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Satellite-based exposure of fine particulate matters has been seldom used as a predictor of mortality. PM 2.5 was predicted using Aerosol Optical Depths (AOD) through a two-stage regression model. The predicted PM 2.5 was corrected for the bias using two approaches. We estimated the impact by two different scenarios of PM 2.5 in the model. We statistically found different distributions of the predicted PM 2.5 over the region. Compared to the reference value (5 µg/m 3 ), 90th and 95th percentiles had significant adverse effect on total mortality (RR 90th percentile :1.45; CI 95%: 1.08-1.95 and RR 95th percentile :1.53; CI 95%: 1.11-2.1). Nearly 1050 deaths were attributed to any range of the air pollution (unhealthy range), of which more than half were attributed to high concentration range. Given the adverse effect of extreme values compared to the both scenarios, more efforts are suggested to define local-specific reference values and preventive strategies.

Objective: To assess the impact of exposure to particulate matter with aerodynamic diameter ≤2.5 μm (PM 2.5 ) on non-accidental mortality under different apparent temperature levels and to further explore the modification effect of apparent temperature., Methods: This study used time-series design. Tianjin and Ningbo from China, Bangkok and Chiang Mai from Thailand were selected as the research sites, and the apparent temperature was applied as the exposure index. Through the quantitative estimation of the threshold temperature, the corresponding pollutant concentration was divided into high and low levels, and the generalized Poisson additive model was used to evaluate the association between PM 2.5 exposure and non-accidental death of residents at different temperature levels., Results: The ave-rage concentrations of PM 2.5 in Tianjin, Ningbo, Bangkok, and Chiang Mai during the study period were (73.6±35.6), (48.0±32.1), (33.5±28.4) and (32.6±28.6) μg/m 3 , respectively; the average daily non-accidental death counts were 148, 57, 28, and 8. The analysis of the generalized Poisson additive model showed that the daily non-accidental death counts increased by 0.43% (95% CI : 0.33%-0.54%) per 10 μg/m 3 increase of PM 2.5 in lag 0 day in Tianjin of China; 0.27% (95% CI : 0.08%-0.46%) per 10 μg/m 3 increase of PM 2.5 in lag 2 days in Ningbo of China. The effect was magnified in high temperature levels in Tianjin and in low temperatures in Ningbo and Bangkok. The mortality effect of PM 2.5 in various temperature levels stayed still in co-pollutant regression models., Conclusion: Exposure to fine particulate matter had an adverse effect on non-accidental mortality, which reminded us to give further attention to the pollution control. The findings also indicated that apparent temperature might modify mortality effects of PM 2.5 and the modification effect varied in different regions. Protective policies due to regional differences should be made and more scientific and social attention on mutual effect of air pollution and climate change needs to be appealed.

Background: Ambient fine particle (PM 2.5 ) pollution is an important public health problem in China. Short-term ambient PM 2.5 exposure is associated with increased mortality of respiratory diseases. However, few evidence was available on the effect of exposure to ambient PM 2.5 on the years of life lost (YLL) from respiratory diseases in the elderly. Furthermore, birth season which is frequently applied as a proxy for environmental exposure in early life may influence the health outcome in the later life. Nevertheless, the modification effect of birth season on the relationship of PM 2.5 exposure and respiratory health need to be explored., Methods: A time-stratified case-crossover design was used to analyze YLL from respiratory diseases in the elderly related to ambient PM 2.5 exposure between 2013 and 2016 in Ningbo, China. The modification effect of birth season was explored by subgroup comparisons between different birth seasons., Results: Each 10 μg/m 3 increase in daily ambient PM 2.5 was associated with an increment of 1.61 (95% CI 0.12, 3.10) years in YLL from respiratory diseases in the elderly population. Individuals who were born in winter had significantly higher YLL from respiratory diseases associated with ambient PM 2.5 exposure than those who were born in other seasons., Conclusions: Birth season which reflects the early-life PM 2.5 exposure level that may influence the lung development has a potential effect on the disease burden of respiratory diseases related to ambient PM 2.5 exposure in later life. The results would provide theoretical basis to protect vulnerable population defined by birth season when exploring the adverse effects of ambient PM 2.5 in the respiratory health., (© 2021. The Author(s).)

Background: Fine particulate matter (PM 2.5 ) is an important environmental risk factor for cardiopulmonary diseases. However, the association between PM 2.5 and risk of CKD remains under-recognized, especially in regions with high levels of PM 2.5 , such as China., Methods: To explore the association between long-term exposure to ambient PM 2.5 and CKD prevalence in China, we used data from the China National Survey of CKD, which included a representative sample of 47,204 adults. We estimated annual exposure to PM 2.5 before the survey date at each participant's address, using a validated, satellite-based, spatiotemporal model with a 10 km×10 km resolution. Participants with eGFR <60 ml/min per 1.73 m 2 or albuminuria were defined as having CKD. We used a logistic regression model to estimate the association and analyzed the influence of potential modifiers., Results: The 2-year mean PM 2.5 concentration was 57.4 μ g/m 3 , with a range from 31.3 to 87.5 μ g/m 3 . An increase of 10 μ g/m 3 in PM 2.5 was positively associated with CKD prevalence (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.22 to 1.35) and albuminuria (OR, 1.39; 95% CI, 1.32 to 1.47). Effect modification indicated these associations were significantly stronger in urban areas compared with rural areas, in males compared with females, in participants aged <65 years compared with participants aged ≥65 years, and in participants without comorbid diseases compared with those with comorbidities., Conclusions: These findings regarding the relationship between long-term exposure to high ambient PM 2.5 levels and CKD in the general Chinese population provide important evidence for policy makers and public health practices to reduce the CKD risk posed by this pollutant., (Copyright © 2021 by the American Society of Nephrology.)

