Change in the number of PM2.5-attributed deaths in China from 2000 to 2010: Comparison between estimations from census-based epidemiology and pre-established exposure-response functions

Tao Xue; Tong Zhu; Yixuan Zheng; Jun Liu; Xin Li; Qiang Zhang

doi:10.1016/j.envint.2019.05.067

Change in the number of PM_2.5-attributed deaths in China from 2000 to 2010: Comparison between estimations from census-based epidemiology and pre-established exposure-response functions

Environ Int. 2019 Aug:129:430-437. doi: 10.1016/j.envint.2019.05.067. Epub 2019 May 30.

Authors

Tao Xue¹, Tong Zhu², Yixuan Zheng³, Jun Liu³, Xin Li³, Qiang Zhang⁴

Affiliations

¹ BIC-ESAT and SKL-ESPC, College of Environmental Science and Engineering, Peking University, Beijing 100871, China.
² BIC-ESAT and SKL-ESPC, College of Environmental Science and Engineering, Peking University, Beijing 100871, China. Electronic address: tzhu@pku.edu.cn.
³ Department of Earth System Science, Tsinghua University, Beijing 100084, China.
⁴ Department of Earth System Science, Tsinghua University, Beijing 100084, China. Electronic address: qiangzhang@tsinghua.edu.cn.

PMID: 31154145
DOI: 10.1016/j.envint.2019.05.067

Abstract

Long-term exposure to ambient fine particulate matter (PM_2.5) has been identified as a major contributor to disease burden in many countries, including China. The effects of long-term PM_2.5 exposure have been evaluated by risk assessment studies, which are based on an exposure-response function (ERF) derived from a specific epidemiological study or multiple studies. To explore whether generalization from the pre-established ERFs (including the integrated exposure-response [IER] model and the global exposure mortality model [GEMM]) introduces biases into risk assessment of a specific local population, we conducted the first census-based epidemiological study of PM_2.5, aimed at the entire population of mainland China. Using a difference-in-difference analysis at the county level, we associated mortality changes from 2000 to 2010 to corresponding PM_2.5 changes, with adjustments made for multiple socioeconomic factors. Based on the epidemiological linkage between PM_2.5 and total mortality, we calculated the change in PM_2.5-attributed deaths and compared this value with the results derived from the pre-established models (IER and GEMM). According to the epidemiological model, a 10-μg/m³ increment in PM_2.5 was associated with a 4.3% (95% confidence interval [CI]: 1.9%-6.7%) increment in total mortality, and the change in PM_2.5-attributed deaths from 2000 to 2010 was estimated as 561,000 (95% CI: 539,000-581,000). The census-based estimation was in better agreement with the GEMM results (545,000-612,000) than was the IER result (354,000 [95% CI: 286,000-421,000]). In sensitivity analyses of the epidemiological model, the association between PM_2.5 exposure and mortality was stronger among younger adults, consistent with the pre-established models. Due to the potential limitations of our findings, we cannot conclusively state that GEMM is more reliable than IER in China. Future studies are warranted to confirm or refute our findings.

Keywords: Air quality; Exposure-response function; Mortality; PM(2.5); Risk assessment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Pollutants / toxicity*
Air Pollution / adverse effects*
China
Environmental Exposure / analysis
Female
Humans
Male
Mortality / trends*
Particulate Matter / analysis
Population Surveillance*
Risk Assessment
Socioeconomic Factors

Substances

Air Pollutants
Particulate Matter