Association of Air Pollution and Mortality of Acute Lower Respiratory Tract Infections in Shenyang, China: A Time Series Analysis Study
AbstractAbstract Background: We aimed to evaluate the risk factors of the daily mortality associated with air pollution causing acute lower respiratory tract infections. Methods: We applied a short time series analysis to the air pollution record, meteorological data and 133 non-accidental death data in Shengyang, China, in 2013-2015. After controlling the seasonality, day of week and weather conditions, the group employed an over-dispersed Possion generalized addictive model to discuss the associations among different variables, then performed the stratified analysis according to age, gender, and season. Results: Mean concentrations of particulate matter with aerodynamic diameters of < 10 μm (PM10) and < 2.5 μm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) were 122.4, 74.8, 79.4, 47.7, and 86.2 μg/m3, respectively. An increase of 10 μg/m3 in the 8-day moving average concentrations of PM10, PM2.5, SO2, NO2, and O3 corresponded to 0.18% (95% confidence interval [CI]: 0.10%, 0.26%), 0.21% (95% CI: 0.11%, 0.31%), 0.16% (95% CI: 0.04%, 0.30%), 0.43% (95% CI: 0.07%, 0.90%), and 0.10% (95% CI: -0.08%, 0.31%) increase in the daily mortality. The effects of air pollution lasted 9 days (lag 0-8), and they were more statistically significant in the elderly than in other age groups. Conclusion: These findings clarified the burden of air pollution on the morbidity of acute lower respiratory tract infections and emphasized the urgency of the control and prevention of air pollution and respiratory diseases in China.
He T, Yang Z, Liu T, et al (2016). Ambient air pollution and years of life lost in Ningbo, China. Sci Rep, 6:22485.
Gouveia N, Junger WL, ESCALA investiga-tors (2018). Effects of air pollution on in-fant and children respiratory mortality in four large Latin-American cities. Environ Pollut, 232: 385- 391.
Cox LAT, Liu X, Shi L, Zu K, Goodman J (2017). Applying Nonparametric Meth-ods to Analyses of Short-Term Fine Par-ticulate Matter Exposure and Hospital Admissions for Cardiovascular Diseases among Older Adults. Int J Environ Res Public Health, 14(9): E1051.
World Health Organization. Air quality guidelines: global update 2005. Particulate matter, ozone, nitrogen dioxide, and sul-fur dioxide. Copenhagen, World Health Organization, Regional Office for Eu-rope.
Pope CA 3rd, Burnett RT, Thurston GD, et al (2004). Cardiovascular mortality and long-term exposure to particulate air pol-lution: epidemiological evidence of gen-eral pathophysiological pathways of dis-ease. Circulation, 109(1):71-77.
Yin P, He G, Fan M, et al (2017). Particulate air pollution and mortality in 38 of Chi-na’s largest cities: time series analysis. BMJ, 356:j667.
Vanos JK, Hebbern C, Cakmak S (2014). Risk assessment for cardiovascular and respiratory mortality due to air pollution and synoptic meteorology in 10 Canadian cities. Environ Pollut, 185: 322-332.
Shi T, McAllister DA, O’Brien KL, et al (2017). Global, regional, and national dis-ease burden estimates of acute lower res-piratory infections due to respiratory syn-cytial virus in young children in 2015: a systematic review and modelling study. Lancet, 390(10098):946-958.
Lozano R, Naghavi M, Foreman K, et al (2012). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Dis-ease Study 2010. Lancet, 380: 2095–2128.
Cavanaugh R (2017). Mortality from chronic respiratory diseases varies widely in USA. Lancet Respir Med, pii:S2213-2600 (17)30390-9.
Shi T, Balsells E, Wastnedge E, et al (2015). Risk factors for respiratory syncytial virus associated with acute lower respiratory in-fection in children under five years: Sys-tematic review and meta-analysis. J Glob Health, 5(2): 020416.
Bargerkamate B, Knoll MD, Kagucia EW, et al (2016). Pertussis-Associated Pneumo-nia in Infants and Children From Low- and Middle-Income Countries Participat-ing in the PERCH Study. Clin Infect Dis, 63(Suppl 4):S187-S196.
Nair H, Simoes EA, Rudan I, et al (2013). Global and regional burden of hospital admissions for severve acute lower res-piratory infections in young children in 2010: a systematic analysis. Lancet, 381:1380-1390.
