Estimating mortality burden attributable to short-term PM2.5 exposure: A national observational study in China

Tiantian Li; Yuming Guo; Yang Liu; Jiaonan Wang; Qing Wang; Zhiying Sun; Mike Z He; Xiaoming Shi

doi:10.1016/j.envint.2019.01.073

Estimating mortality burden attributable to short-term PM_2.5 exposure: A national observational study in China

Environ Int. 2019 Apr:125:245-251. doi: 10.1016/j.envint.2019.01.073. Epub 2019 Feb 4.

Authors

Tiantian Li¹, Yuming Guo², Yang Liu³, Jiaonan Wang¹, Qing Wang¹, Zhiying Sun¹, Mike Z He⁴, Xiaoming Shi⁵

Affiliations

¹ National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
² Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA.
⁴ Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, USA.
⁵ National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: shixm@chinacdc.cn.

Abstract

Studies worldwide have estimated the number of deaths attributable to long-term exposure to fine airborne particles (PM_2.5), but limited information is available on short-term exposure, particularly in China. In addition, most existing studies have assumed that short-term PM_2.5-mortality associations were linear. For this reason, the use of linear exposure-response functions for calculating disease burden of short-term exposure to PM_2.5 in China may not be appropriate. There is an urgent need for a comprehensive, evidence-based assessment of the disease burden related to short-term PM_2.5 exposure in China. Here, we explored the non-linear association between short-term PM_2.5 exposure and all-cause mortality in 104 counties in China; estimated county-specific mortality burdens attributable to short-term PM_2.5 exposure for all counties in the country and analyzed spatial characteristics of the mortality burden due to short-term PM_2.5 exposure in China. The pooled PM_2.5-mortality association was non-linear, with a reversed J-shape. We found an approximately linear increased risk of mortality from 0 to 62 μg/m³ and decreased risk from 62 to 250 μg/m³. We estimated a total of 169,862 additional deaths from short-term PM_2.5 exposure throughout China in 2015. Models using linear exposure-response functions for the PM_2.5-mortality association estimated 32,186 deaths attributable to PM_2.5 exposure, which is 5.3 times lower than estimates from the non-linear effect model. Short-term PM_2.5 exposure contributed greatly to the death burden in China, approximately one seventh of the estimates from the chronic effect. It is essential and crucial to incorporate short-term PM_2.5-related mortality estimations when considering the disease burden attributable to PM_2.5 in developing countries such as China. Traditional linear effect models likely underestimated the mortality burden due to short-term exposure to PM_2.5.

Keywords: Mortality burden; Non-linear; PM(2.5); Short-term.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollution / adverse effects*
China
Environmental Exposure / adverse effects*
Humans
Mortality*
Particulate Matter / analysis
Particulate Matter / toxicity*
Spatial Analysis

Substances

Particulate Matter

Grants and funding

T32 ES023770/ES/NIEHS NIH HHS/United States