Abstract：Objective To analyze the effects of ambient air pollutants including fine particulate matter (PM2.5), ozone (O3) and carbon monoxide (CO) on mortality from respiratory diseases in Qingyuan City, Guangdong Province from 2018 to 2022, so as to provide the evidence for optimizing prevention and control strategies for respiratory diseases. Methods Data on deaths caused by respiratory diseases in Qingyuan City from 2018 to 2022 were collected through the population death registration and management system of the Chinese Center for Disease Control and Prevention, and the corresponding data on ambient air pollutants were collected through the China National Environmental Monitoring Center. A distributed lag non-linear model (DLNM) was established to explore the association between air pollutants and mortality from respiratory diseases. Attributable fraction (AF) and attributable deaths were calculated to assess the attributable risks of air pollutants for respiratory disease mortality. Results A total of 17 008 deaths due to respiratory diseases were reported in Qingyuan City from 2018 to 2022, with an average annual mortality of 88.63/105. The median mass concentrations of PM2.5, O3 and CO were 23.83 (interquartile range, 21.22), 53.00 (interquartile range, 32.82), and 770.83 (interquartile range, 295.29) μg/m3, respectively. The results of DLNM analysis showed that within the lag period of 0-7 days, the cumulative RR on respiratory disease mortality generally increased along with the rising concentrations of PM2.5, O3 and CO. On the exposure day (lag 0 day), high concentrations of PM2.5 (155.04 μg/m3) and CO (2 253.12 μg/m3) were associated with higher mortality risk, with the RR values of 1.520 (95%CI: 1.228-1.904) and 1.891 (95%CI: 1.650-2.314) respectively. A high O3 concentration (148.08 μg/m3) at lag 7 days also led to higher mortality risk, with an RR value of 1.341 (95%CI: 1.088-1.713). The AF of respiratory disease mortality related to PM2.5, O3 and CO exposure was 14.522% (95%CI: 4.320%-24.265%), 8.598% (95%CI: 3.760%-13.351%) and 24.994% (95%CI: 14.903%-34.056%) respectively. The attributable deaths were 2 469 (95%CI: 735-4 128), 1 463 (95%CI: 639-2 270) and 4 250 (95%CI: 2 534-5 793). Conclusions Concentrations of PM2.5, O3 and CO in Qingyuan City had a non-linear relationship with the mortality risk of respiratory diseases, which was affected by lag effects. Exposure to the three air pollutants imposed substantial attributable burdens on respiratory disease mortality. CO contributed the highest burden, followed by PM2.5 and O3.
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