A satellite-driven model to estimate long-term particulate sulfate levels and attributable mortality burden in China

Optimizing BenMAP health impact assessment with meteorological factor driven machine learning models

This study aims to address accuracy challenges in assessing air pollution health impacts using Environmental Benefits Mapping and Analysis Program (BenMap), caused by limited meteorological factor data and missing pollutant data. By employing data increment strategies and multiple machine learning models, this research explores the effects of data volume, time steps, and meteorological factors on model prediction performance using several years of data from Tianjin City as an example. The findings indicate that increasing training data volume enhances the performance of Random Forest Regressor (RF) and Decision Tree Regressor (DT) models, especially for predicting CO, NO2, and PM2.5. The optimal prediction time step varies by pollutant, with the DT model achieving the highest R2 value (0.99) for CO and O3. Combining multiple meteorological factors, such as atmospheric pressure, relative humidity, and dew point temperature, significantly improves model accuracy. When using three meteorological factors, the model achieves an R2 of 0.99 for predicting CO, NO2, PM10, PM2.5, and SO2. Health impact assessments using BenMap demonstrated that the predicted all-cause mortality and specific disease mortalities were highly consistent with actual values, confirming the model's accuracy in assessing health impacts from air pollution. For instance, the predicted and actual all-cause mortality for PM2.5 were both 3120; for cardiovascular disease, both were 1560; and for respiratory disease, both were 780. To validate its generalizability, this method was applied to Chengdu, China, using several years of data for training and prediction of PM2.5, CO, NO2, O3, PM10, and SO2, incorporating atmospheric pressure, relative humidity, and dew point temperature. The model maintained excellent performance, confirming its broad applicability. Overall, we conclude that the machine learning and BenMap-based methods show high accuracy and reliability in predicting air pollutant concentrations and health impacts, providing a valuable reference for air pollution assessment.

Estimating neighborhood-based mortality risk associated with air pollution: A prospective study

Effect modification of integrated neighborhood environment on associations of air pollution with mortality remained unclear. We analyzed data from UK biobank prospective study (n = 421,650, median 12.5 years follow-up) to examine disparities of mortality risk associated with air pollution among varied neighborhood settings. Fine particulate matter (PM2.5), PM10 and nitrogen dioxide (NO2) were measured and assigned to each participants' address. Diverse ecological and societal settings of neighborhoods were integrated with principal component analysis and categorized into disadvantaged, intermediate and advantaged levels. We estimated mortality risk associated with air pollution across diverse neighborhoods using Cox regression. We calculated community-level proportions of mortality attributable to air pollutants. There was evidence of higher all-cause and respiratory disease mortality risk associated with PM2.5 and NO2 among those in disadvantaged neighborhoods. In disadvantaged communities, air pollutants explained larger proportions of deaths and such disparities persisted over past decades. Across 2010-2021, reducing PM2.5 and NO2 to 10 μg/m3 (World Health Organization limits) would save 87,000 (52,000-120,000) and 91,000 (37,000-145,000) deaths of populations aged ≥ 40 years, with 150 000 deaths occurred in disadvantaged neighborhood settings. These findings suggested that disadvantaged neighborhoods can exacerbate mortality risk associated with air pollution.

Accountability analysis of health benefits related to National Action Plan on Air Pollution Prevention and Control in China

China is one of the largest producers and consumers of coal in the world. The National Action Plan on Air Pollution Prevention and Control in China (2013-2017) particularly aimed to reduce emissions from coal combustion. Here, we show whether the acute health effects of PM2.5 changed from 2013 to 2018 and factors that might account for any observed changes in the Beijing-Tianjin-Hebei (BTH) and the surrounding areas where there were major reductions in PM2.5 concentrations. We used a two-stage analysis strategy, with a quasi-Poisson regression model and a random effects meta-analysis, to assess the effects of PM2.5 on mortality in the 47 counties of BTH. We found that the mean daily PM2.5 levels and the SO42- component ratio dramatically decreased in the study period, which was likely related to the control of coal emissions. Subsequently, the acute effects of PM2.5 were significantly decreased for total and circulatory mortality. A 10 μg/m3 increase in PM2.5 concentrations was associated with a 0.16% (95% CI: 0.08, 0.24%) and 0.02% (95% CI: -0.09, 0.13%) increase in mortality from 2013 to 2015 and from 2016 to 2018, respectively. The changes in air pollution sources or PM2.5 components appeared to have played a core role in reducing the health effects. The air pollution control measures implemented recently targeting coal emissions taken in China may have resulted in significant health benefits.

