Abstract
BACKGROUND AND AIM: Evidence on the associations between long-term
exposure to multiple air pollutants and cardiopulmonary mortality is
limited, especially for developing regions with higher pollutant level.
We aimed to characterize the individual and joint associations of
long-term exposure to air pollutants with cardiopulmonary mortality, and
to identify air pollutant that primarily contribute to the mortality
risk.
METHOD: We followed 37,442 participants in four cities in northern China from 1998-2019. Annual PM2.5, PM10, SO2 and NO2 were estimated using daily average values from satellite-derived machine learning models and monitoring stations. Time-varying Cox proportional hazards model was used to evaluate the individual association between air pollutants and mortality from non-accidental causes, cardiovascular diseases (CVDs), non-malignant respiratory diseases (RDs) and lung cancer, accounting for demographic and socioeconomic factors. Effect modifications by age, gender, income and education level were also examined. Quantile-based g-Computation was applied to evaluate the co-effects and the relative weight of contributions.
RESULTS: During 785,807 person-years of follow-up, 5,812 (15.5%) died from non-accidental causes, among which 2,932 (7.8%) were from all CVDs, 479 (1.3%) from non-malignant RDs, and 552 (1.4%) from lung cancer. Long-term exposure to PM10 (mean [baseline]: 136.5 µg/m3), PM2.5 (70.2), SO2 (113.0) and NO2 (39.2) were consistently associated with all mortality outcomes. A monotonically increasing curve with linear or supra-linear shape with no evidence of a threshold was observed for the exposure-response relationship of mortality with individual or joint exposure to air pollutants. PM2.5 consistently contributed most to the elevated mortality risks related to air pollutant mixture, followed by SO2 or PM10.
CONCLUSIONS: There was a strong and positive association of long-term individual and joint exposure to air pollutants with cardiopulmonary mortality in high-exposure settings, with PM2.5 potentially being the main contributor. The shapes of associations were consistent with a linear or supra-linear exposure-response, with no lower threshold observed.
METHOD: We followed 37,442 participants in four cities in northern China from 1998-2019. Annual PM2.5, PM10, SO2 and NO2 were estimated using daily average values from satellite-derived machine learning models and monitoring stations. Time-varying Cox proportional hazards model was used to evaluate the individual association between air pollutants and mortality from non-accidental causes, cardiovascular diseases (CVDs), non-malignant respiratory diseases (RDs) and lung cancer, accounting for demographic and socioeconomic factors. Effect modifications by age, gender, income and education level were also examined. Quantile-based g-Computation was applied to evaluate the co-effects and the relative weight of contributions.
RESULTS: During 785,807 person-years of follow-up, 5,812 (15.5%) died from non-accidental causes, among which 2,932 (7.8%) were from all CVDs, 479 (1.3%) from non-malignant RDs, and 552 (1.4%) from lung cancer. Long-term exposure to PM10 (mean [baseline]: 136.5 µg/m3), PM2.5 (70.2), SO2 (113.0) and NO2 (39.2) were consistently associated with all mortality outcomes. A monotonically increasing curve with linear or supra-linear shape with no evidence of a threshold was observed for the exposure-response relationship of mortality with individual or joint exposure to air pollutants. PM2.5 consistently contributed most to the elevated mortality risks related to air pollutant mixture, followed by SO2 or PM10.
CONCLUSIONS: There was a strong and positive association of long-term individual and joint exposure to air pollutants with cardiopulmonary mortality in high-exposure settings, with PM2.5 potentially being the main contributor. The shapes of associations were consistent with a linear or supra-linear exposure-response, with no lower threshold observed.
Original language | English |
---|---|
Number of pages | 2 |
DOIs | |
Publication status | Published - Sept 2023 |
Event | 35th Annual Conference of the International Society of Environmental Epidemiology, ISEE 2023 - Kaohsiung, Taiwan, Province of China Duration: 17 Sept 2023 → 21 Sept 2023 https://2023.iseeconference.org/?_gl=1*8r079t*_up*MQ..*_ga*MTMwODk1MzkyNy4xNzI3MDYxNzA5*_ga_8R9D80B23G*MTcyNzA2MTcwOC4xLjEuMTcyNzA2MzI3NC4wLjAuMA.. (Conference Website) |
Conference
Conference | 35th Annual Conference of the International Society of Environmental Epidemiology, ISEE 2023 |
---|---|
Country/Territory | Taiwan, Province of China |
City | Kaohsiung |
Period | 17/09/23 → 21/09/23 |
Internet address |
User-Defined Keywords
- Multi-pollutant
- Long-term exposure
- Mortality
- Mixtures analysis