Guojun He

Smog episodes, fine particulate pollution and mortality in China.

BACKGROUND Starting from early January 2013, northern China was hit by multiple prolonged and severe smog events which were characterized by extremely high-level concentrations of ambient fine particulate matter (PM2.5) with hourly peaks of PM2.5 over 800 µg/m(3). However, the consequences of this severe air pollution are largely unknown. This study investigates the acute effect of the smog episodes and PM2.5 on mortality for both urban and rural areas in northern China. DATA AND METHODS We collected PM2.5, mortality, and meteorological data for 5 urban city districts and 2 rural counties in Beijing, Tianjin and Hebei Province of China from January 1, 2013 through December 31, 2013. We employed the generalized additive models to estimate the associations between smog episodes or PM2.5 and daily mortality for each district/county. RESULTS Without any meteorological control, the smog episodes are positively and statistically significantly associated with mortality in 5 out of 7 districts/counties. However, the findings are sensitive to the meteorological factors. After controlling for temperature, humidity, dew point and wind, the statistical significance disappears in all urban districts. In contrast, the smog episodes are consistently and statistically significantly associated with higher total mortality and mortality from cardiovascular/respiratory diseases in the two rural counties. In Ji County, a smog episode is associated with 6.94% (95% Confidence Interval, -0.20 to 14.58) increase in overall mortality, and in Ci County it is associated with a 19.26% (95% CI, 6.66-33.34) increase in overall mortality. The smog episodes kill people primarily through its impact on cardiovascular and respiratory diseases. On average, a smog episode is associated with 11.66% (95% CI, 3.12-20.90) increase in cardiovascular and respiratory mortality in Ji County, and it is associated with a 22.23% (95% CI, 8.11-38.20) increase in cardiovascular and respiratory mortality in Ci County. A 10 μg/m(3) increase in PM2.5 concentration is associated with 0.88% (95% CI, 0.3-1.46) increase in overall mortality and 1.2% (95% CI, 0.55-1.85) in Ji County. A 10 μg/m(3) increase in PM2.5 concentration is associated with 0.55% (95% CI, -0.02 to 1.13) increase in overall mortality in Ci County. The findings suggest that the smog episodes and fine particulate have bigger and more detrimental impacts on rural residents, especially for those living close to big and polluted cities. CONCLUSIONS The smog episodes and PM2.5 are statistically associated with mortality in rural areas of China. The associations for urban areas are not statistically significant.

The associations between ambient air pollution and adult respiratory mortality in 32 major Chinese cities, 2006-2010

BACKGROUND China has experienced increasingly severe levels of air pollution in the past decades, yet studies on the health effects of air pollution in China at a national study level, remain limited. This study assess the sub-chronic effect of ambient air pollution on respiratory mortality in the 32 largest Chinese cities. METHODS We employ two-way fixed effects panel data analysis and monthly air pollution and mortality panel data. We estimate associations between monthly respiratory mortality and air pollution; pollution is defined as particulate matter with aerodynamic diameter <10μm. We adjust for city characteristics, seasonality (monthly effects), and weather conditions (precipitation and temperature). We examine the associations between monthly injury mortality and air pollution to check for robustness. RESULTS The results show positive and statistically significant associations of air pollution with respiratory mortality. During the study period (2006-2010) a 10μg/m(3) increase in monthly PM10 concentration is associated with a 1.05% (95% CI, 0.08-2.04%) increase in adult respiratory mortality rate. The air pollution effect is the most salient in northern cities (with central heating system) during the cold season (October-April); a 10μg/m(3) increase in monthly PM10 concentrations is associated with a 1.62% (95% CI, 0.22-3.46%) increase in the elderly respiratory mortality rate. There is no statistically significant association between the young adult respiratory mortality and air pollution. CONCLUSIONS The elderly respiratory mortality rate in China is positively and statistically significantly associated with air pollution. The effect is largest in northern cities during cold months when coal is burned for heating.

The Effect of Air Pollution on Mortality in China: Evidence from the 2008 Beijing Olympic Games

By exploiting exogenous variations in air quality during the 2008 Beijing Olympic Games, we estimate the effect of air pollution on mortality in China. We find that a 10 percent decrease in PM10 concentrations reduces the monthly standardized all-cause mortality rate by 8 percent. Men and women are equally susceptible to air pollution risks. The age groups for which the air pollution effects are greatest are children under 10 years old and the elderly.

Particulate air pollution and mortality in 38 of China’s largest cities: time series analysis

Objectives To estimate the short term effect of particulate air pollution (particle diameter <10 μm, or PM10) on mortality and explore the heterogeneity of particulate air pollution effects in major cities in China. Design Generalised linear models with different lag structures using time series data. Setting 38 of the largest cities in 27 provinces of China (combined population >200 million). Participants 350 638 deaths (200 912 in males, 149 726 in females) recorded in 38 city districts by the Disease Surveillance Point System of the Chinese Center for Disease Control and Prevention from 1 January 2010 to 29 June 2013. Main outcome measure Daily numbers of deaths from all causes, cardiorespiratory diseases, and non-cardiorespiratory diseases and among different demographic groups were used to estimate the associations between particulate air pollution and mortality. Results A 10 µg/m3 change in concurrent day PM10 concentrations was associated with a 0.44% (95% confidence interval 0.30% to 0.58%) increase in daily number of deaths. Previous day and two day lagged PM10 levels decreased in magnitude by one third and two thirds but remained statistically significantly associated with increased mortality. The estimate for the effect of PM10 on deaths from cardiorespiratory diseases was 0.62% (0.43% to 0.81%) per 10 µg/m3 compared with 0.26% (0.09% to 0.42%) for other cause mortality. Exposure to PM10 had a greater impact on females than on males. Adults aged 60 and over were more vulnerable to particulate air pollution at high levels than those aged less than 60. The PM10 effect varied across different cities and marginally decreased in cities with higher PM10 concentrations. Conclusion Particulate air pollution has a greater impact on deaths from cardiorespiratory diseases than it does on other cause mortality. People aged 60 or more have a higher risk of death from particulate air pollution than people aged less than 60. The estimates of the effect varied across cities and covered a wide range of domain.

Surface Water Quality and Infant Mortality in China

Surface water pollution has a significant, nonmonotonic effect on the infant mortality rate in China. As surface water quality deteriorates, the infant mortality rate first increases and then decreases. Thus, moderate levels of pollution—in the absence of good information on water quality—are the most dangerous.

New Evidence on the Impact of Sustained Exposure to Air Pollution on Life Expectancy from China's Huai

This paper finds that a 10 μg/m3 increase in airborne particulate matter (PM10) reduces life expectancy by 0.64 years (95% CI: 0.21, 1.07). This estimate is derived from quasi-experimental variation in PM10 generated by China’s Huai River Policy, which provides free or heavily subsidized coal for indoor heating during the winter to cities north of the Huai River but not to the south. The findings are derived from a regression discontinuity design based on distance from the Huai River, and are robust to using parametric and non-parametric estimation methods, different kernel types and bandwidth sizes, and adjustment for a rich set of demographic and behavioral covariates. Furthermore, the shorter lifespans are almost entirely due to elevated rates of cardiorespiratory mortality, suggesting that PM10 is the causal factor. The estimates imply that bringing all of China into compliance with its Class I standards for PM10 would save 3.7 billion life years.