Systematic review of Chinese studies of short-term exposure to air pollution and daily mortality

Health effects attributable to air pollution exposure in Chinese population have been least understood. The authors conducted a meta-analysis on 33 time-series and case-crossover studies conducted in China to assess mortality effects of short-term exposure to particulate matter with aerodynamic diameters less than 10 and 2.5μm (PM₁₀ and PM_2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃) and carbon monoxide (CO). Significant associations between air pollution exposure and increased mortality risks were observed in the pooled estimates for all pollutants of interest. In specific, each 10μg/m³ increase in PM_2.5 was associated with a 0.38% (95% Confidence Interval, CI: 0.31, 0.45) increase in total mortality, a 0.51% (95% CI: 0.30, 0.73) in respiratory mortality, and a 0.44% (95% CI: 0.33, 0.54) in cardiovascular mortality. When current annual PM_2.5 levels in mega-Chinese cities to be reduced to the WHO Air Quality Guideline (AQG) of 10μg/m³, mortality attributable to short-term exposure to PM_2.5 could be reduced by 2.7%, 1.7%, 2.3%, and 6.2% in Beijing, Shanghai, Guangzhou and Xi'an, respectively. The authors recommend future studies on the nature of air pollution concentration and health effect relationships in Chinese population to support setting stringent air quality standards to improve public health.