Relationship Between Atmospheric Pollutants and Risk of Death Caused by Cardiovascular and Respiratory Diseases and Malignant Tumors in Shenyang, China, from 2013 to 2016: An Ecological Research
Air pollution is a significant public health concern globally, with numerous studies demonstrating its adverse effects on human health. This study focuses on the relationship between atmospheric pollutants and the risk of death caused by cardiovascular diseases (CDs), respiratory diseases (RDs), and malignant tumors in Shenyang, China, from 2013 to 2016. The research explores the impact of fine particulate matter (PM2.5), sulfur dioxide (SO2), and ozone-8 hours (O3-8h) concentrations during heating and non-heating seasons on mortality rates.
Shenyang, located in the south of northeast China, experiences a temperate and semi-humid continental climate. The city is a major transport hub and industrial center, with air pollutants primarily originating from coal combustion, vehicle emissions, and industrial production. The study period spanned from April 2013 to March 2016, during which data on daily deaths, atmospheric pollutant concentrations, and meteorological conditions were collected and analyzed.
The study utilized data from eleven state-controlled environmental air quality automatic monitoring stations in Shenyang. Daily average concentrations of PM2.5, SO2, and O3-8h were monitored using standardized methods. Meteorological data, including temperature, humidity, wind speed, and atmospheric pressure, were obtained from the Shenyang Meteorological Bureau. Daily death data were collected from the Center for Disease Control of Shenyang, categorized by cause of death according to the International Classification of Diseases.
Statistical analysis was performed using Stata 12.0 software. The Poisson regression generalized linear model (GLM) was employed to analyze the relationship between air pollutant concentrations and mortality rates. Spearman rank correlation was used to assess the correlation between pollutants and death risk, and the rank-sum test was used to compare differences between heating and non-heating seasons.
The study found significant seasonal variations in the concentrations of PM2.5, SO2, and O3-8h. During the heating season (November to March), the median daily PM2.5 concentration was 93 μg/m³, significantly higher than the 55 μg/m³ observed during the non-heating season (April to October). Similarly, SO2 concentrations were higher during the heating season (147 μg/m³) compared to the non-heating season (34 μg/m³). In contrast, O3-8h concentrations were higher during the non-heating season (97 μg/m³) than during the heating season (45 μg/m³).
The number of daily deaths caused by cardiovascular diseases was significantly higher during the heating season (44 deaths per day) compared to the non-heating season (39 deaths per day). However, there was no significant difference in daily deaths caused by respiratory diseases and malignant tumors between the two seasons.
The study identified specific lagged effects of air pollutants on mortality rates. An increase in the daily average SO2 concentration by 10 μg/m³ increased the risk of death due to cardiovascular diseases, peaking on lagging day 4 during the non-heating season with a 2.0% increase (95% CI: 1.3%–2.7%) and on lagging day 3 during the heating season with a 0.2% increase (95% CI: 0.1%–0.4%). The risk of death caused by respiratory diseases peaked on lagging day 1 during the heating season with a 0.8% increase (95% CI: 0.4%–1.2%).
An increase in O3-8h concentration by 10 μg/m³ increased the risk of respiratory disease-related death on lagging day 2 by 1.0% (95% CI: 0.4%–1.7%) during the non-heating season, significantly higher than the 0.1% increase (95% CI: 0%–0.9%) during the heating season. An increase in the daily average PM2.5 concentration by 10 μg/m³ increased the risk of death caused by respiratory diseases by 0.3% and 0.8% during heating and non-heating seasons, respectively, peaking on lagging day 0. However, air pollution was not significantly associated with the risk of death caused by malignant tumors.
The study also analyzed the correlation between air pollutants and meteorological factors. During the heating season, the correlation coefficient between O3-8h and SO2, NO2, CO, and PM2.5 ranged from -0.739 to -0.431. During the non-heating season, the correlation coefficient between O3-8h and these pollutants ranged from -0.027 to 0.154. The correlation coefficient between SO2 and NO2, CO, and PM2.5 ranged from 0.769 to 0.628 during both seasons.
Multivariate model analysis revealed that holidays and temperature on lagging day 5 were significantly correlated with the risk of death in the circulatory system during the heating season. During the non-heating season, PM2.5 concentrations on lagging day 0, temperature on lagging day 6, humidity on lagging day 1, and pressure on lagging day 2 were significant factors. For respiratory diseases, temperature on lagging day 1 during the heating season and O3-8h concentration on lagging day 2, humidity on lagging day 1, and pressure on lagging day 2 during the non-heating season were significant. For malignant tumors, temperature on lagging day 0, humidity on lagging day 1, and pressure on lagging day 1 during the non-heating season were significant.
The study concluded that short-term exposure to PM2.5, SO2, and O3-8h during the non-heating season resulted in higher risks of death due to cardiovascular diseases, followed by respiratory diseases. Low concentrations of SO2 and O3-8h during the non-heating season yielded higher risks of deaths caused by cardiovascular and respiratory diseases than high concentrations during the heating season. The study highlights the need for further research to explore the superposition and modification effects of these pollutants on mortality rates.
The findings of this study provide valuable insights for public health officials and policymakers in developing strategies to mitigate the adverse health effects of air pollution. The results underscore the importance of considering seasonal variations and specific pollutants when assessing the impact of air pollution on human health.
doi.org/10.1097/CM9.0000000000000453
Was this helpful?
0 / 0