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The association between long-term exposure to low-level PM2.5 and mortality in the state of Queensland, Australia: A modelling study with the difference-in-differences approach.
- Source :
-
PLoS medicine [PLoS Med] 2020 Jun 18; Vol. 17 (6), pp. e1003141. Date of Electronic Publication: 2020 Jun 18 (Print Publication: 2020). - Publication Year :
- 2020
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Abstract
- Background: To date, few studies have investigated the causal relationship between mortality and long-term exposure to a low level of fine particulate matter (PM2.5) concentrations.<br />Methods and Findings: We studied 242,320 registered deaths in Queensland between January 1, 1998, and December 31, 2013, with satellite-retrieved annual average PM2.5 concentrations to each postcode. A variant of difference-in-differences (DID) approach was used to investigate the association of long-term PM2.5 exposure with total mortality and cause-specific (cardiovascular, respiratory, and non-accidental) mortality. We observed 217,510 non-accidental deaths, 133,661 cardiovascular deaths, and 30,748 respiratory deaths in Queensland during the study period. The annual average PM2.5 concentrations ranged from 1.6 to 9.0 μg/m3, which were well below the current World Health Organization (WHO) annual standard (10 μg/m3). Long-term exposure to PM2.5 was associated with increased total mortality and cause-specific mortality. For each 1 μg/m3 increase in annual PM2.5, we found a 2.02% (95% CI 1.41%-2.63%; p < 0.01) increase in total mortality. Higher effect estimates were observed in Brisbane than those in Queensland for all types of mortality. A major limitation of our study is that the DID design is under the assumption that no predictors other than seasonal temperature exhibit different spatial-temporal variations in relation to PM2.5 exposure. However, if this assumption is violated (e.g., socioeconomic status [SES] and outdoor physical activities), the DID design is still subject to confounding.<br />Conclusions: Long-term exposure to PM2.5 was associated with total, non-accidental, cardiovascular, and respiratory mortality in Queensland, Australia, where PM2.5 levels were measured well below the WHO air quality standard.<br />Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: YG is an Academic Editor and a member of editorial board of PLOS Medicine.
- Subjects :
- Age Factors
Aged
Cardiovascular Diseases mortality
Cause of Death
Female
Humans
Inhalation Exposure statistics & numerical data
Male
Middle Aged
Models, Statistical
Queensland epidemiology
Respiratory Tract Diseases mortality
Risk Factors
Inhalation Exposure adverse effects
Mortality
Particulate Matter adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1549-1676
- Volume :
- 17
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- PLoS medicine
- Publication Type :
- Academic Journal
- Accession number :
- 32555635
- Full Text :
- https://doi.org/10.1371/journal.pmed.1003141