National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, 20740, USA.
Chemosphere. 2022 Dec;308(Pt 2):136316. doi: 10.1016/j.chemosphere.2022.136316. Epub 2022 Sep 6.
A national and comprehensive evaluation is lacking on the relationship between short-term exposure to submicron particulate matter (PM) pollution and asthma mortality.
Data was obtained from 29,553 asthma deaths from the China National Mortality Surveillance System from 2015 to 2020. We used a bilinear interpolation approach to estimate each participant's daily ambient particulate matter pollution and meteorological variables exposure based on their geocoded residential address and a 10 km × 10 km grid from China High Air Pollutants and the fifth generation of European ReAnalysis-Land reanalysis data set. The associations were estimated using a time-stratified case-crossover design and conditional logistic regressions.
Our results revealed significant associations between short-term exposure to various particulate matter and asthma mortality. The 5-day moving average of particulate matter exposure produced the most pronounced effect. Compared to fine particulate matter (PM) and inhalable particulate matter (PM), significantly stronger effects on asthma mortality related to PM pollution were noted. The ERs% for asthma mortality associated with each interquartile range (IQR) increase of exposures to PM (IQR: 19.2 μg/m) was 5.59% (95% CI: 2.11-9.19), which is 14% and 22% higher than that for PM (IQR: 32.0 μg/m, 4.82% (95% CI: 1.84-7.90)) and PM (IQR: 52.2 μg/m, 4.37% (95% CI: 1.16-7.69)), respectively. The estimates remained consistent in various sensitivity analyses.
Our study provided national evidence that acute exposures to various ambient particulate matter pollution can increase mortality due to asthma in China, highlighting stronger associations with ambient PM than PM and PM. China needs to adjust the current ambient air quality standards urgently and pay greater attention to the adverse health effects of PM.
缺乏对亚微米颗粒物（PM）污染与哮喘死亡率之间短期暴露关系的全国性和综合性评估。
本研究数据来自 2015 年至 2020 年中国国家死因监测系统的 29553 例哮喘死亡病例。我们使用双线性插值方法，根据参与者的地理编码居住地址和中国高空气污染物与第五代欧洲再分析-陆地再分析数据集的 10km×10km 网格，估算每个参与者的每日环境颗粒物污染和气象变量暴露。采用时间分层病例交叉设计和条件逻辑回归估计关联。
我们的结果显示，短期暴露于各种颗粒物与哮喘死亡率之间存在显著关联。颗粒物暴露的 5 天移动平均值产生的影响最显著。与细颗粒物（PM）和可吸入颗粒物（PM）相比，PM 污染与哮喘死亡率的相关性更强。与 PM 暴露每增加一个四分位距（IQR）相关的哮喘死亡率的 ERs%（IQR：19.2μg/m）为 5.59%（95%CI：2.11-9.19），比 PM（IQR：32.0μg/m，4.82%（95%CI：1.84-7.90））和 PM（IQR：52.2μg/m，4.37%（95%CI：1.16-7.69））分别高 14%和 22%。在各种敏感性分析中，估计结果保持一致。
本研究提供了全国性证据，表明中国急性暴露于各种环境颗粒物污染会增加哮喘死亡率，表明与环境 PM 比 PM 和 PM 具有更强的关联。中国需要紧急调整当前的环境空气质量标准，并更加关注 PM 对健康的不良影响。