Long-term exposure to ambient PM2.5, particulate constituents and hospital admissions from non-respiratory infection

The association between PM2.5 and non-respiratory infections is unclear. Using data from Medicare beneficiaries and high-resolution datasets of PM2.5 and its constituents across 39,296 ZIP codes in the U.S between 2000 and 2016, we investigated the associations between annual PM2.5, PM2.5 constituents, source-specific PM2.5, and hospital admissions from non-respiratory infections. Each standard deviation (3.7-μg m-3) increase in PM2.5 was associated with a 10.8% (95%CI 10.8-11.2%) increase in rate of hospital admissions from non-respiratory infections. Sulfates (30.8%), Nickel (22.5%) and Copper (15.3%) contributed the largest weights in the observed associations. Each standard deviation increase in PM2.5 components sourced from oil combustion, coal burning, traffic, dirt, and regionally transported nitrates was associated with 14.5% (95%CI 7.6-21.8%), 18.2% (95%CI 7.2-30.2%), 20.6% (95%CI 5.6-37.9%), 8.9% (95%CI 0.3-18.4%) and 7.8% (95%CI 0.6-15.5%) increases in hospital admissions from non-respiratory infections. Our results suggested that non-respiratory infections are an under-appreciated health effect of PM2.5.

Application of multi-angle spaceborne observations in characterizing the long-term particulate organic carbon pollution in China

Ambient PM2.5 pollution is recognized as a leading environmental risk factor, causing significant mortality and morbidity in China. However, the specific contributions of individual PM2.5 constituents remain unclear, primarily due to the lack of a comprehensive ground monitoring network for constituents. This issue is particularly critical for carbonaceous species such as organic carbon (OC) and elemental carbon (EC), which are known for their significant health impacts, and understanding the OC/EC ratio is crucial for identifying pollution sources. To address this, we developed a Super Learner model integrating Multi-angle Imaging SpectroRadiometer (MISR) retrievals to predict daily OC concentrations across China from 2003 to 2019 at a 10-km spatial resolution. Our model demonstrates robust predictive accuracy, as evidenced by a random cross-validation R2 of 0.84 and an RMSE of 4.9 μg/m3, at the daily level. Although MISR is a polar-orbiting instrument, its fractional aerosol data make a significant contribution to the OC exposure model. We then use the model to explore the spatiotemporal distributions of OC and further calculate the EC/OC ratio in China. We compared regional pollution discrepancies and source contributions of carbonaceous pollution over three selected regions: Beijing-Tianjin-Hebei, Fenwei Plain, and Yunnan Province. Our model observes that OC levels are elevated in Northern China due to industrial operations and central heating during the heating season, while in Yunnan, OC pollution is mainly contributed by local forest fires during fire seasons. Additionally, we found that OC pollution in China is likely influenced by climate phenomena such as the El Niño-Southern Oscillation. Considering that climate change is increasing the severity of OC concentrations with more frequent fire events, and its influence on OC formation and dispersion, we suggest emphasizing the role of climate change in future OC pollution control policies. We believe this study will contribute to future epidemiological studies on OC, aiding in refining public health guidelines and enhancing air quality management in China.

Atmospheric elemental carbon pollution and its regional health disparities in China

Previous studies have reported that atmospheric elemental carbon (EC) may pose potentially elevated toxicity when compared to total ambient fine particulate matter (PM2.5). However, most research on EC has been conducted in the US and Europe, whereas China experiences significantly higher EC pollution levels. Investigating the health impact of EC exposure in China presents considerable challenges due to the absence of a monitoring network to document long-term EC levels. Despite extensive studies on total PM2.5 in China over the past decade and a significant decrease in its concentration, changes in EC levels and the associated mortality burden remain largely unknown. In our study, we employed a combination of satellite remote sensing, available ground observations, machine learning techniques, and atmospheric big data to predict ground EC concentrations across China for the period 2005-2018, achieving a spatial resolution of 10 km. Our findings reveal that the national average annual mean EC concentration has remained relatively stable since 2005, even as total PM2.5 levels have substantially decreased. Furthermore, we calculated the all-cause non-accidental deaths attributed to long-term EC exposure in China using baseline mortality data and pooled mortality risk from a cohort study. This analysis unveiled significant regional disparities in the mortality burden resulting from long-term EC exposure in China. These variations can be attributed to varying levels of effectiveness in EC regulations across different regions. Specifically, our study highlights that these regulations have been effective in mitigating EC-related health risks in first-tier cities. However, in regions characterized by a high concentration of coal-power plants and industrial facilities, additional efforts are necessary to control emissions. This observation underscores the importance of tailoring environmental policies and interventions to address the specific challenges posed by varying emission sources and regional contexts.

