Estimated acute effects of ambient ozone and nitrogen dioxide on mortality in the Pearl River Delta of southern China

Effects of ambient air pollution from shipping on mortality: A systematic review

BACKGROUND

Shipping contributes to air pollution causing adverse health effects. We conducted for the first time a systematic review on the health and economic impacts of ambient air pollution from shipping emissions.

METHODS

We performed a systematic search in PubMed, Web of Science, EBSCO (Medline), and Scopus of all time up to December 2023. We then inter-compared semi-quantitatively the results of the included eligible studies.

RESULTS

We identified 23 eligible studies, 22 applying health impact assessment, and 1 using epidemiological methods. These studies used different methods for the evaluation of emissions, dispersion, and exposure, and for the exposure-mortality risk functions for exposure to shipping emissions for 1-2 years. The estimated excess global all-cause mortality from six studies ranged between 1 and 5 deaths per 100,000 person-years. However, the heterogeneity of the methods and critical gaps in the reporting seriously limited the synthesis of the evidence on health and economic effects of shipping emissions. Sufficient spatial and temporal resolutions in both dispersion and exposure modeling, as well as presentation of uncertainties is needed. Health impact assessment should present the results with all the main risk functions and population attributable risks, and the magnitude of the effect should be expressed in excess number per a given person-time or per population size. Economic effects should also cover work productivity, mental well-being, and cognitive functions.

CONCLUSIONS

We recommend that future studies should properly evaluate and report the uncertainty ranges and the confidence limits of the results. Rigorous studies are needed on multipollutant exposures, exposures from various source categories, and exposures attributed to various particulate matter measures. Studies should report the health impact measures in a format that facilitates straightforward inter-study comparisons. Further research should also specifically report the used grid spacings and resolutions and evaluate whether these are optimal for the task.

Analysis of severe ozone-related human health and weather influence over China in 2019 based on a high-resolution dataset

Ozone pollution in 2019 in China is particularly severe posing a tremendous threat to the health of Chinese inhabitants. In this study, we constructed a more reliable and accurate 1-km gridded dataset for 2019 with as many sites as possible using the inverse distance weight interpolation method to analyze spatiotemporal ozone pollution characteristics and health burden attributed to ozone exposure from the perspective of different diseases and weather influence. The accuracy of this new dataset is higher than other public datasets, with the coefficient of determination of 0.84 and root-mean-square error of 8.77 ppb through the validation of 300 external sites which were never used for establishing retrieval methods by the datasets mentioned-above. The averaged MDA8 (the daily maximum 8 h average) ozone concentrations over China was 43.5 ppb, and during April-July, 83.9% of total grids occurred peak-month ozone concentrations. Overall, the highest averaged exceedance days (60 days) and population-weighted ozone concentrations (55.0 ppb) both concentrated in central-eastern China including 9 provinces (only 11.4% of the national territory); meanwhile, all-cause premature deaths attributable to ozone exposure reached up to 142,000 (54.9% of national total deaths) with higher deaths for cardiovascular and respiratory, and the provincial per capita premature mortality was 0.27~0.44‰. The six most polluted weather types in the central-eastern China are in order as follows: westerly (SW and W), cyclonic, northerly, and southerly (NW, N, and S) types, which accounts for approximately 73.2% of health burden attributed to daily ozone exposure and poses the greatest public health risk with mean daily premature deaths ranging from 466 to 610. Our findings could provide an effective support for regional ozone pollution control and public health management in China.

The rationale behind updates to ambient ozone guidelines and standards

Although air quality has gradually improved in recent years, as shown by the decrease in PM2.5 concentration, the problem of rising ambient ozone has become increasingly serious. To reduce hazards to human health and environmental welfare exposure to ozone, scientists and government regulators have developed ozone guidelines and standards. These answer the questions of which levels of exposure are hazardous to human health and the environment, and how can ambient ozone exposure be guaranteed, respectively. So what are the basis for the ozone guidelines and standards? This paper reviews in detail the process of revising ozone guidelines and standards by the World Health Organization (WHO) and the United States Environmental Protection Agency (EPA). The present study attempts to explore and analyze the scientific basis and empirical methods for updating guidelines and standards, in a view to guide the future revision process and provide directions for further scientific research. We found many epidemiological and toxicological studies and exposure-response relationships provided strong support for developing and revising the ozone guidelines. When setting standards, ozone exposure has been effectively considered, and the economic costs, health, and indirect economic benefits of standard compliance were reasonably estimated. Accordingly, epidemiological and toxicological studies and the establishment of exposure-response relationships, as well as exposure and risk assessment and benefit-cost estimates of standards compliance should be strengthened for the further update of guidelines and standards. In addition, with the increasing prominence of combined air pollution led by ozone and PM2.5, more joint exposure scientific research related to ozone guidelines and standards should be undertaken.