Few multicity studies have been conducted in developing countries to distinguish the acute effects of ambient nitrogen dioxide (NO 2 ) on the years of life lost (YLL) from different subtypes of stroke. We aimed to differentiate the associations between NO 2 exposure and YLL from major pathological types of stroke in China, and estimate the relevant economic loss. A time-series study was conducted to explore the associations between short-term NO 2 exposure and YLL from ischaemic and haemorrhagic stroke from 2013 to 2017 in 48 Chinese cities. Daily NO 2 data and stroke mortality counts for each city were obtained from the National Urban Air Quality Real-time Publishing Platform and Chinese Center for Disease Control and Prevention, respectively. Generalized additive models were applied to estimate the cumulative effects of NO 2 in each city, and meta-analysis was used to combine the city-specific estimates. The relevant economic loss was estimated using the method of the value per statistical life year (VSLY). A 10 μg/m 3 increase in ambient NO 2 concentration on the present day and previous day (lag 0-1) would lead to relatively higher increments in percentage change of YLL from ischaemic stroke (0.82%, 95% CI: 0.46%, 1.19%) than haemorrhagic stroke (0.46%, 95% CI: 0.09%, 0.84%). The association was significantly stronger in the low-education population than high-education population for ischaemic stroke. Furthermore, significantly higher association was found in South China than those in North China for both subtypes of stroke. Economic loss due to excess YLL from ischaemic stroke related to NO 2 exposure was higher than that for haemorrhagic stroke. Our study indicated higher association and economic loss of ischaemic than haemorrhagic stroke related to NO 2 exposure in China, which informed priorities for type-specific stroke prevention strategies related to NO 2 pollution and vulnerable population protection., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Currently, the quantitative assessment of the public excess risk for the update of the air quality guidelines only considered the mortality and morbidity without disease burden indicators. To provide evidences for the update of air quality guidelines and the policy analysis of air control, a simple framework to identify the excess disease burden of PM 10 was used in this study. Daily data on PM 10 , meteorological factors, and deaths were collected in this 10-year (2001-2010) time series study in Tianjin, China. The excess disease burden advanced by PM 10 was assessed when the PM 10 levels exceeded the expected levels. Generalized additive model was used to estimate the associations of PM 10 with mortality and years of life lost (YLL). Our study found that the exposure of PM 10 was associated with the increasing of mortality and YLL in different diseases. The excess deaths and YLL of different diseases advanced by PM 10 when the PM 10 levels exceeded the expected levels were high and showed a decreasing trend from 2001 to 2010. The annual deaths and YLL standardized per million population advanced by PM 10 when the annual PM 10 levels exceeded the China national ambient air quality secondary standard targets (70 μg/m 3 ) and WHO guideline (20 μg/m 3 ) were 126 persons, 2670 person years and 260 persons, 5449 person years, respectively. This study may provide a simple framework to identify the excess disease burden of PM and provide basic and intuitive evidences to update the air quality guidelines. Furthermore, these findings may also provide decisionmakers with intuitive quantitative information for policymaking and emphasize health considerations in air quality policy discussions.

Satellite-driven statistical models have been proven to be able to provide spatially resolved PM 2.5 estimates worldwide. The North China Plain has been suffering from severe PM 2.5 pollution in recent years. An accurate assessment of the spatiotemporal characteristics of PM 2.5 levels in this region is crucial to design effective air pollution control policy. Our objective is to estimate daily PM 2.5 concentrations at 1km spatial resolution from 2004 to 2014 in Beijing and its surrounding areas using the Multi-angle implementation of atmospheric correction (MAIAC) aerosol optical depth (AOD). A high-performance three-stage model was developed with AOD, meteorological, demographic and land use variables as predictors, which includes a custom-designed PM 2.5 gap-filling method. The 11-year average annual coverage increased from 177days to 279days and annual PM 2.5 prediction error decreased from 14.1μg/m 3 to 8.3μg/m 3 after gap-filling techniques were applied. Results show that the 11-year overall mean of predicted PM 2.5 was 67.1μg/m 3 in our study domain. The cross-validation R 2 value of our model is 0.82 in 2013 and 0.79 in 2014. In addition, the models predicted historical PM 2.5 concentrations with relatively high accuracy at the seasonal and annual levels (R 2 ranged from 0.78 to 0.86). Our long-term PM 2.5 prediction filled the gaps left by ground monitors, which would be beneficial to PM 2.5 related epidemiological studies in Beijing., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Short-term exposure to outdoor fine particulate matter air pollution is associated with adverse health effects. However, existing literature have been limited in size and scope in countries with high air pollution level, especially in China. The study aims to examine the association of fine particulate matter with daily total mortality in 160 Chinese communities between 2013 and 2014. Two-stage analyses were used to assess the relationship between fine particulate matter (PM 2.5 ) and mortality. Firstly, Poisson regression model was used to estimate the community-specific PM 2.5 -mortalty association. Secondly, a meta-analysis was used to pool the effect estimates within each region. During the study period, a total of 1.4 million deaths were recorded in 160 communities. There was a significant association between PM 2.5 and mortality. Specifically, a 10μg/m 3 increase in 2-day moving average PM 2.5 concentration on total morality corresponded to a 0.17% (95% confidence interval (CI): 0.10, 0.23) in national level. The estimate of PM 2.5 on morality in Pearl Delta River was highest among Beijing-Tianjin-Hebei regions, Pearl River Delta, and Yangtze River Delta. Females, older population and widowed population appeared to be more vulnerable to particulate matter exposure. Conclusively, this largest epidemiologic study of fine particulate matter in China suggests that PM 2.5 is associated with increased mortality risk., (Copyright © 2017 Elsevier B.V. All rights reserved.)