Association between co-exposure to phenols, phthalates, and polycyclic aromatic hydrocarbons with the risk of frailty

The phenomenon of population aging has brought forth the challenge of frailty. Nevertheless, the contribution of environmental exposure to frailty remains ambiguous. Our objective was to investigate the association between phenols, phthalates (PAEs), and polycyclic aromatic hydrocarbons (PAHs) with frailty. We constructed a 48-item frailty index using data from the National Health and Nutrition Examination Survey (NHANES). The exposure levels of 20 organic contaminants were obtained from the survey circle between 2005 and 2016. The association between individual organic contaminants and the frailty index was assessed using negative binomial regression models. The combined effect of organic contaminants was examined using weighted quantile sum (WQS) regression. Dose-response patterns were modeled using generalized additive models (GAMs). Additionally, an interpretable machine learning approach was employed to develop a predictive model for the frailty index. A total of 1566 participants were included in the analysis. Positive associations were observed between exposure to MIB, P02, ECP, MBP, MHH, MOH, MZP, MC1, and P01 with the frailty index. WQS regression analysis revealed a significant increase in the frailty index with higher levels of the mixture of organic contaminants (aOR, 1.12; 95% CI, 1.05-1.20; p < 0.001), with MIB, ECP, COP, MBP, P02, and P01 identified as the major contributors. Dose-response relationships were observed between MIB, ECP, MBP, P02, and P01 exposure with an increased risk of frailty (both with p < 0.05). The developed predictive model based on organic contaminants exposure demonstrated high performance, with an R2 of 0.9634 and 0.9611 in the training and testing sets, respectively. Furthermore, the predictive model suggested potential synergistic effects in the MIB-MBP and P01-P02 pairs. Taken together, these findings suggest a significant association between exposure to phthalates and PAHs with an increased susceptibility to frailty.

Effects of heavy metal exposure on hypertension: A machine learning modeling approach

Heavy metal exposure is a common risk factor for hypertension. To develop an interpretable predictive machine learning (ML) model for hypertension based on levels of heavy metal exposure, data from the NHANES (2003-2016) were employed. Random forest (RF), support vector machine (SVM), decision tree (DT), multilayer perceptron (MLP), ridge regression (RR), AdaBoost (AB), gradient boosting decision tree (GBDT), voting classifier (VC), and K-nearest neighbour (KNN) algorithms were utilized to generate an optimal predictive model for hypertension. Three interpretable methods, the permutation feature importance analysis, partial dependence plot (PDP), and Shapley additive explanations (SHAP) methods, were integrated into a pipeline and embedded in ML for model interpretation. A total of 9005 eligible individuals were randomly allocated into two distinct sets for predictive model training and validation. The results showed that among the predictive models, the RF model demonstrated the highest performance, achieving an accuracy rate of 77.40% in the validation set. The AUC and F1 score for the model were 0.84 and 0.76, respectively. Blood Pb, urinary Cd, urinary Tl, and urinary Co levels were identified as the main influencers of hypertension, and their contribution weights were 0.0504 ± 0.0482, 0.0389 ± 0.0256, 0.0307 ± 0.0179, and 0.0296 ± 0.0162, respectively. Blood Pb (0.55-2.93 μg/dL) and urinary Cd (0.06-0.15 μg/L) levels exhibited the most pronounced upwards trend with the risk of hypertension within a specific value range, while urinary Tl (0.06-0.26 μg/L) and urinary Co (0.02-0.32 μg/L) levels demonstrated a declining trend with hypertension. The findings on the synergistic effects indicated that Pb and Cd were the primary determinants of hypertension. Our findings underscore the predictive value of heavy metals for hypertension. By utilizing interpretable methods, we discerned that Pb, Cd, Tl, and Co emerged as noteworthy contributors within the predictive model.

Mortality burden due to ambient nitrogen dioxide pollution in China: Application of high-resolution models

BACKGROUND

A large gap exists between the latest Global Air Quality Guidelines (AQG 2021) and Chinese air quality standards for NO₂. Assessing whether and to what extent air quality standards for NO₂ should be tightened in China requires a comprehensive understanding of the spatiotemporal characteristics of population exposure to ambient NO₂ and related health risks, which have not been studied to date.

OBJECTIVE

We predicted ground NO₂ concentrations with high resolution in mainland China, explored exposure characteristics to NO₂ pollution, and assessed the mortality burden attributable to NO₂ exposure.

METHODS

Daily NO₂ concentrations in 2019 were predicted at 1-km spatial resolution in mainland China using random forest models incorporating multiple predictors. From these high-resolution predictions, we explored the spatiotemporal distribution of NO₂, population and area percentages with NO₂ exposure exceeding criterion levels, and premature deaths attributable to long- and short-term NO₂ exposure in China.

RESULTS

The cross-validation R²and root mean squared error of the NO₂ predicting model were 0.80 and 7.78 μg/m³, respectively,at the daily level in 2019.The percentage of people (population number) with annual NO₂ exposure over 40 μg/m³ in mainland China in 2019 was 10.40 % (145,605,200), and it reached 99.68 % (1,395,569,840) with the AQG guideline value of 10 μg/m³. NO₂ levels and population exposure risk were elevated in urban areas than in rural. Long- and short-term exposures to NO₂ were associated with 285,036 and 121,263 non-accidental deaths, respectively, in China in 2019. Tightening standards in steps gradually would increase the potential health benefit.

CONCLUSION

In China, NO₂ pollution is associated with significant mortality burden. Spatial disparities exist in NO₂ pollution and exposure risks. China's current air quality standards may no longer objectively reflect the severity of NO₂ pollution and exposure risk. Tightening the national standards for NO₂ is needed and will lead to significant health benefits.