title: Fine particulate matter constituents and cardiopulmonary mortality in a heavily polluted Chinese city.
abstract: BACKGROUND
  Although ambient fine particulate matter (PM(2.5); particulate matter ≤ 2.5 µm in aerodynamic diameter) has been linked to adverse human health effects, the chemical constituents that cause harm are unknown. To our knowledge, the health effects of PM(2.5) constituents have not been reported for a developing country.
  
  
  OBJECTIVE
  We examined the short-term association between PM(2.5) constituents and daily mortality in Xi'an, a heavily polluted Chinese city.
  
  
  METHODS
  We obtained daily mortality data and daily concentrations of PM(2.5), organic carbon (OC), elemental carbon (EC), and 10 water-soluble ions for 1 January 2004 through 31 December 2008. We also measured concentrations of fifteen elements 1 January 2006 through 31 December 2008. We analyzed the data using overdispersed generalized linear Poisson models.
  
  
  RESULTS
  During the study period, the mean daily average concentration of PM(2.5) in Xi'an was 182.2 µg/m³. Major contributors to PM(2.5) mass included OC, EC, sulfate, nitrate, and ammonium. After adjustment for PM(2.5) mass, we found significant positive associations of total, cardiovascular, or respiratory mortality with OC, EC, ammonium, nitrate, chlorine ion, chlorine, and nickel for at least one lag period. Nitrate demonstrated stronger associations with total and cardiovascular mortality than PM(2.5) mass. For a 1-day lag, interquartile range increases in PM(2.5) mass and nitrate (114.9 and 15.4 µg/m³, respectively) were associated with 1.8% [95% confidence interval (CI): 0.8%, 2.8%] and 3.8% (95% CI: 1.7%, 5.9%) increases in total mortality.
  
  
  CONCLUSIONS
  Our findings suggest that PM(2.5) constituents from the combustion of fossil fuel may have an appreciable influence on the health effects attributable to PM(2.5) in Xi'an.
authors.affiliation: State Key Laboratory of Loess and Quaternary Geology, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China.
authors.forename: Junji
authors.initials: J
authors.lastname: Cao
authors.forename: Hongmei
authors.initials: H
authors.lastname: Xu
authors.forename: Qun
authors.initials: Q
authors.lastname: Xu
authors.forename: Bingheng
authors.initials: B
authors.lastname: Chen
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
mesh_terms: D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality*; D002681:China / Q000453:epidemiology; D004781:Environmental Exposure; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D006801:Humans; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*; D012621:Seasons; D014504:Urban Health
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter