Urban-rural disparity of the short-term association of PM2.5 with mortality and its attributable burden

Tao Liu; Haorong Meng; Min Yu; Yize Xiao; Biao Huang; Lifeng Lin; Haoming Zhang; Ruying Hu; Zhulin Hou; Yanjun Xu; Letao Yuan; Mingfang Qin; Qinglong Zhao; Xiaojun Xu; Weiwei Gong; Jianxiong Hu; Jianpeng Xiao; Siqi Chen; Weilin Zeng; Xing Li; Guanhao He; Zuhua Rong; Cunrui Huang; Yaodong Du; Wenjun Ma

doi:10.1016/j.xinn.2021.100171

Urban-rural disparity of the short-term association of PM_2.5 with mortality and its attributable burden

Innovation (Camb). 2021 Sep 30;2(4):100171. doi: 10.1016/j.xinn.2021.100171. eCollection 2021 Nov 28.

Authors

Tao Liu^{1

2}, Haorong Meng², Min Yu³, Yize Xiao⁴, Biao Huang⁵, Lifeng Lin⁶, Haoming Zhang⁴, Ruying Hu³, Zhulin Hou⁵, Yanjun Xu⁶, Letao Yuan⁷, Mingfang Qin⁴, Qinglong Zhao⁵, Xiaojun Xu⁶, Weiwei Gong³, Jianxiong Hu², Jianpeng Xiao², Siqi Chen², Weilin Zeng², Xing Li², Guanhao He², Zuhua Rong², Cunrui Huang⁷, Yaodong Du⁸, Wenjun Ma^{1

2}

Affiliations

¹ School of Medicine, Jinan University, Guangzhou 510632, China.
² Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
³ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
⁴ Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China.
⁵ Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China.
⁶ Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
⁷ School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
⁸ Guangdong Provincial Climate Center, Guangzhou 510080, China.

Abstract

Although studies have investigated the associations between PM_2.5 and mortality risk, evidence from rural areas is scarce. We aimed to compare the PM_2.5-mortality associations between urban cities and rural areas in China. Daily mortality and air pollution data were collected from 215 locations during 2014-2017 in China. A two-stage approach was employed to estimate the location-specific and combined cumulative associations between short-term exposure to PM_2.5 (lag 0-3 days) and mortality risks. The excess risks (ER) of all-cause, respiratory disease (RESP), cardiovascular disease (CVD), and cerebrovascular disease (CED) mortality for each 10 μg/m³ increment in PM_2.5 across all locations were 0.54% (95% confidence interval [CI]: 0.38%, 0.70%), 0.51% (0.10%, 0.93%), 0.74% (0.50%, 0.97%), and 0.52% (0.20%, 0.83%), respectively. Slightly stronger associations for CVD (0.80% versus 0.60%) and CED (0.61% versus 0.26%) mortality were observed in urban cities than in rural areas, and slightly greater associations for RESP mortality (0.51% versus 0.43%) were found in rural areas than in urban cities. A mean of 2.11% (attributable fraction [AF], 95% CI: 1.48%, 2.76%) of all-cause mortality was attributable to PM_2.5 exposure in China, with a larger AF in urban cities (2.89% [2.12%, 3.67%]) than in rural areas (0.61% [-0.60%, 1.84%]). Disparities in PM_2.5-mortality associations between urban cities and rural areas were also found in some subgroups classified by sex and age. This study provided robust evidence on the associations of PM_2.5 with mortality risks in China and demonstrated urban-rural disparities of PM_2.5-mortality associations for various causes of death.

Keywords: China; fine particulate matter; mortality; urban-rural disparity.