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Associations of long-term exposure to ambient PM2.5 with mortality in Chinese adults: A pooled analysis of cohorts in the China-PAR project
Environment International ( IF 10.3 ) Pub Date : 2020-03-05 , DOI: 10.1016/j.envint.2020.105589
Xueli Yang , Fengchao Liang , Jianxin Li , Jichun Chen , Fangchao Liu , Keyong Huang , Jie Cao , Shufeng Chen , Qingyang Xiao , Xiaoqing Liu , Chong Shen , Ling Yu , Fanghong Lu , Xianping Wu , Xigui Wu , Ying Li , Liancheng Zhao , Dongsheng Hu , Jianfeng Huang , Xiangfeng Lu , Yang Liu , Dongfeng Gu

Background

The concentration-response relationship between mortality and long-term exposure to fine particulate matter (PM2.5) has not been fully elucidated, especially at high levels of PM2.5 concentrations.

Objective

We aimed to evaluate chronic effects of ambient PM2.5 exposure on deaths among Chinese adults in high-exposure settings.

Methods

Participants of the Prediction for Atherosclerotic cardiovascular disease Risk in China (China-PAR) project were included from four prospective cohorts among Chinese adults aged ≥18 years old. The overall follow-up rate of the four cohorts was 93.4% until the recent follow-up survey that ended in 2015. The average of satellite-based PM2.5 concentrations during 2000–2015 at 1-km spatial resolution was assigned to each participant according to individual residence addresses. Based on the pooled analysis of individual data from the four cohorts, a Cox proportional hazards model was used to estimate the hazard ratio (HR) and corresponding 95% confidence intervals (95% CIs) for the association of PM2.5 exposure with mortality after multivariate adjustment.

Results

A total of 116,821 participants were eligible in the final analysis. During a mean of 7.7 years of follow-up, 6,395 non-accidental deaths and 2,507 cardio-metabolic deaths occurred. The mean of PM2.5 concentration was 64.9 μg/m3 ranging from 31.2 μg/m3 to 97.0 μg/m3. For each 10 μg/m3 increment in PM2.5, the HR was 1.11 (95% CI: 1.08–1.14) for non-accidental mortality and 1.22 (95% CI: 1.16–1.27) for cardio-metabolic mortality. In addition, a weak exponential curve for the concentration-response association between mortality and PM2.5 was observed among Chinese adults.

Conclusions

Our study provided important evidence of the long-term effects of PM2.5 exposure on deaths among Chinese adults. The findings expand our knowledge on concentration-response relationship in high-exposure environments, which is essential to address the urgent challenge of reducing the disease burden attributable to PM2.5 exposure in rapidly industrializing countries such as China.

更新日期:2020-03-05
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