Long-term exposure to ambient PM2.5 and stroke mortality among urban residents in northern China

• Type of Material: Article
• Authors: Xueli Yang, Tianjin Medical University; Liwen Zhang, Tianjin Medical University; Xi Chen, Tianjin Medical University; Fangchao Liu, Chinese Academy of Medical Sciences and Peking Union Medical College; Anqi Shan, Tianjin Medical University; Fengchao Liang, Chinese Academy of Medical Sciences and Peking Union Medical College; Xuejun Li, Tianjin Medical University; Hui Wu, Tianjin Medical University; Mengfan Yan, Tianjin Medical University; Zhao Ma, Tianjin Medical University; Guanghui Dong, Sun Yat Sen University; Yamin Liu, Shandong Academy of Medical Sciences; Jie Chen, China Medical University; Tong Wang, Shanxi Medical University; Baoxin Zhao, Taiyuan Center for Disease Control and Prevention; Yang Liu, Emory University; Dongfeng Gu, Chinese Academy of Medical Sciences and Peking Union Medical College; Naijun Tang, Tianjin Medical University
• Language: English
• Date: 2021-02-24
• Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 The Authors. Published by Elsevier Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ecoenv.2021.112063
• Title of Journal or Parent Work: ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY
• Volume: 213
• Start Page: 112063
• End Page: 112063
• Grant/Funding Information: The work of Yang Liu is supported by the Multi-Angle Imager for Aerosols Science Team at the Jet Propulsion Laboratory, California Institute of Technology (Subcontract No. 1588347) and the National Institute of Environmental Health Sciences of the National Institutes of Health (Grant No. 1R01ES032140). The content is solely the responsibility of the authors and does not necessarily represent the official views of NASA JPL or NIH.; This work was supported by the National Key Research and Development Program of China (2017YFC0211600, 2017YFC0211605 and 2017YFC0211704); and the Special Environmental Research Fund for Public Welfare (No. 200709048) from Ministry of Environmental Protection of the People’s Republic of China.
• Keywords: Satellite-based model; ASSOCIATION; Toxicology; TEMPERATURE; CITIES; ALL-CAUSE; AIR-POLLUTION; Environmental Sciences & Ecology; IMPACTS; Temperature variation; FINE PARTICULATE MATTER; Stroke mortality; HOSPITAL ADMISSIONS; 12-YEAR COHORT; Science & Technology; Life Sciences & Biomedicine; Population-based cohort; CARDIOVASCULAR-DISEASE; Long-term exposure; Environmental Sciences

Abstract

Evidence is still limited for the role of long-term PM2.5 exposure in cerebrovascular diseases among residents in high pollution regions. The study is aimed to investigate the long-term effects of PM2.5 exposure on stroke mortality, and further explore the effect modification of temperature variation on the PM2.5-mortality association in northern China. Based on a cohort data with an average follow-up of 9.8 years among 38,435 urban adults, high-resolution estimates of PM2.5 derived from a satellite-based model were assigned to each participant. A Cox regression model with time-varying exposures and strata of geographic regions was employed to assess the risks of stroke mortality associated with PM2.5, after adjusting for individual risk factors. The cross-product term of PM2.5 exposure and annual temperature range was further added into the regression model to test whether the long-term temperature variation would modify the association of PM2.5 with stroke mortality. Among the study participants, the annual mean level of PM2.5 concentration was 66.3 μg/m3 ranging from 39.0 μg/m3 to 100.6 μg/m3. For each 10 μg/m3 increment in PM2.5, the hazard ratio (HR) was 1.31 (95% CI: 1.04–1.65) for stroke mortality after multivariable adjustment. In addition, the HRs of PM2.5 decreased gradually as the increase of annual temperature range with the HRs of 1.95 (95% CI: 1.36–2.81), 1.53 (95% CI: 1.06–2.22), and 1.11 (95% CI: 0.75–1.63) in the low, middle, and high group of annual temperature range, respectively. The findings provided further evidence of long-term PM2.5 exposure on stroke mortality in high-exposure settings such as northern China, and also highlighted the view that assessing the adverse health effects of air pollution might not ignore the role of temperature variations in the context of climate change.