There is limited evidence available worldwide about the quantitative relationship between particulate matter with an aerodynamic diameter of less than 10µm (PM 10 ) and years of life lost (YLL) caused by respiratory diseases (RD), especially regarding long-term time series data. We investigated the quantitative exposure-response association between PM 10 and the disease burden of RD. We obtained the daily concentration of ambient pollutants (PM 10 , nitrogen dioxide and sulphur dioxide), temperature and relative humidity data, as well as the death monitoring data from 2001 to 2010 in Tianjin. Then, a time series database was built after the daily YLL of RD was calculated. We applied a generalized additive model (GAM) to estimate the burden of PM 10 on daily YLL of RD and to determine the effect (the increase of daily YLL) of every 10μg/m 3 increase in PM 10 on health. We found that every 10μg/m 3 increase in PM 10 was associated with the greatest increase in YLL of 0.84 (95% CI: 0.45, 1.23) years at a 2-day (current day and previous day, lag01) moving average PM 10 concentration for RD. The association between PM 10 and YLL was stronger in females and the elderly (≥65 years of age). The association between PM 10 and YLL of RD differed according to district. These findings also provide new epidemiological evidence for respiratory disease prevention., (Copyright © 2017 Elsevier Inc. All rights reserved.)

In January 2013, severe haze events over northeastern China sparked substantial health concerns. This study explores the associations of fine particulate matter less than 2.5 μm (PM 2.5 ) and black carbon (BC) with hospital emergency room visits (ERVs) during a haze season in Beijing. During that period, daily counts of ERVs for respiratory, cardiovascular and ocular diseases were obtained from a Level-3A hospital in Beijing from 1 December 2012 to 28 February 2013, and associations of which with PM 2.5 and BC were estimated by time-stratified case-crossover analysis in single- and two-pollutant models. We found a 27.5% (95% confidence interval (CI): 13.0, 43.9%) increase in respiratory ERV (lag02), a 19.4% (95% CI: 2.5, 39.0%) increase in cardiovascular ERV (lag0), and a 12.6% (95% CI: 0.0, 26.7%) increase in ocular ERV (lag0) along with an interquartile range (IQR) increase in the PM 2.5 . An IQR increase of BC was associated with 27.6% (95% CI: 9.6, 48.6%) (lag02), 18.8% (95% CI: 1.4, 39.2%) (lag0) and 11.8% (95% CI: -1.4, 26.8%) (lag0) increases for changes in these same health outcomes respectively. Estimated associations were consistent after adjusting SO₂ or NO₂ in two-pollutant models. This study provides evidence that improving air quality and reducing haze days would greatly benefit the population health., Competing Interests: The authors declare no conflict of interest.

Background: Numerous studies have found associations between ambient fine particulate matter (PM 2.5 ) and increased mortality risk. However, little evidence is available on associations between PM 2.5 and years of life lost (YLL). We aimed to estimate the YLL due to chronic obstructive pulmonary disease (COPD) mortality related to ambient PM 2.5 exposure., Methods: A time-series study was conducted based on the data on air pollutants, meteorological conditions and 18,472 registered COPD deaths in Ningbo, China, 2011-2015. The effects of PM 2.5 on YLL and daily death of COPD were estimated, after controlling long term trend, meteorological index and other confounders., Results: The impact of PM 2.5 on YLL due to COPD lasted for 5 days (lag 0-4). Per 10 μg/m 3 increase in PM 2.5 was associated with 0.91 (95%CI: 0.16, 1.66) years increase in YLL. The excess YLL of COPD mortality were 8206 years, and 0.38 day per person in Ningbo from 2011 to 2015. The exposure-response curve of PM 2.5 and YLL due to COPD showed a non-linear pattern, with relatively steep at low levels and flattened out at higher exposures.. Furthermore, the effects were significantly higher in the elderly than those in the younger., Conclusions: Our findings explored burden of PM 2.5 on YLL due to COPD and highlight the importance and urgency of ambient PM 2.5 pollution control and protection of the vulnerable populations.

Years of life lost (YLL) is a more informative and accurate indicator than daily death counts for assessing air pollution related premature death. However, there is limited evidence available about the relationship of air pollution with YLL, especially in China. We conducted a ten-year (from January 1st, 2001 to December 31st, 2010) multi-district time-series study to estimate the effects of ambient particulate matter with an aerodynamic diameter of less than 10 μm in size (PM 10 ) on daily non-accidental deaths and YLL in six districts of Tianjin, China. Meta-analysis was used to merge the results of the six districts. We found that the increase of PM 10 was significantly associated with daily death and YLL in the six districts, except with the YLL in Heping district. 10 μg/m 3 increases in PM 10 were associated with the maximum increases in excess risk (ER) of death counts of 0.33% (95% confidence interval [CI]: 0.25%, 0.41%) at lag01 and in YLL of 0.80 (95%CI: 0.47, 1.13) person year at lag01 for the combined effects of six districts, respectively. Moreover, the associations of PM 10 on daily death counts and YLL were stronger in the elder people (≥65 years) than those in the younger ones (<65 years). These findings may help to shed light on the policy-making of PM-control in China and provide useful information for the protection of susceptible population., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Aims: To obtain a reliable estimation of the health impact of air pollution, we explored the effects of air pollutants on years of life lost from ischaemic heart disease in Tianjin, China., Methods and Results: We conducted a retrospective ecological analysis using daily time series set in six urban districts in Tianjin. Our data included 28,365 ischaemic heart disease deaths registered in 2002-2006. The main outcome measures were years of life lost and deaths from ischaemic heart disease. We found mean concentrations of daily particulate matter with an aerodynamic diameter of less than 10 µm in size (PM 10 ), sulfur dioxide and nitrogen dioxide of 125.6 µg/m 3 , 78.7 µg/m 3 , 55.1 µg/m 3 , respectively. Interquartile range increases of PM 10 , sulfur dioxide and nitrogen dioxide were associated with increases in years of life lost from ischaemic heart disease of 13.8, 4.8 and 22.7 years in single pollutant models, respectively. The effects associated with an interquartile range increase in PM 10 were greater in women than men. During the 5 years, there were 27,485 years and 1252 deaths advanced by PM 10 pollution over expected rates when daily levels did exceed the World Health Organization air quality guidelines. That is to say, on average, 63.12 hours per person were lost by air pollution in the 5-year period in Tianjin., Conclusions: Short-term exposure to air pollution has a significant impact on ischaemic heart disease years of life lost and mortality in Tianjin, particularly among women. Air quality improvement has become necessary to protect public health., (© The European Society of Cardiology 2016.)