Ministry of Environmental Protection of the People’s Republic of China (MEP). Am-bient Air Quality Standards (On Trial). In National Environmental Protection Standards of the People’s Republic of China; GB3095;
Memirie ST, Metaferia ZS, Norheim OF, Levin CE, Verguet S, Johansson KA (2017). Household expenditures on pneumonia and diarrhoea treatment in Ethiopia: a facility-based study. BMJ Glob Health, 2(1):e000166.
Li G, Huang J, Xu G, et al (2017). The short term burden of ambient fine particulate matter on chronic obstructive pulmonary disease in Ningbo, China. Environ Health, 16(1):54.
Zeng Q, Ni Y, Jiang G, Li G, Pan X (2017). The short term burden of ambient par-ticulate matters on non-accidental mor-tality and years of life lost: a ten-year mul-ti-district study in Tianjin. China Environ Pollut, 220(Pt A):713-719.
Gouveia N, Junger WL (2018). Effects of air pollution on infant and children respira-tory mortality in four large Latin-American cities. Environ Pollut, 232:385-391.
Bates MN, Chandyo RK, Valentiner-Branth P, et al (2013). Acute lower respiratory in-fection in childhood and household fuel use in Bhaktapur, Nepal. Environmental Health Perspectives, 121(5):637.
Lee A, Leon Hsu HH, et al (2017). Prenatal fine particulate exposure and early child-hood asthma: Effect of maternal stress and fetal sex. J Allergy Clin Immunol. [Epub ahead of print]
Mustafic H, Jabre P, Caussin C, et al (2012). Main air pollutan- ts and myocardial in-farction: a systematic review and meta-analysis. JAMA, 307 (7):713–721.
Makar M, Antonelli J, Di Q, Cutler D, Schwartz J, Dominici F (2017). Estimat-ing the Causal Effect of Low Levels of Fine Particulate Matter on Hospitalization. Epidemiology, 28(5): 627-634.
Shang Y, Sun Z, Cao J, et al (2013). System-atic review of Chinese studies of short-term exposure to air pollution and daily mortality. Environ Int, 54: 100– 111.
Chen R, Huang W, Wong CM, et al (2012). Short-term exposure to sulfur dioxide and daily mortality in 17 Chinese cities: the China air pollution and health effects study (CAPES). Environ Res, 118: 101–106.
Chen R, Samoli E, Wong CM, et al (2012). Associations between short-term expo-sure to nitrogen dioxide and mortality in 17 Chinese cities: the China Air Pollution and Health Effects Study (CAPES). Envi-ron Int, 45 (14):32-38.
DeVries R, Kriebel D, Sama S (2017). Out-door Air Pollution and COPD-Related Emergency Department Visits, Hospital Admissions, and Mortality: A Meta-Analysis. COPD, 14 (1): 113-121.
Zeng Q, Wu Z, Jiang G, et al (2017). The association between ambient inhalable particulate matter and the disease burden of respiratory disease: An ecological study based on ten - year time series data in Tianjin, China. Environ Res, 157:71-77.
Guo Y, Ma Y, Zhang Y, et al (2017). Time series analysis of ambient air po- llution effects on daily mortality. Environ Sci Pollut Res Int, 24(25):20261-20272..
Guo Y, Li S, Tian Z, Pan X, Zhang J, Wil-liams G (2013). The burden of air pollu-tion on years of life lost in Beijing, China, 2004–08: retrospective regression analysis of daily deaths. BMJ, 347; f7139.
Strickland MJ, Gass KM, Goldman GT, Mulholland JA (2015). Effects of ambient air pollution measurement error on health effect estimates in time-series studies: a simulation-based analysis. J Expo Sci Envi-ron Epidemiol, 25(2):160-166.
Goldman GT, Mulholland JA, Russell AG, et al (2011). Impact of exposure meas-urement Error in air pollution epidemiol-ogy: effect of error type in time-series studies. Environ Health, 10:61.
Qian XJ, Li GX, He TF, et al (2017). Acute effect of air pollutants (carbon monoxide and ozone) on myocardial infarction mortality in Ningbo. Zhong hua Liu Xing Bing Xue Za Zhi, 38(3):297-302.
Yang C, Chen A, Chen R, et al (2014). Acute effect of ambient air pollution on heart failure in Guangzhou, China. Int J Cardiol, 177(2):436-441.
César AC, Carvalho JA Jr, Nascimento LF (2015). Association between NOx expo-sure and deaths caused by respiratory diseases in a medium-sized Brazilian city. Braz J Med Biol Res, 48(12):1130-1135.