Long-term Fine Particulate Matter Exposure and Nonaccidental and Cause-specific Mortality in a Large National Cohort of Chinese Men

Abstract

Background:Cohort studies in North America and western Europe have reported increased risk of mortality associated with long-term exposure to fine particles (PM2.5), but to date, no such studies have been reported in China, where higher levels of exposure are experienced.Objectives:We estimated the association between long-term exposure to PM2.5 with nonaccidental and cause-specific mortality in a cohort of Chinese men.Methods:We conducted a prospective cohort study of 189,793 men 40 y old or older during 1990–91 from 45 areas in China. Annual average PM2.5 levels for the years 1990, 1995, 2000, and 2005 were estimated for each cohort location using a combination of satellite-based estimates, chemical transport model simulations, and ground-level measurements developed for the Global Burden of Disease (GBD) 2013 study. A Cox proportional hazards regression model was used to estimate hazard ratios (HR) for nonaccidental cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), and lung-cancer mortality. We also assessed the shape of the concentration–response relationship and compared the risk estimates with those predicted by Integrated Exposure-Response (IER) function, which incorporated estimates of mortality risk from previous cohort studies in western Europe and North America.Results:The mean level of PM2.5 exposure during 2000–2005 was 43.7 μg/m3 (ranging from 4.2 to 83.8 μg/m3). Mortality HRs (95% CI) per 10-μg/m3 increase in PM2.5 were 1.09 (1.08, 1.09) for nonaccidental causes; 1.09 (1.08, 1.10) for CVD, 1.12 (1.10, 1.13) for COPD; and 1.12 (1.07, 1.14) for lung cancer. The HR estimate from our cohort was consistently higher than IER predictions.Conclusions:Long-term exposure to PM2.5 was associated with nonaccidental, CVD, lung cancer, and COPD mortality in China. The IER estimator may underestimate the excess relative risk of cause-specific mortality due to long-term exposure to PM2.5 over the exposure range experienced in China and other low- and middle-income countries. https://doi.org/10.1289/EHP1673

A time‐to‐event analysis on air pollutants with the risk of cardiovascular disease and mortality: A systematic review and meta‐analysis of 84 cohort studies

“…After assessing 58 full‐text for eligibility; we excluded nine studies because of: (1) no PM 2.5 data for the hypertension outcome ( n = 3), (2) increments for the pollutant concentration was change from previous concentration/place ( n = 2), (3) no clear data on hazard ratio, only in a diagram without precise data on hazard ratio and confidence interval ( n = 1), and (4) no specific data on pollutants, only distance from highways/road ( n = 3) (Figure 1). We included 49 articles in qualitative and quantitative synthesis; 5 articles were a joint cohort studies comprising of 2 (Dehbi 2017), 2 (Stockfelt 2018), 3 (Cai 2018), 11 (ESCAPE 2014), and 22 (Beelen 2014) cohorts, adding up to a total of 84 cohorts 1,3,5‐7,9‐52 . There were a total of 28 215 394 subjects from 84 cohorts.…”

Concentrations of criteria pollutants in the contiguous U.S., 1979 – 2015: Role of prediction model parsimony in integrated empirical geographic regression

“…Recent population-level studies of air pollution have relied on empirical models to estimate long-term concentrations of outdoor air pollution based largely on observation-driven geostatistical approaches [1][2][3] or hybrid approaches that incorporate satellite-based observations of air quality and theory-based mechanistic models with geostatistical approaches [4][5][6][7]. These model predictions are used to assess population-level characteristics of air pollution, such as health effects [8][9][10][11], the burden of disease [12,13], and exposure disparities [14,15].…”

Interactive effects of changing stratospheric ozone and climate on tropospheric composition and air quality, and the consequences for human and ecosystem health

“…In a prospective cohort study of 189,793 older men (age > 40 in 1990 and 1991) in 45 locations in China, non-accidental mortality from several causes was associated with concentrations of PM2.5. 90 Annual average levels of PM2.5 were estimated from measurements and models and, for the period of investigation (2000-2005), ranged from 4.2 to 83.8 µg m -3 . HRs and the (95% CIs) for a 10µg m -3 increment in PM2.5 were 1.09 (1.08-1.09) for non-accidental causes; 1.09 (1.08-1.10) for cardiovascular disease; 1.12 (1.10-1.13) for chronic obstructive pulmonary disease (COPD); and 1.12 (1.07-1.14) for lung cancer.…”