This study explored the association between particulate matter with an aerodynamic diameter of less than 10 μm (PM10) and the cause-specific respiratory mortality. We used the ordinary kriging method to estimate the spatial characteristics of ambient PM10 at 1-km × 1-km resolution across Beijing during 2008-2009 and subsequently fit the exposure-response relationship between the estimated PM10 and the mortality due to total respiratory disease, chronic lower respiratory disease, chronic obstructive pulmonary disease (COPD), and pneumonia at the street or township area levels using the generalized additive mixed model (GAMM). We also examined the effects of age, gender, and season in the stratified analysis. The effects of ambient PM10 on the cause-specific respiratory mortality were the strongest at lag0-5 except for pneumonia, and an inter-quantile range increase in PM10 was associated with an 8.04 % (95 % CI 4.00, 12.63) increase in mortality for total respiratory disease, a 6.63 % (95 % CI 1.65, 11.86) increase for chronic lower respiratory disease, and a 5.68 % (95 % CI 0.54, 11.09) increase for COPD, respectively. Higher risks due to the PM10 exposure were observed for females and elderly individuals. Seasonal stratification analysis showed that the effects of PM10 on mortality due to pneumonia were stronger during spring and autumn. While for COPD, the effect of PM10 in winter was statistically significant (15.54 %, 95 % CI 5.64, 26.35) and the greatest among the seasons. The GAMM model evaluated stronger associations between concentration of PM10. There were significant associations between PM10 and mortality due to respiratory disease at the street or township area levels. The GAMM model using high-resolution PM10 could better capture the association between PM10 and respiratory mortality. Gender, age, and season also acted as effect modifiers for the relationship between PM10 and respiratory mortality.

Objective: To explore the concentration-response relationship between ambient concentration of PM2.5 and daily total hospital emergency room visits in Beijing during 2012 and 2013. This study also examined the effects of ambient PM2.5 during heavy polluted days on emergency room visits compared with the light polluted days., Methods: We collected the daily meteorological factors monitoring data and concentrations of air pollutants in Beijing during October 1, 2012 to December 31, 2013. We also collected the daily emergency room visits from a tertiary hospital in Beijing in the same time period. Generalized additive model was fitted to estimate the association between the ambient PM2.5 and the hospital emergency room visits, by using the smooth function to adjust long term trend of time, public holidays and day of week. In addition, constrained piecewise linear function was then used to estimate the excess risk for different segment of concentration-response function., Results: The annual average concentration of PM2.5 was 90.9 µg/m(3) during October 1, 2012 and December 31, 2013. There were total 64 260 cases for total emergency room visits, of which respiratory disease had 9 849 cases and cardiovascular disease had 11 168 cases. PM2.5 was positive related with PM10, NO2 and SO2. The corresponding correlation coefficients were 0.87, 0.78 and 0.62, respectively (P<0.05). And PM2.5 was positively related with relative humidity, with correlation coefficient 0.45 (P<0.05). But PM2.5 was negatively related with mean temperature (r=-0.17, P< 0.05) and wind speed (- 0.32, P<0.05). In the single polluted model, after adjusting the effects of temperature, relative humidity and wind, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits was 0.25% (95% CI: 0.07-0.43). In the two-pollutant model PM2.5+SO2 and PM2.5+NO2, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits were 1.07% (95%CI:0.83-1.30) and 0.56% (95%CI: 0.32-0.80) respectively, which were higher than the effect in single pollutant model. Average concentration of ambient particulate matters (PM2.5) was 204.16 µg/m(3) during heavy pollution, higher than control period (85.24 µg/m(3)). When PM2.5 as the primary air pollutants during heavy polluted days, we observed a significant increase in emergency room visits, and the odd ratios was 1.16 (95% CI:1.09-1.22)., Conclusion: There were positive correlation between high concentration of ambient particulate matters (PM2.5) and increasing daily emergency room visits. Especially during the heavy polluted days, the effects of elevated concentration of PM2.5 on hospital emergency room visits were much larger.

Objectives: To explore the characteristics of the exposure-response relationship of particulate matter concentration and mortality on the multicity scale in China., Methods: Generalized additive models were used to explore the short-term effects of particulate matter with an aerodynamic diameter of less than 10 μm (PM10) on mortality while adjusting for confounding variables, including seasonal periodicity, air temperature, relative humidity, day-of-the-week effect, and holiday effect. Additionally, possible PM10 thresholds for daily mortality were evaluated., Results: In most cities, the relationships of PM10 concentration and daily cause-specific mortalities were all nearly linear when PM10 concentration was below 150 μg/m3. The estimated PM10 thresholds associated with nonaccidental and cardiovascular mortalities were 80 μg/m3 and 45 μg/m3, respectively., Conclusions: Our findings indicated that, at least in China, the PM10 pollutant has threshold effects.

