Association between fine ambient particulate matter and daily total mortality: An analysis from 160 communities of China

Short-term exposure to outdoor fine particulate matter air pollution is associated with adverse health effects. However, existing literature have been limited in size and scope in countries with high air pollution level, especially in China. The study aims to examine the association of fine particulate matter with daily total mortality in 160 Chinese communities between 2013 and 2014. Two-stage analyses were used to assess the relationship between fine particulate matter(PM2.5) and mortality. Firstly, Poisson regression model was used to estimate the community-specific PM2.5-mortalty association. Secondly, a meta-analysis was used to pool the effect estimates within each region. During the study period, a total of 1.4 million deaths were recorded in 160 communities. There was a significant association between PM2.5 and mortality. Specifically, a 10 mu g/m(3) increase in 2-day moving average PM2.5 concentration on total morality corresponded to a 0.17% (95% confidence interval (CI): 0.10, 023) in national level. The estimate of PM2.5 on morality in Pearl Delta River was highest among Beijing-Tianjin-Hebei regions, Pearl River Delta, and Yangtze River Delta. Females, older population and widowed population appeared to be more vulnerable to particulate matter exposure. Conclusively, this largest epidemiologic study of fine particulate matter in China suggests that PM2.5 is associated with increased mortality risk. (C) 2017 Elsevier B.V. All rights reserved.