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. 2022 Oct 1:244:114025.
doi: 10.1016/j.ecoenv.2022.114025. Epub 2022 Aug 29.

Long-term PM2.5 exposure in association with chronic respiratory diseases morbidity: A cohort study in Northern China

Mengfan Yan  1 , Han Ge  2 , Liwen Zhang  2 , Xi Chen  2 , Xueli Yang  2 , Fangchao Liu  3 , Anqi Shan  2 , Fengchao Liang  4 , Xuejun Li  2 , Zhao Ma  2 , Guanghui Dong  5 , Yamin Liu  6 , Jie Chen  7 , Tong Wang  8 , Baoxin Zhao  9 , Qiang Zeng  10 , Xiangfeng Lu  3 , Yang Liu  11 , Nai-Jun Tang  12
Affiliations

Long-term PM2.5 exposure in association with chronic respiratory diseases morbidity: A cohort study in Northern China

Mengfan Yan et al. Ecotoxicol Environ Saf. .

Abstract

Several literatures have examined the risk of chronic respiratory diseases in association with short-term ambient PM2.5 exposure in China. However, little evidence has examined the chronic impacts of PM2.5 exposure on morbidity of chronic respiratory diseases in cohorts from high pollution countries. Our study aims to investigate the associations. Based on a retrospective cohort among adults in northern China, a Cox regression model with time-varying PM2.5 exposure and a concentration-response (C-R) curve model were performed to access the relationships between incidence of chronic respiratory diseases and long-term PM2.5 exposure during a mean follow-up time of 9.8 years. Individual annual average PM2.5 estimates were obtained from a satellite-based model with high resolution. The incident date of a chronic respiratory disease was identified according to self-reported physician diagnosis time and/or intake of medication for treatment. Among 38,047 urban subjects analyzed in all-cause chronic respiratory disease cohort, 482 developed new cases. In CB (38,369), asthma (38,783), and COPD (38,921) cohorts, the onsets were 276, 89, and 14, respectively. After multivariable adjustment, hazard ratio and 95% confidence interval for morbidity of all-cause chronic respiratory disease, CB, asthma, and COPD were 1.15 (1.01, 1.31), 1.20 (1.00, 1.42), 0.76 (0.55, 1.04), and 0.66 (0.29, 1.47) with each 10 μg/m3 increment in PM2.5, respectively. Stronger effect estimates were suggested in alcohol drinkers across stratified analyses. Additionally, the shape of C-R curve showed an increasing linear relationship before 75.00 μg/m3 concentrations of PM2.5 for new-onset all-cause chronic respiratory disease, and leveled off at higher levels. These findings indicated that long-term exposure to high-level PM2.5 increased the risks of incident chronic respiratory diseases in China. Further evidence of C-R curves is warranted to clarify the associations of adverse chronic respiratory outcomes involving air pollution.

Keywords: China; Chronic respiratory diseases; Cohort study; Incidence; PM(2.5); Satellite-based model.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.
The temporal trends for average annual concentrations of PM2.5 (μg/m3) during the period from 2000 to 2009 across the four cities in northern China.
Fig. 2.
Fig. 2.
The concentration-response curve for the association between long-term PM2·5 exposure and morbidity of all-cause chronic respiratory disease. The X-axis is the average concentration of PM2.5 in the cohort study. The Y-axis is the log relative risk. The solid line represents the mean risk estimate, and the dotted lines represent the 95% confidence intervals.
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