Objective: To assess the relationship between fine particulate matter (PM2.5) concentration and ischaemic heart disease (IHD) morbidity and mortality., Methods: A time-series study conducted in Beijing from 1 January 2010 to 31 December 2012. Data on 369,469 IHD cases and 53,247 IHD deaths were collected by the Beijing Monitoring System for Cardiovascular Diseases, which covers all hospital admissions and deaths from IHD from Beijing's population of 19.61 million., Results: The mean daily PM2.5 concentration was 96.2 μg/m(3) with a range from 3.9 to 493.9 μg/m(3). Only 15.3% of the daily PM2.5 concentrations achieved WHO Air Quality Guidelines target (25 μg/m(3)) in the study period. The dose-response relationships between PM2.5 and IHD morbidity and mortality were non-linear, with a steeper dose-response function at lower concentrations and a shallower response at higher concentrations. A 10 μg/m(3) increase in PM2.5 was associated with a 0.27% (95% CI 0.21 to 0.33%, p<2.00×10(-16)) increase in IHD morbidity and a 0.25% (95% CI 0.10 to 0.40%, p=1.15×10(-3)) increase in mortality on the same day. During the 3 years, there were 7703 cases and 1475 deaths advanced by PM2.5 pollution over expected rates if daily levels had not exceeded the WHO target., Conclusions: PM2.5 concentration was significantly associated with IHD morbidity and mortality in Beijing. Our findings provide a rationale for the urgent need for stringent control of air pollution to reduce PM2.5 concentration., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Recent time series studies have indicated that daily mortality and morbidity are associated with particulate matters. However, about the relative effects and its seasonal patterns of fine particulate matter constituents is particularly limited in developing Asian countries. In this study, we examined the role of particulate matters and its key chemical components of fine particles on both mortality and morbidity in Beijing. We applied several overdispersed Poisson generalized nonlinear models, adjusting for time, day of week, holiday, temperature, and relative humidity, to investigate the association between risk of mortality or morbidity and particulate matters and its constituents in Beijing, China, for January 2005 through December 2009. Particles and several constituents were associated with multiple mortality or morbidity categories, especially on respiratory health. For a 3-day lag, the nonaccident mortality increased by 1.52, 0.19, 1.03, 0.56, 0.42, and 0.32% for particulate matter (PM)2.5, PM10, K(+), SO4(2-), Ca(2+), and NO3(-) based on interquartile ranges of 36.00, 64.00, 0.41, 8.75, 1.43, and 2.24 μg/m(3), respectively. The estimates of short-term effects for PM2.5 and its components in the cold season were 1 ~ 6 times higher than that in the full year on these health outcomes. Most of components had stronger adverse effects on human health in the heavy PM2.5 mass concentrations, especially for K(+), NO3(-), and SO4(2-). This analysis added to the growing body of evidence linking PM2.5 with mortality or morbidity and indicated that excess risks may vary among specific PM2.5 components. Combustion-related products, traffic sources, vegetative burning, and crustal component and resuspended road dust may play a key role in the associations between air pollution and public health in Beijing.

The aim of this study is to explore whether the effect of PM10 (particulate matter with an aerodynamic diameter of <10 µm) on daily mortality was modified by extreme temperatures in Guangzhou from 2005 to 2009. The present study used time-series analysis to explore the modification effects of temperature on the association between PM10 and the cause-specific mortalities for cardiovascular, respiratory, cardiopulmonary, and nonaccidental mortality. The interactions between PM10 and temperature were statistically significant on respiratory mortality. The effect estimates per 10-µg/m(3) increase in PM10 concentrations at the moving average of lags of 0 and 1 day on high-temperature days were 2.34% (95% confidence interval = 0.55, 4.16) for nonaccidental, 1.35% (-1.69, 4.48) for cardiovascular, 6.09% (2.42, 9.89) for respiratory, and 3.36% (0.92, 5.86) for cardiopulmonary mortalities. The results suggest that it is important to control and reduce the emission of air particles in Guangzhou, particularly on extreme-high-temperature days., (© 2014 APJPH.)

Recent epidemiological and toxicological studies have shown associations between particulate matter and human health. However, the estimates of adverse health effects are inconsistent across many countries and areas. The stratification and interaction models were employed within the context of the generalized additive Poisson regression equation to examine the acute effects of fine particles on respiratory health and to explore the possible joint modification of temperature, humidity, and season in Beijing, China, for the period 2004-2009. The results revealed that the respiratory health damage threshold of the PM2.5 concentration was mainly within the range of 20-60 μg/m(3), and the adverse effect of excessively high PM2.5 concentration maintained a stable level. In the most serious case, an increase of 10 μg/m(3) PM2.5 results in an elevation of 4.60 % (95 % CI 3.84-4.60 %) and 4.48 % (95 % CI 3.53-5.41 %) with a lag of 3 days, values far higher than the average level of 0.69 % (95 % CI 0.54-0.85 %) and 1.32 % (95 % CI 1.02-1.61 %) for respiratory mortality and morbidity, respectively. There were strong seasonal patterns of adverse effects with the seasonal variation of temperature and humidity. The growth rates of respiratory mortality and morbidity were highest in winter. And, they increased 1.4 and 1.8 times in winter, greater than in the full year as PM2.5 increased 10 μg/m(3).

