Background

Sulfur dioxide (SO₂) is one of the major gaseous pollutants in China and other developing countries. Few multicity studies have been done to examine the short-term effect of SO₂ on cause-specific years of life lost (YLL). This study was designed to investigate the burden of chronic obstructive pulmonary disease (COPD) associated with SO₂ exposure.

Methods

A 5-year time-series study was conducted in 48 Chinese cities from 2013 to 2017. Generalized additive models were first used to estimate the city-specific relationship. Then, random-effects meta-analyses were applied to pool the estimates. Furthermore, the roles of potential modifiers and the related economic loss estimated by the method of value per statistical life year were also evaluated.

Results

The annual mean concentration of SO₂ was 27.1 μg/m³. A 10 μg/m³ increase in 4-day moving average (lag03) of SO₂ concentration was associated with 0.83% (95% CI: 0.13%, 1.53%) relative increment in YLL from COPD, and relevant percent change of mortality was 0.78% (95% CI: 0.16%, 1.41%). Moreover, a significantly higher effect was observed in the warm season, particularly in the south region. SO₂ exposure was estimated to account for 1.89% of the total economic loss due to YLL from COPD.

Conclusions

Our findings showed a positive association between short-term exposure to SO₂ and YLL from COPD and highlighted the importance of continuous control of SO₂ pollution to reduce corresponding attributable disease burden.