Association between ambient air pollution and mortality from chronic obstructive pulmonary disease in Wuhan, China: a population-based time-series study
2021
Yan, Yaqiong | She, Lu | Guo, Yan | Zhao, Yuanyuan | Zhang, Pei | Xiang, Bing | Zeng, Jing | Yang, Mei | Wang, Liang
Evidence on the short-term effects of ambient air pollution on chronic obstructive pulmonary disease (COPD) mortality is still not conclusive. The aim of this study was to investigate the relationships between them in Wuhan China. Daily death numbers, concentrations of air pollutants (PM₂.₅, PM₁₀, SO₂, NO₂, and O₃), and meteorological characteristics in Wuhan from January 1, 2014, to December 31, 2019, were collected. Time-series analysis using generalized additive model was applied. The results showed that a total of 16,150 deaths (7.37 deaths per day) from COPD were observed. The daily average concentrations of PM₂.₅, PM₁₀, SO₂, NO₂, and O₃ were 59.03, 90.48, 12.91, 48.84, and 91.77 μg/m³, respectively. In single pollutant model, for every increase of 10 μg/m³ in PM₁₀, SO₂, and NO₂ levels, COPD mortality increased by 0.583% (95% CI: 0.055–1.113%), 4.299% (95% CI: 0.978–7.729%), and 1.816% (95% CI: 0.515–3.313%) at lag03, respectively. No significant associations were found for PM₂.₅ and O₃. Subgroup analysis demonstrated that females were more susceptible to PM₂.₅, PM₁₀, SO₂, and NO₂. The concentrations of PM₁₀, SO₂, and NO₂ were significantly associated with COPD mortality for older adults. The effects of PM₂.₅ and O₃ on COPD mortality were higher in warm period. In two-pollutant models, the significantly positive associations between SO₂ and NO₂ and COPD mortality remained after adjusting for PM₂.₅ or O₃. In conclusions, short-term exposure to PM₁₀, SO₂, and NO₂ are significantly associated with a higher risk of COPD mortality. Female or elderly are more susceptible to air pollution. It is urgent to implement the environmental protection policy.
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