Short-term associations of particulate matter with different aerodynamic diameters with mortality due to mental disorders and dementia in Ningde, China

Zhi-Ying Zhan; Xin-Ying Xu; Jing Wei; Hai-Yin Fang; Xue Zhong; Mao-Lin Liu; Zi-Shan Chen; Wei-Min Ye; Fei He

doi:10.1016/j.ecoenv.2024.115931

Short-term associations of particulate matter with different aerodynamic diameters with mortality due to mental disorders and dementia in Ningde, China

Ecotoxicol Environ Saf. 2024 Feb:271:115931. doi: 10.1016/j.ecoenv.2024.115931. Epub 2024 Jan 11.

Authors

Zhi-Ying Zhan¹, Xin-Ying Xu¹, Jing Wei², Hai-Yin Fang³, Xue Zhong¹, Mao-Lin Liu¹, Zi-Shan Chen¹, Wei-Min Ye⁴, Fei He⁵

Affiliations

¹ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China.
² Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA.
³ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China; Fuzhou Center for Disease Control and Prevention, Fuzhou 350209, Fujian Province, China.
⁴ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China. Electronic address: ywm@fjmu.edu.cn.
⁵ Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China. Electronic address: i.fei.he@fjmu.edu.cn.

PMID: 38215667
DOI: 10.1016/j.ecoenv.2024.115931

Abstract

Limited evidence is available regarding the impact of ambient inhalable particulate matter (PM) on mental disorder (MD) or dementia-related deaths, particularly PM₁, PM_1-2.5, and coarse particles (PM_2.5-10). Moreover, individual confounders have rarely been considered. In addition, evidence from low-pollution areas is needed but is inadequate. Using death records from the Death Registration System during 2015-2021 in Ningde, a coastal city in southeast China, we combined a conditional quasi-Poisson model with a distributed lag nonlinear model to estimate the nonlinear and lagged associations of PM exposure with MD or dementia-related deaths in Ningde, China, comprehensively controlling for individual time-invariant confounders using a time-stratified case-crossover design. The attributable fraction and number were calculated to quantify the burden of MD or dementia-related deaths that were related to PMs. We found J-shaped relationships between MD or dementia-related deaths and PMs, with different thresholds of 13, 9, 19, 33 and 12 μg/m³ for PM₁, PM_1-2.5, PM_2.5, PM₁₀ and PM_2.5-10. An inter-quartile range increase for PM₁, PM_1-2.5, PM_2.5, PM₁₀ and PM_2.5-10 above the thresholds led to an increase of 31.8% (95% confidence interval, 14.3-51.9%), 53.7% (22.4-93.1%), 32.6% (15.0-53.0%), 35.1% (17.7-55.0%) and 25.9% (13.0-40.3%) in MD-related deaths at lag 0-3 days, respectively. The associations were significant in the cool season rather than in the warm season and were significantly greater among people aged 75-84 years than in others. The fractions of MD-related deaths attributable to PM₁, PM_1-2.5, PM_2.5, PM₁₀ and PM_2.5-10 were 5.55%, 6.49%, 7.68%, 10.66%, and 15.11%, respectively; however, only some of them could be protected by the concentrations recommended by the World Health Organisation or China grade I standard. Smaller associations and similar patterns were observed between PMs and dementia-related death. These findings suggest stricter standards, and provide evidence for the development of relevant policies and measures.

Keywords: Ambient particulate matter; Distributed lag nonlinear model; Mental disorders; Mortality risk; Time-stratified case-crossover design.

MeSH terms

Aged
Aged, 80 and over
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
China
Cross-Over Studies
Dementia*
Environmental Exposure / adverse effects
Environmental Exposure / analysis
Humans
Particulate Matter / adverse effects
Particulate Matter / analysis

Substances

Air Pollutants
Particulate Matter