title: The burden of ambient air pollution on years of life lost in Wuxi, China, 2012-2015: A time-series study using a distributed lag non-linear model.
abstract: Ambient air pollution ranks high among the risk factors that increase the global burden of disease. Previous studies focused on assessing mortality risk and were sparsely performed in populous developing countries with deteriorating environments. We conducted a time-series study to evaluate the air pollution-associated years of life lost (YLL) and mortality risk and to identify potential modifiers relating to the season and demographic characteristics. Using linear (for YLL) and Poisson (for mortality) regression models and controlling for time-varying factors, we found that an interquartile range (IQR) increase in a three-day average cumulative (lag 0-2 day) concentrations of PM2.5, PM10, NO2and SO2corresponded to increases in YLL of 12.09 (95% confidence interval [CI]: 2.98-21.20), 13.69 (95% CI: 3.32-24.07), 26.95 (95% CI: 13.99-39.91) and 24.39 (95% CI: 8.62-40.15) years, respectively, and to percent increases in mortality of 1.34% (95% CI: 0.67-2.01%), 1.56% (95% CI: 0.80-2.33%), 3.36% (95% CI: 2.39-4.33%) and 2.39% (95% CI: 1.24-3.55%), respectively. Among the specific causes of death, cardiovascular and respiratory diseases were positively associated with gaseous pollutants (NO2and SO2), and diabetes was positively correlated with NO2(in terms of the mortality risk). The effects of air pollutants were more pronounced in the cool season than in the warm season. The elderly (>65 years) and females were more vulnerable to air pollution. Studying effect estimates and their modifications by using YLL to detect premature death should support implementing health risk assessments, identifying susceptible groups and guiding policy-making and resource allocation according to specific local conditions.
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Jingying
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Xuhui
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Wuxi Municipal Environmental Monitoring Center, 58 Caozhangxincun, Liangxi District, Wuxi, Jiangsu, 214025, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Dong
authors.affiliation: Wuxi Municipal Meteorological Monitoring Center, 8 Jianheng Road, Xishan District, Wuxi, Jiangsu, 214101, China.
authors.forename: Jiamei
authors.initials: J
authors.lastname: Wu
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Yunqiu
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Chen
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Xinliang
authors.initials: X
authors.lastname: Ding
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Chunhua
authors.initials: C
authors.lastname: Huang
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China. Electronic address: wxcdczwj@163.com.
authors.forename: Weijie
authors.initials: W
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D002423:Cause of Death; D002681:China; D005260:Female; D005544:Forecasting; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017711:Nonlinear Dynamics; D012120:Respiration Disorders / Q000139:chemically induced* / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors
chemical_list: D000393:Air Pollutants
keywords: Air pollution; Modifiers; Non-accidental mortality; Time-series study; Years of life lost