School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Environ Health Perspect. 2019 Jan;127(1):17008. doi: 10.1289/EHP2711.
Coarse particulate matter with aerodynamic diameter between 2.5 and [Formula: see text] ([Formula: see text]) air pollution is a severe environmental problem in developing countries, but its challenges to public health were rarely evaluated.
We aimed to investigate the associations between day-to-day changes in [Formula: see text] and cause-specific mortality in China.
We conducted a nationwide daily time-series analysis in 272 main Chinese cities from 2013 to 2015. The associations between [Formula: see text] concentrations and mortality were analyzed in each city using overdispersed generalized additive models. Two-stage Bayesian hierarchical models were used to estimate national and regional average associations, and random-effect models were used to pool city-specific concentration-response curves. Two-pollutant models were adjusted for fine particles with aerodynamic diameter [Formula: see text] ([Formula: see text]) or gaseous pollutants.
Overall, we observed positive and approximately linear concentration-response associations between [Formula: see text] and daily mortality. A [Formula: see text] increase in [Formula: see text] was associated with higher mortality due to nonaccidental causes [0.23%; 95% posterior interval (PI): 0.13, 0.33], cardiovascular diseases (CVDs; 0.25%; 95% PI: 0.13, 0.37), coronary heart disease (CHD; 0.21%; 95% PI: 0.05, 0.36), stroke (0.21%; 95% PI: 0.08, 0.35), respiratory diseases (0.26%; 95% PI: 0.07, 0.46), and chronic obstructive pulmonary disease (COPD; 0.34%; 95% PI: 0.12, 0.57). Associations were stronger for cities in southern vs. northern China, with significant differences for total and cardiovascular mortality. Associations with [Formula: see text] were of similar magnitude to those for [Formula: see text] in both single- and two-pollutant models with mutual adjustment. Associations were robust to adjustment for gaseous pollutants other than nitrogen dioxide and sulfur dioxide. Meta-regression indicated that a larger positive correlation between [Formula: see text] and [Formula: see text] predicted stronger city-specific associations between [Formula: see text] and total mortality.
This analysis showed significant associations between short-term [Formula: see text] exposure and daily nonaccidental and cardiopulmonary mortality based on data from 272 cities located throughout China. Associations appeared to be independent of exposure to [Formula: see text], carbon monoxide, and ozone. https://doi.org/10.1289/EHP2711.
空气动力学直径在 2.5 到 [Formula: see text] 之间的粗颗粒物（[Formula: see text]）是发展中国家的一个严重的环境问题，但它对公众健康的挑战很少得到评估。
我们旨在研究中国 [Formula: see text] 的日变化与特定原因死亡率之间的关系。
我们于 2013 年至 2015 年在中国 272 个主要城市进行了全国性的每日时间序列分析。使用过度分散广义加性模型在每个城市分析 [Formula: see text] 浓度与死亡率之间的关系。使用两阶段贝叶斯层次模型估计全国和地区平均关联，并使用随机效应模型汇集城市特定的浓度-反应曲线。双污染物模型调整了空气动力学直径为 [Formula: see text] 的细颗粒物（[Formula: see text]）或气态污染物。
总的来说，我们观察到 [Formula: see text] 与每日死亡率之间存在正的、近似线性的浓度-反应关联。[Formula: see text] 增加 [Formula: see text] 与非意外原因导致的死亡率升高有关[0.23%；95%后验区间（PI）：0.13，0.33]，心血管疾病（CVDs；0.25%；95%PI：0.13，0.37），冠心病（CHD；0.21%；95%PI：0.05，0.36），中风（0.21%；95%PI：0.08，0.35），呼吸道疾病（0.26%；95%PI：0.07，0.46）和慢性阻塞性肺疾病（COPD；0.34%；95%PI：0.12，0.57）。与中国南部城市相比，中国北部城市的关联更强，总死亡率和心血管死亡率存在显著差异。在单污染物和双污染物模型中，在相互调整后，与 [Formula: see text] 的关联与与 [Formula: see text] 的关联具有相似的幅度。在调整除二氧化氮和二氧化硫以外的其他气态污染物后，关联仍然稳健。荟萃回归表明，[Formula: see text] 与 [Formula: see text] 之间的正相关关系越大，表明 [Formula: see text] 与总死亡率之间的城市特定关联越强。
本分析基于中国 272 个城市的数据显示，[Formula: see text] 短期暴露与非意外和心肺死亡率之间存在显著关联。关联似乎独立于 [Formula: see text]、一氧化碳和臭氧的暴露。https://doi.org/10.1289/EHP2711。
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