The synergistic effect of high temperature and ozone on the number of deaths from circulatory system diseases in Shijiazhuang, China

Introduction

Urban ozone pollution in China is becoming increasingly serious. Climate warming, high temperatures, and ozone pollution all have significant impacts on human health. However, the synergistic effects of high temperatures and ozone pollution in summer on human health are rarely studied. China is at a critical stage of environmental pollution control. Assessing the health impact of high temperatures and ozone exposure on the number of deaths from circulatory diseases is of great significance for formulating ozone-related prevention and control policies.

Methods

This study uses daily data on deaths from circulatory system diseases in Shijiazhuang from June to August during the summer of 2013-2016, as well as concurrent meteorological data and concentration of O3 and PM2.5 pollution data. The generalized additive model (GAM) with Poisson distribution, smooth curve threshold effect, and saturation effect method is used to control for confounding effects.

Results

The study evaluates the impact of short-term exposure to temperature and ozone on deaths from circulatory system diseases and the synergistic effect after controlling for confounding factors. The results show that the impact of temperature and ozone on deaths from circulatory system diseases in Shijiazhuang is nonlinear, with a temperature threshold of 27.5°C and an ozone concentration threshold of 100 μg/m3. With an increase of temperature by 1°C, the risk of deaths for total population, men and women are 6.8%, 4.6% and 9.3%, respectively. The increase in temperature and ozone concentration has a greater impact on women; in men, the increase has a lag effect of 2 to 3 days, but the lag did not affect women.

Discussion

In conclusion, high temperatures and high ozone concentration have synergistic enhancement effects on circulatory system diseases. Prevention and scientific management strategies of circulatory system diseases in high temperatures and high ozone environments should be strengthened.

Short-term exposure to ambient ozone and cardiovascular mortality in China: a systematic review and meta-analysis

Air pollution is a major public health concern in China. Notwithstanding this, there is limited evidence regarding the impact of short-term exposure to ambient ozone on cardiovascular mortality in the Chinese population. Therefore, we conducted this meta-analysis to address this important question. The random-effects model was applied to pool the results from individual studies. Finally, 32 effect estimates extracted from 19 studies were pooled in this meta-analysis. The pooled relative risk for cardiovascular mortality for each 10 µg/m3 increment in ozone concentration was 1.0068 (95% CI: 1.0049, 1.0086). Ths significant positive association between ozone exposure and cardiovascular mortality was also observed in different two-pollutant models. This meta-analysis revealed that exposure to ozone was associated with an increased risk of cardiovascular mortality in China, and more efforts on controlling the population from ozone are needed to improve cardiovascular health of Chinese population.

An assessment of O3-related health risks and economic losses in typical regions of China

Introduction

As one of the key areas for air pollution prevention and control in China, the Fenwei Plain is experiencing serious near-surface O3 pollution, which is a key issue that needs to be solved urgently.

Methods

Based on pollutant concentration monitoring data and meteorological and health data over the same period, this study analyzed the temporal and spatial characteristics, the relationships with meteorological factors of O3 pollution, and the health effects and economic losses caused by exposure to O3 pollution using environmental health risk and environmental value assessment methods in 11 cities on the Fenwei Plain in China from 2014 to 2020.

Results

The results showed that O3 pollution has become increasingly serious on the Fenwei Plain in recent years. The annual average concentration of O3_8h_max showed an overall upwards trend, with an increase of 32.39% in 2020 compared to 2014. The mean concentrations observed in summer were the highest, followed by spring and autumn, and the lowest was in winter. The O3 concentration had a significant positive correlation with air temperature and sunshine hours. The evaluation results of the impact of air pollution on population health showed that the number of premature deaths caused by O3 pollution fluctuated and increased during 2014-2020. In 2020, the numbers of total, cardiovascular and respiratory deaths attributable to O3 pollution on the Fenwei Plain were 6,867 (95% CI: 3,739-9,965), 3,652 (95% CI: 1,363-5,905), and 1,257 (95% CI: 747-2,365), respectively, and the total number of premature deaths related to O3 exposure increased by 48.05% compared with 2014. The health and economic losses attributed to O3 pollution on the Fenwei Plain during the study period were 44.22 (95% CI: 22.17-69.18), 47.16 (95% CI: 23.64-73.77), 68.28 (95% CI: 34.27-106.31), 114.44 (95% CI: 57.42-177.76), 110.85 (95% CI: 55.45-172.52), 116.41 (95% CI: 58.24-180.74), and 116.81 (95% CI: 58.00-180.88) billion yuan, respectively. In Linfen City, the increasing rate of the number of premature deaths reached 283.39% because the O3 concentration increased greatly.

Discussion

Due to high O3 concentrations and obvious population growth in Xi'an, the problems of premature death and health and economic losses attributed to O3 concentrations exceeding the standard value are prominent.

