Associations Between Air Pollution And Repiratory Diseases Mortality In Wuhan,China

Objective:The aim of the thesis is to investigate the effects of air pollution on the death of respiratory diseases based on the condition of the air pollution and the death of respiratory diseases in Wuhan,and to analyze the differences of short-term health effects among different gender,age and respiratory diseases.Also,in order to provide new ideas for the future study on the health effect of air pollution,this study explored the association between aerosol optical depth(AOD)and respiratory diseases in Wuhan.Methods:AOD data,air pollutants data(PM10,SO2,NO2),meteorological data(temperature,relative humidity)and residents' daily respiratory diseases data in Wuhan during 2007—2009 were collected and descriptive analysis have been applied.In the time series analysis,we fitted generalized additive models(GAM)by using smoothing spline function to control the confounding factors like time trend,meteorological factors and week effect;In the bidirectional time stratified case-crossover study,we fitted the case-crossover models by setting the death day of patients with respiratory disease as index period and the day before or after death day 14 days as referent period.We analyzed the exposure response relationship between AOD,PM10,SO2,NO2 concentration and daily respiratory disease mortality,and futher built multi-pollutant model by adjusting coexisting air pollutants as well as conducted gender,age and disease subgroup analysis.SPSS20.0 is adopted to conduct descriptive analysis,and statistical models were performed by using R2.12.0.The inspection level was a=0.05 and p = 0.05 on both sides was significant efficiency boundary values.Results:1.Characteristics of residents:During 2007—2009,there was a total of 2,120 respiratory disease deaths in Wuhan,of which 142(6.7%),833(39.3%)and 481(22.7%)were due to pneumonia,chronic obstructive pulmonary disease and asthma respectively.Mortality differed based on the gender and and gender,men and 65 years old and above were 1,349(63.6%),1,844(87%),respectively.2.Conditions of air pollution:Over a 3-year period,the mean daily pollutant levels were 136?g/m3 for PM10,52?g/m3 for SO2 and 54?g/m3 for NO2.Annual average of valid AOD was 1.13,temperature was 18? and relative humidity was 70%.Weekly moving average trends of PM10 and AOD:Both valid AOD and imputed AOD had consistent weekly moving average trends with that of PM10?3.The association between air pollutants and respiratory disease deaths:Statistical significant were found both in single and multi-pollutant models.For example:A 10?g/m3 increment of SO2 was associated with 1.9%(95%CI:0.2%—3.6%)and 2.4%(95%CI:0.7%—4.1%)increase of lag 1 respiratory disease mortality in GAM and case-crossover.After adjusting the existing contaminants of PM10 and NO2,these two models also showed the statistical significant results,the relative risks and 95%confidence intervals(CIs)were 2.4%(95%CI:0.2%—4.8%)and 2.9%(95%CI:1.2%—4.6%).4.Subgroup analysis between air pollutants and respiratory disease deaths:(1)In men and 65 years old and above groups,statistical significant were found between air pollutants and respiratory disease deaths.For example:A 10?g/m3 increment of SO2 was associated with 3.4%(95%CI:1.3%-5.5%)and 2.3%(95%CI:0.5%-4.1%)increase of lag 1 respiratory disease mortality in case-crossover among men and 65 years old and above groups.(2)In single-respiratory diseases groups,statistical significant was only found between PM10 and pneumonia that is a 10?g/m3 increment of PM10 was associated with 4.3%(95%CI:1.1%-7.5%)and 4.8%(95%CI:1.2%-8.4%)increase of lag 1 pneumonia mortality in GAM and case-crossover respectively.5.The association between PM10,AOD and respiratory disease deaths:(1)There was no significant difference between PM10,valid AOD,RH ad-AOD and respiratory disease deaths,but similar results were found between them.(2)There was no significant difference between PM10,imputed AOD,RH ad-AOD and respiratory disease deaths,but similar results were also found between them.Conclusion:Chronic obstructive pulmonary disease is the major respiratory diseases among residents in Wuhan.Statistical significant were found between air pollutants(PM10,SO2,NO2)and respiratory disease deaths and especially in men,65 years old and above groups,the relative risks were more higher.In addition,similar results were found between PM10,AOD,RH ad-AOD and respiratory diseases.