title: Multi-site time series analysis of acute effects of multiple air pollutants on respiratory mortality: a population-based study in Beijing, China.
abstract: In large cities in China, the traffic-related air pollution has become the focus of attention, and its adverse effects on health have raised public concerns. We conducted a study to quantify the association between exposure to three major traffic-related pollutants - particulate matter < 10 μm in aerodynamic diameter (PM10), carbon monoxide (CO) and nitrogen dioxide (NO2) and the risk of respiratory mortality in Beijing, China at a daily spatiotemporal resolution. We used the generalized additive models (GAM) with natural splines and principal component regression method to associate air pollutants with daily respiratory mortality, covariates and confounders. The GAM analysis adjusting for the collinearity among pollutants indicated that PM10, CO and NO2 had significant effects on daily respiratory mortality in Beijing. An interquartile range increase in 2-day moving averages concentrations of day 0 and day 1 of PM10, CO and NO2 corresponded to 0.99 [95% confidence interval (CI): 0.30, 1.67], 0.89 (95% CI: 0.27, 1.51) and 0.95 (95% CI: 0.29, 1.61) percent increase in daily respiratory mortality, respectively. The effects were varied across the districts. The strongest effects were found in two rural districts and one suburban district but significant in only one district. In conclusion, high level of several traffic-related air pollutants is associated with an increased risk of respiratory mortality in Beijing over a short-time period. The high risk found in rural areas suggests a potential susceptible sub-population with undiagnosed respiratory diseases in these areas. Although the rural areas have relatively lower air pollution levels, they deserve more attention to respiratory disease prevention and air pollution reduction.
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Unit of Biostatistics, Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden. Electronic address: yang.cao@ki.se.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Li
authors.affiliation: College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
authors.forename: Runkui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Zhenglai
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China. Electronic address: xuqun66@aliyun.com.
authors.forename: Qun
authors.initials: Q
authors.lastname: Xu
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000032:analysis; D000397:Air Pollution / Q000706:statistics & numerical data*; D002248:Carbon Monoxide / Q000032:analysis; D002681:China / Q000453:epidemiology; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009585:Nitrogen Dioxide / Q000032:analysis; D010126:Ozone / Q000032:analysis; D052638:Particulate Matter; D012140:Respiratory Tract Diseases / Q000401:mortality*; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D010126:Ozone; D002248:Carbon Monoxide; D009585:Nitrogen Dioxide
keywords: Air pollutants; Generalized additive model; Principal component analysis; Respiratory mortality; Time series analysis