Few epidemiological studies have reported the spatial characteristics of the association between particulate matter <10μm in aerodynamic diameter (PM(10)) and mortality in China. This study explored the spatial characteristics of the association between ambient PM(10) and mortality in the urban area of Beijing, China. We collected daily data on air pollution, weather conditions and mortality in the eight urban districts of Beijing from Jan. 1st 2008 to Dec. 31st 2009. A Poisson Generalized Additive Model (GAM) was used to examine the district-specific effects of PM(10) on cause-specific mortality. A Poisson Generalized Additive Mixed Model (GAMM) was used to examine the urban-wide association between PM(10) and cause-specific mortality while controlling for the random effects of districts, compared with GAM which did not control for the random effects of districts. The inter-quartile ranges (IQRs) of annual PM(10) ranged from 83.5 μg/m(3) (Chaoyang district) to 96.0 μg/m(3) (Shijingshan district). A 96.0 μg/m(3) increase of PM(10) was associated with a 7.52% (95%CI: 1.78%-13.56%) increase of cardiovascular mortality in Shijingshan district while an 87.0 μg/m(3) increase of PM(10) was associated with a 7.68% (95%CI: 0.08%-15.86%) increase of respiratory deaths in Dongcheng district. The urban-wide effects derived from GAMM showed that an 88.0 μg/m(3) increase of PM(10) was associated with an increase of 1.30% (95%CI: 0.45%-2.16%), 2.60% (95%CI: 0.14%-5.11%) in non-accidental and respiratory mortality, illustrating, higher results than those from the GAM. In conclusion, there is spatial variation in ambient PM(10) concentration as well as in the effects of PM(10) on cause-specific mortality in the urban area of Beijing. Additionally, GAMM model may be more effective in estimating the spatial association between urban-wide PM(10) and cause-specific mortality., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Only a few epidemiological studies have explored whether there were interactive effects between temperature and particulate matter <10μm in aerodynamic diameter (PM(10)) on mortality, especially in Asian countries. The present study used time-series analysis to explore the modification effects of temperature on the association between PM(10) and the cause-specific mortality for cardiovascular, respiratory, cardiopulmonary, stroke and ischemic heart diseases (IHD), as well as non-accidental mortality in Tianjin between 2007 and 2009. Results showed that the PM(10) effects were stronger on high temperature level days than that on low temperature level days. The interactions between PM(10) and temperature were statistically significant on cardiovascular, cardiopulmonary, and IHD mortalities. The effect estimates per 10-μg/m(3) increase in PM(10) concentrations at the moving average of lags 0 and 1 day in high temperature level were 0.62% (95% confidence interval (CI): 0.27, 0.97) for non-accidental, 0.92% (0.47, 1.36) for cardiovascular, 0.74% (-0.33, 1.82) for respiratory, 0.89% (0.47, 1.32) for cardiopulmonary, 0.65% (0.00, 1.31) for stroke and 1.20% (0.63, 1.78) for IHD mortalities. In addition, the PM(10) effects on high temperature level days were stronger on older (≥65 years) compared with younger subjects (<65 years). This suggests that the modifying effects of the temperature should be considered when analyzing health impacts of ambient PM(10)., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Satellite-based exposure of fine particulate matters has been seldom used as a predictor of mortality. PM2.5 was predicted using Aerosol Optical Depths (AOD) through a two-stage regression model. The predicted PM2.5 was corrected for the bias using two approaches. We estimated the impact by two different scenarios of PM2.5 in the model. We statistically found different distributions of the predicted PM2.5 over the region. Compared to the reference value (5 µg/m3), 90th and 95th percentiles had significant adverse effect on total mortality (RR 90th percentile:1.45; CI 95%: 1.08–1.95 and RR 95th percentile:1.53; CI 95%: 1.11–2.1). Nearly 1050 deaths were attributed to any range of the air pollution (unhealthy range), of which more than half were attributed to high concentration range. Given the adverse effect of extreme values compared to the both scenarios, more efforts are suggested to define local-specific reference values and preventive strategies. [ABSTRACT FROM AUTHOR]

Ambient fine particulate matter (PM2.5), as one of the predominant air pollutants, has achieved effective control in recent years in China. Whether the use of indoor air purifiers is still necessary needs further exploration. A randomized crossover trial was conducted in 54 healthy students in Beijing, China. Participants were randomized assigned to the use of real or sham high‐efficiency particulate air filter (HEPA) for a week and changed the status after a washout period. Health measurements of cardiorespiratory biomarkers were performed at the end of each period. Linear mixed‐effects models were used to evaluate the association between PM2.5 exposure and cardiorespiratory biomarkers. Compared with sham air purification, average diastolic blood pressure (DBP), fractional exhaled nitric oxide (FeNO), and 8‐isoprostane (8‐isoPGF2α) levels decreased significantly in the real purification. The effects of indoor air purification on lung function indicators including forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and forced expiratory flow between the 25th and 75th percentile of forced vital capacity (FEF25%–75%) were also significant. Our findings showed a protective effect of indoor HEPA air purifiers on cardiorespiratory health of young healthy adults reflected by the decreased blood pressure, respiratory inflammation, and systematic oxidative stress and improved lung function. [ABSTRACT FROM AUTHOR]

Particulate matter (PM) is an important component of air pollutants and is associated with various health risks. However, the impact of PM on toddlers' gut microbiota is rarely investigated. This study aimed to assess the cumulative and lagged effects of varying-sized PMs on toddlers' gut microbiota. We collected demographic information, stool samples, and exposure to PM from 36 toddlers aged 2–3 years. The toddlers were divided into warm season group and cooler season group according to the collection time of stool samples. The gut microbiota was processed and analyzed using 16S rRNA V3–V4 gene regions. The concentration of PM was calculated using China High Air Pollutants (CHAP) database. To assess the mixed effects of varying-sized PM, multiple-PM models were utilized. There were significant differences between the community composition, α - and β -diversity between two groups. In multiple-PM models, there was a significant effect of weight quantile sum (PM 1 , PM 2.5 , and PM 10) on α -diversity indices. In weight quantile sum models, after adjusting for a priori confounders, we found a negative effect of weight quantile sum on Enterococcus (β = -0.134, 95% CI -0.263 to -0.006), positive effects of weight quantile sum on unclassified_f__Ruminococcaceae (β = 0.247, 95% CI 0.102 to 0.393), Ruminococcus_1 (β = 0.444, 95% CI 0.238 to 0.650), unclassified_f__Lachnospiraceae (β = 0.278, 95% CI 0.099 to 0.458), and Family_XIII_AD_3011_group (β = 0.254, 95% CI 0.086 to 0.422) in WSG and CSG. In lagged weight quantile sum models, the correlation between lag time PM levels and the gut microbiota showed seasonal trends, and weights of PM changed with lag periods. This is the first study to highlight that cumulative and lagged effects of PMs synergistically affect the diversities (α - and β -diversity) and abundance of the gut microbiota in toddlers. Further research is needed to explore the mediating mechanism of varying-sized PMs exposure on the gut microbiota in toddlers. [Display omitted] • Differences shown in community composition between different PM exposure groups. • Differences shown in α - and β -diversity of gut microbiota between two groups. • Cumulative effects of single and double PM exposure on genera were found. • Cumulative effects of multiple PM exposure on five genera were revealed. • Lagged effects of multiple PM exposure on special genera had seasonal trends. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have found associations between ambient fine particulate matter (PM2.5) and increased mortality risk. However, little evidence is available on associations between PM2.5 and years of life lost (YLL). We aimed to estimate the YLL due to chronic obstructive pulmonary disease (COPD) mortality related to ambient PM2.5 exposure.Methods: A time-series study was conducted based on the data on air pollutants, meteorological conditions and 18,472 registered COPD deaths in Ningbo, China, 2011-2015. The effects of PM2.5 on YLL and daily death of COPD were estimated, after controlling long term trend, meteorological index and other confounders.Results: The impact of PM2.5 on YLL due to COPD lasted for 5 days (lag 0-4). Per 10 μg/m3 increase in PM2.5 was associated with 0.91 (95%CI: 0.16, 1.66) years increase in YLL. The excess YLL of COPD mortality were 8206 years, and 0.38 day per person in Ningbo from 2011 to 2015. The exposure-response curve of PM2.5 and YLL due to COPD showed a non-linear pattern, with relatively steep at low levels and flattened out at higher exposures.. Furthermore, the effects were significantly higher in the elderly than those in the younger.Conclusions: Our findings explored burden of PM2.5 on YLL due to COPD and highlight the importance and urgency of ambient PM2.5 pollution control and protection of the vulnerable populations. [ABSTRACT FROM AUTHOR]