Health impacts under different ozone mitigation pathways in Beijing-Tianjin-Hebei and its surroundings

To evaluate the effects of the various ozone (O₃) control approaches on environmental health and health inequalities, 121 reduction scenarios for nitrogen oxides (NO_x) and volatile organic compounds (VOCs) were developed, and their environmental health impacts were calculated. With the target of achieving the 90th percentile of the daily maximum 8 h mean O₃ concentration (MDA8-90th) of 160 μg/m³ in Beijing-Tianjin-Hebei and its surroundings ("2 + 26" cities), three typical scenarios namely, High-NO_x reduction ratio (HN, NO_x/VOCs = 6:1), High-VOCs reduction ratio (HV, NO_x/VOCs = 3:7), and Balanced reduction ratio (Balanced, NO_x/VOCs = 1:1) were investigated. The results show that O₃ formation is currently NO_x-limited at the regional scale, while some developed cities are VOC-limited, indicating that NO_x mitigation should be the core for achieving the targeted concentration (160 μg/m³) at the regional scale, whereas cities such as Beijing in the short term should focus on VOCs mitigation. The population-weighted O₃ concentrations in the HN, Balanced, and HV scenarios were 159.19, 159.19, and 158.44 μg/m³, respectively. In addition, the O₃-related premature mortality was 41,320 in "2 + 26" cities; control measures under HN, Balanced, and HV could potentially decrease O₃-related premature deaths by 59.94 %, 60.25 %, and 71.48 %, respectively. The HV scenario has been found to be more advantageous in lowering the O₃-related environmental health impacts than the HN and Balanced scenarios. It was further found that premature deaths avoided by the HN scenario were mainly concentrated in economically unadvanced regions, whereas those prevented by the HV scenario were mainly concentrated in developed cities. This may lead to geographical inequities in environmental health. As ozone pollution in large cities with high population density is primarily VOC-limited, decrease in VOCs should be focused on in the short term to avoid more O₃-related premature deaths, whereas NO_x control may be more important in decreasing ozone concentrations and ozone-related mortality in the future.

Seasonal associations between air pollutants and influenza in 10 cities of southern China

Few studies have explored the associations between air pollutants and influenza across seasons, especially at large scales. This study aimed to evaluate seasons' modifying effects on associations between air pollutants and influenza from 10 cities of southern China. Through scientific evidence, it provides mitigation and adaptation strategies with practical guidelines to local health authorities and environmental protection agencies. Daily influenza incidence, meteorological, and air pollutants data from 2016 to 2019 were collected. Quasi-Poisson regression with a distributed lag nonlinear model was used to evaluate city-specific air pollutants and influenza associations. Meta-analysis was used to pool site-specific estimates. Attributable fractions (AFs) of influenza incidence due to pollutants were calculated. Stratified analyses were conducted by season, sex, and age. Overall, the cumulative relative risk (CRR) of influenza incidence for a 10-unit increase in PM_2.5, PM₁₀, SO₂, NO₂, and CO was 1.45 (95% CI: 1.25, 1.68), 1.53 (95% CI: 1.29, 1.81), 1.87 (95% CI: 1.40, 2.48), 1.74 (95% CI: 1.49, 2.03), and 1.19 (95% CI: 1.04, 1.36), respectively. Children aged 0-17 were more sensitive to air pollutants in spring and winter. PM₁₀ had greater effect on influenza than PM_2.5 in autumn, winter, and overall, lesser in spring. The overall AF due to PM_2.5, PM₁₀, SO₂, NO_2, and CO was 4.46% (95% eCI: 2.43%, 6.43%), 5.03% (95% eCI: 2.33%, 7.56%), 5.36% (95% eCI: 3.12%, 7.58%), 24.88% (95% eCI: 18.02%, 31.67%), and 23.22% (95% eCI: 17.56%, 28.61%), respectively. AF due to O₃ was 10.00% (95% eCI: 4.76%, 14.95%) and 3.65% (95% eCI: 0.50%, 6.59%) in spring and summer, respectively. The seasonal variations in the associations between air pollutants and influenza in southern China would provide evidence to service providers for tailored intervention, especially for vulnerable populations.

Evaluation of the health risk using multi-pollutant air quality health index: case study in Tianjin, China

Introduction

Air pollution imposes a significant burden on public health. Compared with the popular air quality index (AQI), the air quality health index (AQHI) provides a more comprehensive approach to measuring mixtures of air pollutants and is suitable for overall assessments of the short-term health effects of such mixtures.

Methods

We established an AQHI and cumulative risk index (CRI)-AQHI for Tianjin using single-and multi-pollutant models, respectively, as well as environmental, meteorological, and daily mortality data of residents in Tianjin between 2018 and 2020.

