Short-term effects of fine particulate matter on non-accidental and circulatory diseases mortality: A time series study among the elder in Changchun

BACKGROUND AND OBJECTIVES: Fine particulate matter (PM(2.5), particulate matter with an aerodynamic diameter less than or equal to 2.5 μm) has multiple adverse effects on human health, especially on the respiratory and circulatory system. The purpose of this study was to evaluate the short-term effect of PM(2.5) on the mortality risk of non-accidental and circulatory diseases, and to explore the potential effect modification by sex, education and death location. METHODS: We collected daily mortality counts of Changchun (China) residents, daily meteorology and air pollution data, from January 1, 2014, to January 1, 2017. We focused on the elderly (≥65 years old) population who died from non-accidental causes and circulatory diseases, and stratified them by sex, education, and death location. A generalized additive Poisson regression model (GAM) was used to analyse the impact of air pollutants on mortality. We fit single pollutant models to examine PM(2.5) effects with different lag structures of single-day (distributed lag:lag0-lag3) and multi-day (moving average lag: lag01-lag03). To test the sensitivity of the model, a multi-pollutant model was established when the PM(2.5) effect was strongest. RESULTS: In the single pollutant models, an increment of PM(2.5) by 10 μg/m(3) at lag0-3 was associated with a 0.385% (95% CI: 0.069% to 0.702%) increase in daily non-accidental mortality and a 0.442% (95% CI: 0.038% to 0.848%) increase in daily circulatory disease mortality. NO(2) (lag1) and O(3) (lag0, lag1, lag2, lag01,lag02, lag03) were associated with daily non-accidental death and NO(2) (lag1, lag3, lag03) and O(3) (lag0, lag1, lag01,lag02, lag03) were associated with daily circulatory disease mortality. In the co-pollutant models, the risk estimates for PM(2.5) changed slightly. The excess mortality risk of non-accidental and circulatory diseases was higher for women, people with low education, and died outside hospital. CONCLUSIONS: We found that short-term exposure to PM(2.5) increased the mortality risk of non-accidental and circulatory diseases among the elderly in Changchun. Women, people with low education and died outside hospital are more susceptible to PM(2.5). NO(2) and O(3) were also associated with an increase in mortality from non-accidental and circulatory diseases and the O(3) is a high effect.