Six air pollutants and cause-specific mortality: a multi-area study in nine counties or districts of Anhui Province, China.

Air pollution and its negative effects on health of people have been a global concern. Many studies had found a strong association between air pollutants and risk of death, but few had focused on the effects of six pollutants and rural areas. Our study aimed to investigate the effects of six air pollutants (CO, NO, O, PM, PM, and SO) on non-accidental and respiratory deaths in rural areas of Anhui Province by adjusting for confounding factors, and to further clarify which populations were susceptible to death associated with air pollution. In the first phase of the analysis, the generalized additive models were combined with the distributed lag non-linear models to evaluate the individual effects of air pollution on death in each area. In the second stage, random-effects models were used to aggregate the associations between air pollutants and mortality risk in nine areas. Overall, six pollutants had the strongest effects on the risk of death on the lag 07 days. The associations between PM and NO and daily non-accidental deaths were strongest, with maximum RR (lag 07): 1.63 (1.37-1.88) and 1.67 (1.37-1.96). The maximum pooled effects of association between six air pollutants and RD were PM, with RR (lag 07): 1.89 (1.45-2.34). PM and PM had significant differences between the elderly and the non-elderly with respectively, RRR: 1.22 (1.04-1.41) and 1.26 (1.11-1.42). In general, we found that six air pollutants were the important risk factors for deaths (deaths from respiratory disease and non-accidental) in rural areas of Anhui Province. PM and PM had a considerable impact on the elderly.