The burden of air pollution and weather condition on daily respiratory deaths among older adults in China, Jinan from 2011 to 2017

The health effects of short-term exposure to air pollutants on respiratory deaths and its modifiers such as meteorological indexes have been widely investigated. However, most of the previous studies are limited to single pollutants or total respiratory deaths, and their findings are inconsistent. To comprehensively examine the short-term effects of air pollutants on daily respiratory mortality. Our analysis included 16,931 nonaccidental respiratory deaths (except lung cancer and tuberculosis) among older adults (>65 years) from 2011 to 2017 in Jinan, China. We used a generalized additive Poisson models adjusted for meteorology and population dynamics to examine the associations between air pollutants (particulate matter with an aerodynamic diameter of b2.5μm [PM(2.5)], particulate matter with an aerodynamic diameter of b10μm [PM(10)], SO(2), NO(2), O(3)) and daily mortality for the total patients, males, females, chronic airway diseases, pneumonia patients, and rest patients in Jinan. Outdoor air pollution was significantly related to mortality from all respiratory diseases especially from chronic airway disease in Jinan, China. The effects of air pollutants had lag effects and harvesting effects, and the effects estimates usually reached a peak at lag 1 or 2 day. An increase of 10 μg/m(3) or 10 ppb of PM(2.5), PM(10), SO(2), NO(2), and O(3) corresponds to increments in mortality caused by chronic airway disease of 0.243% (95% confidence interval [CI]: −0.172–0.659) at lag 1 day, 0.127% (95% CI: −0.161–0.415) at lag 1 day, 0.603% (95% CI: 0.069–1.139) at lag 3 day, 0.649% (95% CI: −0.808–2.128) at lag 0 day and 0.944% (95% CI: 0.156–0.1598) at lag 1 day, respectively. The effects of air pollutants were usually greater in females and varied by respiratory subgroups. Spearman correlation analysis suggested that there was a significant association between meteorological indexes and air pollutants. Sex, age, temperature, humidity, pressure, and wind speed may modify the short-term effects of outdoor air pollution on mortality in Jinan. Compared with the other pollutants, O(3) had a stronger effect on respiratory deaths among the elderly. Moreover, chronic airway diseases were more susceptible to air pollution. Our findings provided new evidence for new local environmental and health policies making.