Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
The Joint Associations of Ambient Air Pollutants and Weather Factors with Mortality: Evidence from a National Time-Stratified Case-Crossover Study in China
22 Pages Posted: 2 Jun 2023
More...
There are 2 versions of this paper
The Joint Associations of Ambient Air Pollutants and Weather Factors with Mortality: Evidence from a National Time-Stratified Case-Crossover Study in China
The Joint Associations of Ambient Air Pollutants and Weather Factors with Mortality: Evidence from a National Time-Stratified Case-Crossover Study in China
Abstract
Background: People in daily life are usually exposed to multiple environmental factors, but few studies have evaluated the joint health impacts of ambient air pollutants and weather factors. We estimated the joint associations of air pollutants ((PM2·5, O3, NO2, SO2, and CO) and weather factors (temperature and relative humidity) with mortality.
Methods: Individual death information was collected from six provinces in China during 2013 to 2018, and a time-stratified case-crossover study was conducted. Excess risks (ER) of exposure to air pollutants and weather factors were estimated using Cox proportional regression models and the population-attributable fraction (PAF) was calculated.
Findings: A total of 6,685,146 deaths were enrolled in this study. The overall PAF of total mortality attributed to air pollutants (lag03 days) and weather factors (lag021 days) was 16·65% (95%CI: 16·43%, 16·87%), in which the joint PAFs attributable to air pollutants and weather factors were 5·31% (95%CI: 5·08%, 5·53%) and 11·34% (95%CI: 11·12%, 11·56%) respectively, and temperature contributed 56% in the joint effects. Stratified analyses showed greater PAFs in females (21·32%) than in males (14·61%), and in the elderly (>100years, 42·34 %) than in young people (21-30years, 7·67%). The PAFs of mortality from cardiovascular diseases, respiratory diseases, and pneumonia attributed to the joint exposures were 22·72%, 24·82% and 33·03%, respectively.
Interpretation: This study provides the joint associations of short-term exposures to both air pollutants and weather factors with mortality risk in China, which has important implications in comprehensively assessing the health impacts of environmental exposures, and taking actions to protect human health.
Funding: This work was supported by the National Key Research and Development Program of China (2018YFA0606200), National Natural Science Foundation of China (81874276, 42075173, 42175181), Natural Science Foundation of Guangdong, China (2019A1515011264), and the Science and Technology Program of Guangzhou (201607010004).
Declaration of Interest: We declare no competing interests.
Keywords: Environmental exposures, Air pollution, Temperature, Joint association, Mortality burden
Suggested Citation: Suggested Citation