The burden of COPD mortality due to ambient air pollution in Guangzhou, China

Few studies have investigated the chronic obstructive pulmonary disease (COPD) mortality fraction attributable to air pollution and modification by individual characteristics of air pollution effects. We applied distributed lag non-linear models to assess the associations between air pollution and COPD mortality in 2007–2011 in Guangzhou, China, and the total COPD mortality fraction attributable to air pollution was calculated as well. We found that an increase of 10 μg/m(3) in particulate matter with an aerodynamic diameter of 10 μm or less (PM(10)), sulfur dioxide (SO(2)) and nitrogen dioxide (NO(2)) was associated with a 1.58% (95% confidence interval (CI): 0.12–3.06%), 3.45% (95% CI: 1.30–5.66%) and 2.35% (95% CI: 0.42–4.32%) increase of COPD mortality over a lag of 0–15 days, respectively. Greater air pollution effects were observed in the elderly, males and residents with low educational attainment. The results showed 10.91% (95% CI: 1.02–9.58%), 12.71% (95% CI: 5.03–19.85%) and 13.38% (95% CI: 2.67–22.84%) COPD mortality was attributable to current PM(10), SO(2) and NO(2) exposure, respectively. In conclusion, the associations between air pollution and COPD mortality differed by individual characteristics. There were remarkable COPD mortality burdens attributable to air pollution in Guangzhou.