title: Fine Particulate Air Pollution and Daily Mortality. A Nationwide Analysis in 272 Chinese Cities.
abstract: Evidence concerning the acute health effects of air pollution caused by fine particulate matter (PM2.5) in developing countries is quite limited.
  
  
  
  To evaluate short-term associations between PM2.5and daily cause-specific mortality in China.
  
  
  
  A nationwide time-series analysis was performed in 272 representative Chinese cities from 2013 to 2015. Two-stage Bayesian hierarchical models were applied to estimate regional- and national-average associations between PM2.5concentrations and daily cause-specific mortality. City-specific effects of PM2.5were estimated using the overdispersed generalized additive models after adjusting for time trends, day of the week, and weather conditions. Exposure-response relationship curves and potential effect modifiers were also evaluated.
  
  
  
  The average of annual mean PM2.5concentration in each city was 56 μg/m3(minimum, 18 μg/m3; maximum, 127 μg/m3). Each 10-μg/m3increase in 2-day moving average of PM2.5concentrations was significantly associated with increments in mortality of 0.22% from total nonaccidental causes, 0.27% from cardiovascular diseases, 0.39% from hypertension, 0.30% from coronary heart diseases, 0.23% from stroke, 0.29% from respiratory diseases, and 0.38% from chronic obstructive pulmonary disease. There was a leveling off in the exposure-response curves at high concentrations in most, but not all, regions. The associations were stronger in cities with lower PM2.5levels or higher temperatures, and in subpopulations with elder age or less education.
  
  
  
  This nationwide investigation provided robust evidence of the associations between short-term exposure to PM2.5and increased mortality from various cardiopulmonary diseases in China. The magnitude of associations was lower than those reported in Europe and North America.
authors.affiliation: 1 School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health.|2 Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), and.
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.affiliation: 3 National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yin
authors.affiliation: 4 Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Xia
authors.initials: X
authors.lastname: Meng
authors.affiliation: 1 School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health.
authors.forename: Cong
authors.initials: C
authors.lastname: Liu
authors.affiliation: 3 National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Wang
authors.affiliation: 5 Texas A&M School of Public Health, College Station, Texas; and.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Xu
authors.affiliation: 5 Texas A&M School of Public Health, College Station, Texas; and.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Ross
authors.affiliation: 6 JC School of Public Health and Primary Care, Prince of Wales Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Lap A
authors.initials: LA
authors.lastname: Tse
authors.affiliation: 1 School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health.
authors.forename: Zhuohui
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: 1 School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health.|2 Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), and.|7 Key Lab of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproduction and Development, Fudan University, Shanghai, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
authors.affiliation: 3 National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, China.
authors.forename: Maigeng
authors.initials: M
authors.lastname: Zhou
mesh_terms: D000397:Air Pollution / Q000032:analysis* / Q000706:statistics & numerical data; D001499:Bayes Theorem; D002318:Cardiovascular Diseases / Q000401:mortality*; D002681:China / Q000453:epidemiology; D002947:Cities / Q000706:statistics & numerical data; D006801:Humans; D009026:Mortality; D052638:Particulate Matter / Q000032:analysis*
chemical_list: D052638:Particulate Matter
keywords: China; air pollution; fine particulates; mortality; time-series