Research on the relationship between short-term exposure to fine particulate matter (PM 2.5) and urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) is sparse in the nonoccupationally exposed populations. A quasi-experimental observation of haze events nested within a randomized crossover trial of alternative 1-week real or sham indoor air filtration was conducted to evaluate the associations of urinary monohydroxy-PAHs (OH-PAHs) with short-term exposure to PM 2.5 and PM 2.5 -bound PAHs. The study was conducted among 57 healthy college students in Beijing, China. PM 2.5 -bound PAHs and urinary OH-PAHs were quantified using gas chromatography coupled with a triple-quadrupole tandem mass spectrometer. Linear mixed-effect models were applied to evaluate the association of urinary OH-PAHs with time-weighted personal PM 2.5 and PM 2.5 -bound PAHs, controlling for potentially confounding variables. The results demonstrated that air filtration could markedly reduce external exposure to PM 2.5 and PM 2.5 -bound parent, nitrated, and oxygenated PAHs. In the intervention trial, the urinary concentrations of 2-hydroxyfluorene (2-OH-FLU) and 9-hydroxyphenanthrene (9-OH-PHE) were elevated significantly by 16.5% (95% CI, 2.1%, 33.1%) and 37.9% (95% CI, 8.4%, 75.4%), respectively, in association with a doubling increase in personal PM 2.5 exposure. Urinary 9-OH-PHE was also significantly positively associated with the increase in the sum of PM 2.5 -bound parent PAHs. Furthermore, the levels of urinary OH-PAHs such as 2-OH-FLU and 9-OH-PHE in the haze events were elevated by 31.1% (95% CI, 8.7%, 53.4%) and 73.5% (95% CI, 16.0%, 131.0%), respectively, in association with a doubling increase in personal PM 2.5 exposure. The findings indicated that urinary 2-OH-FLU and 9-OH-PHE could serve as potential internal exposure biomarkers for assessing short-term PM 2.5 exposure in nonoccupational populations. [Display omitted] • Air filtration markedly reduced indoor PM 2.5 and most PM 2.5 -bound PAHs. • Air filtration abated increases in specific urinary OH-PAHs during haze events. • Urinary 2-OH-FLU and 9-OH-PHE could indicate short-term PM 2.5 exposure levels. Urinary 2-OH-FLU and 9-OH-PHE could serve as potential internal exposure biomarkers to indicate short-term PM 2.5 exposure in nonoccupational populations. [ABSTRACT FROM AUTHOR]

Ambient air pollutant exposure can change the composition of gut microbiota at 6-months of age, but there is no epidemiological evidence on the impacts of exposure to particulate matter with an aerodynamic diameter ≤1 μm (PM 1) during pregnancy on gut microbiota in mothers and neonates. We aimed to determine if gestational PM 1 exposure is associated with the gut microbiota of mothers and neonates. Leveraging a mother-infant cohort from the central region of China, we estimated the exposure concentrations of PM 1 during pregnancy based on residential address records. The gut microbiota of mothers and neonates was analyzed using 16 S rRNA V3–V4 gene sequences. Functional pathway analyses of 16 S rRNA V3–V4 bacterial communities were conducted using Tax4fun. The impact of PM 1 exposure on α-diversity, composition, and function of gut microbiota in mothers and neonates was evaluated using multiple linear regression, controlling for nitrogen dioxide (NO 2) and ozone (O 3). Permutation multivariate analysis of variance (PERMANOVA) was used to analyze the interpretation degree of PM 1 on the sample differences at the OTU level using the Bray-Curtis distance algorithm. Gestational PM 1 exposure was positively associated with the α-diversity of gut microbiota in neonates and explained 14.8% (adj. P = 0.026) of the differences in community composition among neonatal samples. In contrast, gestational PM 1 exposure had no impact on the α- and β-diversity of gut microbiota in mothers. Gestational PM 1 exposure was positively associated with phylum Actinobacteria of gut microbiota in mothers, and genera Clostridium_sensu_stricto_1 , Streptococcus , Faecalibacterium of gut microbiota in neonates. At Kyoto Encyclopedia of Genes and Genomes pathway level 3, the functional analysis results showed that gestational PM 1 exposure significantly down-regulated Nitrogen metabolism in mothers, as well as Two-component system and Pyruvate metabolism in neonates. While Purine metabolism, Aminoacyl-tRNA biosynthesis, Pyrimidine metabolism, and Ribosome in neonates were significantly up-regulated. Our study provides the first evidence that exposure to PM 1 has a significant impact on the gut microbiota of mothers and neonates, especially on the diversity, composition, and function of neonatal meconium microbiota, which may have important significance for maternal health management in the future. • Exposure to PM 1 has significant impacts on the gut microbiota of mothers and neonates. • Gestational PM 1 exposure especially impacts the gut microbiota of neonates. • Interventions from environment perspective may benefit the offspring's gut microbiota. [ABSTRACT FROM AUTHOR]

