking and emphasize health considerations in air quality policy discussions.