Ambient PM2.5, ozone and mortality in Chinese older adults: A nationwide cohort analysis (2005–2018)

Zhang，Yunquan1; Yin，Zhouxin1,2; Li，Shaojie3; Zhang，Junfeng (Jim)4; Sun，Haitong Zhe5,6; Liu，Keyang7; Shirai，Kokoro7; Hu，Kejia8; Qiu，Chengxuan9; Liu，Xiaoyun3; Li，Yachen1; Zeng，Yi10,11; Yao，Yao3,10

2023-07-15

10.1016/j.jhazmat.2023.131539

Journal of Hazardous Materials   影响因子和分区

0304-3894

1873-3336

Background: Cohort evidence linking long-term survival with exposure to multiple air pollutants (e.g., fine particulate matter [PM] and ozone) was extensively sparse in low- and middle-income countries, especially among older adults. This study aimed to investigate potential associations of long-term exposures to PM and ozone with all-cause mortality in Chinese older adults. Methods: A dynamic nationwide prospective cohort comprising 20,352 adults aged ≥65 years were enrolled from the Chinese Longitudinal Healthy Longevity Study and followed up through 2005–2018. Participants’ annual exposures to warm-season ozone and year-round PM were assigned using satellite-derived spatiotemporal estimates. A directed acyclic graph (DAG) was developed to identify confounding variables. Associations of annual mean exposures to PM and ozone with mortality were evaluated using single- and two-pollutant Cox proportional hazards models, adjusting for time-dependent individual risk factors and ambient temperature. Results: During 100 thousand person-years of follow-up (median: 3.6 years), a total of 14,313 death events occurred. The participants were averagely aged 87.1 years at baseline and exposed to a wide range of annual average concentrations of warm-season maximum 8-hour ozone (mean, 54.4 ppb; range, 23.3–81.6 ppb) and year-round PM (mean, 65.5 μg/m; range, 10.1–162.9 μg/m). Approximately linear concentration-response relationship was identified for ozone, whereas significant increases in PM-associated mortality risks were observed only when concentrations were above 60 μg/m. Rises of 10 ppb in ozone and 10 µg/m in PM above 60 µg/m were associated with increases in all-cause mortality of 13.2% (95% confidence interval [CI]: 10.2–16.2%) and 6.2% (95% CI: 4.6–7.7%) in DAG-based single-pollutant model, and of 9.7% (95% CI: 6.6–13.0%) and 5.3% (95% CI: 3.7–6.9%) in DAG-based two-pollutant model, respectively. We detected significant effect modification by temperature in associations of mortality with ozone (P <0.001 for interaction), suggesting greater ozone-related risks among participants in warmer locations. Conclusions: This study provided longitudinal evidence that long-term exposure to ambient PM and ozone significantly and independently contributed to elevated risks of all-cause mortality among older adults in China.

CLHLS Cohort Fine particulate matter Mortality Older adults Ozone

SCI ; EI

英语

其他

National Key R&D Program of China[2018YFC2000400] ; National Natural Sciences Foundation of China[72061137004] ; U.S. National Institute on Aging, National Institutes of Health[P01AG031719] ; Youth Fund Project of Humanities and Social Sciences Research of the Ministry of Education[21YJCZH229] ; 14th Five Year Plan" Hubei Provincial Advantaged Characteristic Disciplines (Groups) Project of Wuhan University of Science and Technology[2023C0102] ; Hubei Provincial Natural Science Foundation of China[2021CFB032]

Engineering ; Environmental Sciences & Ecology

Engineering, Environmental ; Environmental Sciences

WOS:000999055700001

ELSEVIER

20231914053465

Air pollution ; Directed graphs ; Particles (particulate matter)

Air Pollution:451 ; Chemical Products Generally:804 ; Combinatorial Mathematics, Includes Graph Theory, Set Theory:921.4 ; Materials Science:951

ENGINEERING

2-s2.0-85156182841

Scopus

1.Institute of Social Development and Health Management,Hubei Province Key Laboratory of Occupational Hazard Identification and Control,School of Public Health,Wuhan University of Science and Technology,Wuhan,430065,China
2.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,518055,China
3.China Center for Health Development Studies,Peking University,Beijing,China
4.Nicholas School of the Environment and Duke Global Health Institute,Duke University,Durham,United States
5.Centre for Atmospheric Science,Yusuf Hamied Department of Chemistry,University of Cambridge,Cambridge,CB2 1EW,United Kingdom
6.Department of Earth Sciences,University of Cambridge,Cambridge,CB2 3EQ,United Kingdom
7.Public Health,Department of Social Medicine,Osaka University Graduate School of Medicine,Suita Shi,Osaka,Japan
8.Institute of Big Data in Health Science,School of Public Health,Zhejiang University,Hangzhou,310058,China
9.Aging Research Center,Karolinska Institutet,Widerströmska Huset,Solna,SE-171 65,Sweden
10.Center for Healthy Aging and Development Studies,National School of Development,Peking University,Beijing,China
11.Center for the Study of Aging and Human Development and Geriatrics Division,Medical School of Duke University,Durham,United States

Zhang，Yunquan,Yin，Zhouxin,Li，Shaojie,等. Ambient PM2.5, ozone and mortality in Chinese older adults: A nationwide cohort analysis (2005–2018)[J]. Journal of Hazardous Materials,2023,454.

Zhang，Yunquan.,Yin，Zhouxin.,Li，Shaojie.,Zhang，Junfeng .,Sun，Haitong Zhe.,...&Yao，Yao.(2023).Ambient PM2.5, ozone and mortality in Chinese older adults: A nationwide cohort analysis (2005–2018).Journal of Hazardous Materials,454.

Zhang，Yunquan,et al."Ambient PM2.5, ozone and mortality in Chinese older adults: A nationwide cohort analysis (2005–2018)".Journal of Hazardous Materials 454(2023).