Long-Term Exposure to PM(2.5) and Mortality: A Cohort Study in China

We investigated the association of long-term exposure to atmospheric PM(2.5) with non-accidental and cause-specific mortality in Yinzhou, China. From July 2015 to January 2018, a total of 29,564 individuals aged ≥ 40 years in Yinzhou were recruited for a prospective cohort study. We used the Cox proportional-hazards model to analyze the relationship of the 2-year average concentration of PM(2.5) prior to the baseline with non-accidental and cause-specific mortality. The median PM(2.5) concentration was 36.51 μg/m(3) (range: 25.57–45.40 μg/m(3)). In model 4, the hazard ratios per 10 μg/m(3) increment in PM(2.5) were 1.25 (95%CI: 1.04–1.50) for non-accidental mortality and 1.38 (95%CI:1.02–1.86) for cardiovascular disease mortality. We observed no associations between PM(2.5) and deaths from respiratory disease or cancer. In the subgroup analysis, interactions were observed between PM(2.5) and age, as well as preventive measures on hazy days. The observed association between long-term exposure to atmospheric PM(2.5) at a relatively moderate concentration and the risk of non-accidental and cardiovascular disease mortality among middle-aged and elderly Chinese adults could provide evidence for government decision-makers to revise environmental policies towards a more stringent standard.