To estimate the impact of short- and long-term exposure to PM 2.5 on hospital admission (HA) risks of circulatory diseases, respiratory diseases, mental disorders, endocrine and metabolic diseases, allergic diseases, urogenital diseases and malignant tumors respectively in an exposed population (by gender and age groups). Based on the data of ambient PM 2.5 concentration and HAs in Beijing from January 1, 2013 to December 31, 2014, the spatial-temporal method is employed for a mixed Poisson regression model to integrate both short- and long-term exposure simultaneously when estimating the risk of HAs in the whole and subgroup population. The HA risks of mental disorders, urogenital diseases, diabetes and malignant tumors of the exposed population were associated with higher short-term ambient PM 2.5 exposure. Positive associations between long-term PM 2.5 exposure and the HAs were found for ischemic stroke, respiratory diseases, endocrine and metabolic diseases, allergic diseases, urogenital diseases, and malignant tumors (except lung cancer). The estimates of PM 2.5 -HA associations varied by sex and age groups. Ambient PM 2.5 levels were positively associated with previously identified causes of HAs such as circulatory and respiratory diseases, as well as several prevalent but rarely studied diseases such as mental disorders, endocrine and metabolic diseases, allergic diseases, urogenital diseases, and malignant tumors (except lung cancer). The health losses caused by PM 2.5 exposure could be underestimated if only circulatory and respiratory diseases were considered. Sex and age were modifying factors for the PM 2.5 -HA associations. [Display omitted] • One of the first study in China to explore the PM 2.5 -HA association comprehensively. • Rarely studied and previously identified causes of HAs were associated with PM 2.5. • Short- and long-term effects of PM 2.5 were estimated simultaneously. • Effects due to long-term exposure were larger than those of short-term exposure. • It is valuable to extend short-term PM 2.5 exposure to a longer time span to estimate its effect of HA. [ABSTRACT FROM AUTHOR]

There is an increasing interest in understanding whether air pollutants modify the quantitative relationships between temperature and health outcomes. The results of available studies were, however, inconsistent. This study aims to sum up the current evidence and provide a comprehensive understanding of this topic. We conducted an electronic search in PubMed (MEDLINE), EMBASE, Web of Science Core Collection, and ProQuest Dissertations and Theses. The modified Navigation Guide was applied to evaluate the quality and strength of evidence. We calculated pooled temperature-related mortality at low and high pollutant levels respectively, using the random-effects model. We identified 22 eligible studies, eleven of which were included in the meta-analysis. Significant effect modification was observed on heat effects for all-cause and non-accidental mortality by particulate matter with an aerodynamic diameter of <10 μm (PM 10) and ozone (O 3) (p < 0.05). The excess risks (ER s) for all-cause and non-accidental mortality were 5.4% (4.4%, 6.4%) and 6.3% (4.8%, 7.8%) at the low PM 10 level, 8.8% (7.5%, 10.1%) and 11.4% (8.7%, 14.2%) at the high PM 10 level, respectively. As for O 3 , the ER s for all-cause and non-accidental mortality were 5.1% (3.9%, 6.3%) and 3.6% (0.1%, 7.2%) at the low O 3 level, 7.6% (6.3%, 9.0%) and 12.5% (4.7%, 20.9%) at the high O 3 level, respectively. Surprisingly, the heat effects on cardiovascular mortality were found to be lower at high carbon monoxide (CO) levels [ ER s = 5.4% (3.9%, 6.9%)] than that at low levels [ ER s = 9.4% (7.0%, 11.9%)]. The heterogeneity varied, but the results of sensitivity analyses were generally robust. Significant effect modification by air pollutants was not observed for heatwave or cold effects. PM 10 and O 3 modify the heat-related all-cause and non-accidental mortality, indicating that policymakers should consider air pollutants when establishing heat-health warning systems. Future studies with comparable designs and settings are needed. [Display omitted] • This is the first review on whether pollutants modify temperature-related mortality. • Higher PM10 and O3 elevate the heat-related all-cause and non-accidental mortality. • Air pollutants should be considered when developing heat-health warning systems. [ABSTRACT FROM AUTHOR]

Abstract: Evidence concerning the health risk of fine and coarse particles is limited in developing Asian countries. The modifying effect between particles and temperature and season also remains unclear. Our study is one of the first to investigate the acute effect of particles size fractions, modifying effects and interannual variations of relative risk in a developing megacity where particulate levels are extraordinarily high compared to other Asian cities. After controlling for potential confounding, the results of a time-series analysis during the period 2005&#x2013;2009 show that a 10 &#x03bc;g m&#x2212;3 increase in PM2.5 levels is associated with a 0.65% (95% CI: 0.29&#x2013;0.80%), 0.63% (95% CI: 0.25&#x2013;0.83%), and 1.38% (95% CI: 0.51&#x2013;1.71%) increase in non-accidental mortality, respiratory mortality, and circulatory mortality, respectively, while a 10 &#x03bc;g m&#x2212;3 increase in PM10 is similarly associated with increases of 0.15% (95% CI: 0.04&#x2013;0.22%), 0.08% (95% CI: 0.01&#x2013;0.18%), and 0.44% (95% CI: 0.12&#x2013;0.63%). We did not find a significant effect of PM2.5 &#x2013; 10 on daily mortality outcomes. Our analyses conclude that temperature and particulates, exposures to both of which are expected to increase with climate change, might act together to worsen human health in Beijing, especially in the cool seasons. The level of the estimated percentage increase assume an escalating tendency during the study period, in addition to having a low value in 2008, and after the Olympic Games, the values increased significantly as the temporary atmospheric pollution control measures were terminated mostly. [ABSTRACT FROM AUTHOR]