Particulate matter pollution and asthma mortality in China: A nationwide time-stratified case-crossover study from 2015 to 2020

Wei Liu; Jing Wei; Miao Cai; Zhengmin Qian; Zheng Long; Lijun Wang; Michael G Vaughn; Hannah E Aaron; Xunliang Tong; Yanming Li; Peng Yin; Hualiang Lin; Maigeng Zhou

doi:10.1016/j.chemosphere.2022.136316

Particulate matter pollution and asthma mortality in China: A nationwide time-stratified case-crossover study from 2015 to 2020

Chemosphere. 2022 Dec;308(Pt 2):136316. doi: 10.1016/j.chemosphere.2022.136316. Epub 2022 Sep 6.

Authors

Wei Liu¹, Jing Wei², Miao Cai³, Zhengmin Qian⁴, Zheng Long¹, Lijun Wang¹, Michael G Vaughn⁵, Hannah E Aaron⁴, Xunliang Tong⁶, Yanming Li⁶, Peng Yin⁷, Hualiang Lin⁸, Maigeng Zhou¹

Affiliations

¹ National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
² Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, 20740, USA.
³ Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
⁴ Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, USA.
⁵ School of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, USA.
⁶ Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
⁷ National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: yinpeng@ncncd.chinacdc.cn.
⁸ Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China. Electronic address: linhualiang@mail.sysu.edu.cn.

PMID: 36084833
DOI: 10.1016/j.chemosphere.2022.136316

Abstract

Background: A national and comprehensive evaluation is lacking on the relationship between short-term exposure to submicron particulate matter (PM₁) pollution and asthma mortality.

Methods: 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.

Results: 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_2.5) and inhalable particulate matter (PM₁₀), significantly stronger effects on asthma mortality related to PM₁ pollution were noted. The ERs% for asthma mortality associated with each interquartile range (IQR) increase of exposures to PM₁ (IQR: 19.2 μg/m³) was 5.59% (95% CI: 2.11-9.19), which is 14% and 22% higher than that for PM_2.5 (IQR: 32.0 μg/m³, 4.82% (95% CI: 1.84-7.90)) and PM₁₀ (IQR: 52.2 μg/m³, 4.37% (95% CI: 1.16-7.69)), respectively. The estimates remained consistent in various sensitivity analyses.

Conclusions: 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 PM₁ than PM_2.5 and PM₁₀. China needs to adjust the current ambient air quality standards urgently and pay greater attention to the adverse health effects of PM₁.

Keywords: Air pollutants; Asthma; Mortality; Particle size; Particulate matter; Submicron particulate matter.

MeSH terms

Air Pollutants* / adverse effects
Air Pollutants* / analysis
Asthma* / chemically induced
Asthma* / epidemiology
Cross-Over Studies
Environmental Exposure / adverse effects
Environmental Exposure / analysis
Humans
Particulate Matter / adverse effects
Particulate Matter / analysis

Substances

Air Pollutants
Particulate Matter