Effect Of Short-term Exposure To Air Pollution On Mortality In Jing'an Distict,Wuhan

Objective To investigate the short-term burden of ambient air pollution on mortality and years of life lost(YLL),and to examine the possible modifiers.Methods Air pollution data,daily mortality,and meteorological data were collected from 2002 to 2010 in Jiang'an District of Wuhan.By using the Poisson regression with Generalized Additive Models(GAM)and adjusted by the long-term and seasonal trend,meteorological factors,weeks and holiday effect,Time-series analysis was conducted to examine the effect of PM10,SO2,NO2 on daily mortality and YLL,Stratified analysis by age,sex,education level,season,and temperature was conducted to identify the modifiers.Results(1)During the study period,the average concentration was(118.65±62.67)?g/m3 for PM10,(49,26±33.60)?g/m3 for SO2 and(58.32±25.37)?g/m3 for NO2,and the median of daily non-accidental,cardiovascular and respiratory deaths were 11.0,5.0 and 1.0,respectively.(2)Three air pollutants were significantly associated with non-accidental mortality,cardiovascular mortality and YLL.With an increase of 10 ?g/M3 in 2-day average concentrations of PM10,SO2,and NO2,daily non-accidental mortality increased by 0.29%(95%CI:0.06,0.53),1.22%(95%CI:0.77,1.67),and 1.60%(95%CI:1.00,2.19);YLL increased by 0.62%(95%CI:0.01,1.24),2.83%(95%CI:1.38,4.27)and 3.12%(95%CI:1.29,4.95)years.(3)The magnitude of the estimates was higher for females and those with low education.To be more specific,we observed that per 10 ?g/m3 increase in SO2 was association with increases in non-accidental mortality of 2.03%(95%CI:1.38,2.67)for all females and 3.10%(95%CI:2.05,4.16)for females with low education.(4)A trough in summer was observed in the acute effect of ambient air pollution on non-accidental and cardiovascular mortality.A 10 ?g/m3 increase in 2-day average for PM10 was associated with 0.28%(95%CI:0.01,0.56),0.28%(95%CI:-0.05,0.61),0.11%(95%CI:-0.38,0.59)and 0.31%(95%CI:-0.03,0.65)for non-accidental mortality.There was a clear single peak in winter for respiratory mortality.(5)High temperature(daily average temperature>33.4?)obviously enhanced the effect of PM10 on mortality.With 10 ?g/m3 increase in PM10 concentrations,non-accidental mortality increased 2.95%(95%CI:1.68,4.24).However,low temperature(daily average temperature<-0.21?)enhanced PM10 effect on respiratory mortality with 3.31%(95%CI:0.07,6.64)increase.At high temperature,PM10 had significantly stronger effect on non-accidental mortality of female aged over 65 and people with high educational level groups,whereas people with low educational level were more susceptible to low temperature.Conclusion The short-term exposure to air pollution was significantly associated with mortality and years of life lost,while the females and those with low education were more vulnerable and susceptible to air pollution.Season and temperature may modify the health effects of air pollution in Jiang'an District of Wuhan.