Effect of air pollution on mortality among residents in Hangzhou City
LI Chaokang1, GONG Kemi2, LÜ Ye1, XU Shanshan1, LÜ Na1, YE Chun3, ZHU Bing1, LIU Weiyan1, GAO Bing1, XU Hong1
1. Institute of Health Hazard Monitoring, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang 310021, China; 2. Zhejiang Shuren University, Hangzhou, Zhejiang 310015, China; 3. Hangzhou Meteorological Service Center, Hangzhou, Zhejiang 310051, China
Abstract：Objective To examine the effects of air pollution on overall mortality, mortality of respiratory diseases, and mortality of circulatory diseases among residents in Hangzhou City. Methods Residents' mortality data in Hangzhou City from 2014 to 2016 were captured from Zhejiang Provincial Chronic Disease Surveillance Information Management System, and the ambient air quality in Hangzhou City from 2014 to 2016 were collected from Hangzhou Environmental Monitoring Center, while the meteorological monitoring data during the study period were collected from Hangzhou Meteorological Bureau. The effects of PM2.5, PM10, NO2 and SO2 on overall mortality, morality of respiratory diseases and mortality of circulatory diseases were evaluated a generalized additive model (GAM) based on Poisson distribution, and the risk of mortality was described with excess risk (ER) and its 95%CI. Results The daily M (QR) overall deaths, deaths from respiratory diseases and deaths from circulatory diseases were 111 (30), 16 (9) and 37 (14) persons in Hangzhou City from 2014 to 2016, respectively. A 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 resulted in 0.47% (95%CI: 0.23%-0.70%), 0.37% (95%CI: 0.21%-0.53%), 1.06% (95%CI: 0.50%-1.61%) and 3.08% (95%CI: 2.18%-3.99%) rises in the risk of overall mortality, 0.60% (95%CI: 0.04%-1.16%), 0.45% (95%CI: 0.06%-0.83%), 2.01% (95%CI: 0.84%-3.20%) and 6.06% (95%CI: 3.80%-8.37%) rises in the risk of mortality of respiratory diseases, and 0.45% (95%CI: 0.08%-0.83%), 0.44% (95%CI: 0.17%-0.71%), 1.43% (95%CI: 0.49%-2.37%) and 3.66% (95%CI: 2.13%-5.22%) rises in the risk of mortality of circulatory diseases, and the greatest effect was observed at a 2-day lag. Multi-pollutant model analysis showed that, after adjustment for PM2.5, NO2 and PM2.5+NO2+SO2, a 10 μg/m3 increase in SO2 resulted in an elevated risk of mortality of respiratory diseases than a single-pollutant model. Conclusions The air pollutants PM10, PM2.5, NO2, and SO2 correlated positively with the risk of overall mortality, mortality of respiratory diseases and mortality of circulatory diseases in Hangzhou City from 2014 to 2016, and the co-existence of multiple pollutants enhanced the effect of SO2 on mortality of respiratory diseases.
[1] COHEN A J,BRAUER M,BURNETT R,et al.Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution:an analysis of data from the Global Burden of Diseases Study 2015[J].Lancet,2017,389(10082):1907-1918. [2] 徐琪,叶辉,朱冰,等.大气PM2.5与呼吸系统、心脑血管疾病急救病例数的相关性研究[J].预防医学,2022,34(7):710-714. [3] LIN H,TAO J,DU Y,et al.Particle size and chemical constituents of ambient particulate pollution associated with cardiovascular mortality in Guangzhou,China[J].Environ Pollut,2016,208(Part B):758-766. [4] GBD 2019 Risk Factors Collaborators.Global burden of 87 risk factors in 204 countries and territories,1990-2019:a systematic analysis for the Global Burden of Disease Study 2019BD 2019 Risk Factors Collaborators.Global burden of 87 risk factors in 204 countries and territories,1990-2019:a systematic analysis for the Global Burden of Disease Study 2019[J].Lancet,2020,396(10258):1223-1249. [5] LELIEVELD J,EVANS J S,FNAIS M,et al.The contribution of outdoor air pollution sources to premature mortality on a global scale[J].Nature,2015,525(7569):367-371. [6] 徐珊珊,吕烨,刘卫艳,等.大气PM2.5污染对淳安县居民呼吸系统疾病和症状的影响[J].预防医学,2021,33(10):988-993. [7] MO Z,FU Q,LYU D,et al.Impacts of air pollution on dry eye disease among residents in Hangzhou,China:a case-crossover study[J].Environ Pollut,2019,246:183-189. [8] 吴芸芸,王子豪,李群英,等.2014—2018年重庆市主要城区大气PM2.5水平与居民非意外死亡的关系[J].环境与职业医学,2020,37(8):735-740. [9] 路凤,李亚伟,李成橙,等.时间序列分析在空气污染与健康领域的应用及其R软件实现[J].中国卫生统计,2018,35(4):622-625. [10] 中华人民共和国环境保护部,国家质量监督检验检疫总局.环境空气质量标准:GB 3095—2012[S].北京:中国环境科学出版社,2012. [11] 何晓庆,王小红,罗进斌.大气PM10与呼吸系统疾病死亡的关系研究[J].预防医学,2019,31(10):987-991. [12] 顾雯雯,杨洛贤,程庆林.大气PM2.5对呼吸系统疾病死亡率影响的Meta分析[J].预防医学,2018,30(11):1100-1106. [13] 王任洪. 兰州市大气污染与呼吸、循环系统疾病死亡的时间序列分析[D].兰州:兰州大学,2017. [14] SEATON A,MACNEE W,DONALDSON K,et al.Particulate air pollution and acute health effects[J].Lancet,1995,345(8943):176-178. [15] LI P,XIN J,WANG Y,et al.Association between particulate matter and its chemical constituents of urban air pollution and daily mortality or morbidity in Beijing City[J].Environ Sci Pollut Res Int,2015,22(1):358-368. [16] BURNETT R T,BROOK J,DANN T,et al.Association between particulate- and gas-phase components of urban air pollution and daily mortality in eight Canadian cities[J].Inhal Toxicol,2000,12(Suppl. 4):15-39. [17] LIU C,CHEN R,SERA F,et al.Ambient particulate air pollution and daily mortality in 652 cities[J].N Engl J Med,2019,381(8):705-715. [18] SO R,JØRGENSEN J T,LIM Y H,et al.Long-term exposure to low levels of air pollution and mortality adjusting for road traffic noise:a Danish Nurse Cohort study[J/OL].Environ Int,2020,143[2022-11-26].http://doi.org/10.1016/j.envint.2020.105983. [19] YAN Y,CHEN X,GUO Y,et al.Ambient air pollution and cerebrovascular disease mortality:an ecological time-series study based on 7-year death records in central China[J].Environ Sci Pollut Res Int,2021,28(21):27299-27307. [20] 马洪群,崔莲花.大气污染物(SO2、NO2)对中国居民健康效应影响的meta分析[J].职业与健康,2016,32(8):1038-1044. [21] MILLS I C,ATKINSON R W,ANDERSON H R,et al.Distinguishing the associations between daily mortality and hospital admissions and nitrogen dioxide from those of particulate matter:a systematic review and meta-analysis[J/OL].BMJ Open,2016,6(7)[2022-11-26].http://dx.doi.org/10.1136/bmjopen-2015-010751. [22] BHASKARAN K,GASPARRINI A,HAJAT S,et al.Time series regression studies in environmental epidemiology[J].Int J Epidemiol,2013,42(4):1187-1195.