Results and discussion

Compared with the AQI, the AQHI and CRI-AQHI established herein correlated more closely with the exposure-response relationships of the total mortality effects on residents. For each increase in the interquartile range of the AQHI, CRI-AQHI and AQI, the total daily mortality rates increased by 2.06, 1.69 and 0.62%, respectively. The AQHI and CRI-AQHI predicted daily mortality rate of residents more effectively than the AQI, and the correlations of AQHI and CRI-AQHI with health were similar. Our AQHI of Tianjin was used to establish specific (S)-AQHIs for different disease groups. The results showed that all measured air pollutants had the greatest impact on the health of persons with chronic respiratory diseases, followed by lung cancer, and cardiovascular and cerebrovascular diseases. The AQHI of Tianjin established in this study was accurate and dependable for assessing short-term health risks of air pollution in Tianjin, and the established S-AQHI can be used to separately assess health risks among different disease groups.

Associations between Different Ozone Indicators and Cardiovascular Hospital Admission: A Time-Stratified Case-Crossover Analysis in Guangzhou, China

Epidemiological studies reported that ozone (O₃) is associated with cardiovascular diseases. However, only few of these studies examined the impact of multiple O₃ indicators on cardiovascular hospital admissions. This study aimed to explore and compare the impacts of different O₃ indicators on cardiovascular hospital admissions in Guangzhou, China. Based upon the data on daily cardiovascular hospital admissions, air pollution, and meteorological factors in Guangzhou from 2014 to 2018, a time-stratified case-crossover design model was used to analyze the associations between different O₃ indicators and cardiovascular hospital admissions. Moreover, the sensitivities of different age and gender groups were analyzed for the whole year and different seasons (i.e., warm and cold). During the warm season, for the single-pollutant model, the odds ratio (OR) value of cardiovascular hospital admissions was 1.0067 (95% confidence interval (CI): 1.0037, 1.0098) for every IQR increase in MDA8 O₃ at a lag of five days. The effect of O₃ on people over 60 year was stronger than that on the 15-60 years age group. Females were more sensitive than males to O₃ exposure. These results provided valuable references for further scientific research and environmental improvement in Guangzhou. Given that short-term O₃ exposure poses a threat to human health, the government should therefore pay attention to prevention and control policies to reduce and eliminate O₃ pollution and protect human health.

Role of oxides of nitrogen in the ozone-cardiorespiratory visit association

Ozone (O₃)-induced health effects vary in terms of severity, from deterioration of lung function and hospitalization to death. Several studies have reported a linear increase in health risks after O₃ exposure. However, current evidence suggests a non-linear U- and J-shaped concentration-response (C-R) function. The potential increasing risks with decreasing O₃ concentrations may seem counterintuitive from the traditional standpoint that decreasing exposure should lead to decreasing health risks. Tus, the question of whether the increasing risks with decreasing concentrations are truly O₃-induced or might be from other C-R mechanisms. If these potential risks were not accounted for, this may have contributed to the risks observed at the low ozone concentration range. In this study, we examined the short-term effects of photochemical oxidant (O_x, parts per billiion) on outpatient cardiorespiratory visits in 21 Japanese cities after adjusting for other air pollutant-specific C-R functions. Daily cardiorespiratory visits from January 1, 2014 to December 31, 2016 were obtained from the Japanese Medical Data Center Co. Ltd. Similar period of meteorological and air pollution variables were obtained from relevant data sources. We utilized a time-stratified case crossover design coupled with the generalized additive mixed model (TSCC-GAMM) to estimate the association between O_x and cardiorespiratory outpatient visits, after adjusting for several covariates. A total of 2,588,930 visits were recorded across the study period, with a mean of 111.87 and a standard deviation of 138.75. The results revealed that crude O_x-cardiorespiratory visits exhibited a U-shaped pattern. However, adjustment of the oxides of nitrogen, particularly nitrogen monoxide (NO), attenuated the lower risk curve and subsequently altered the shape of the C-R function, with a substantial reduction observed during winter. NO- and nitrogen dioxide (NO_2)-adjusted O_x-cardiorespiratory associations increased nearly linearly, without an apparent threshold. Current evidence suggests the importance of adjusting the oxides of nitrogen in estimating the O_x C-R risk functions.

Health impact assessments of shipping and port-sourced air pollution on a global scale: A scoping literature review

BACKGROUND

Globalisation has led to international trade expand rapidly. Seaborne transport moves 80% of traded goods across the globe, producing around 3% of greenhouse gases and other hazardous pollutants, such as PM, NO_x and SO_x, known to be harmful to health.

METHODS

A scoping literature review was conducted reviewing peer-reviewed studies on health impact assessments (HIA) of global shipping and port-sourced air pollution. For review inclusion, studies had to (1) use a HIA methodology; (2) quantify the air pollution concentration attributable to at least one shipping or port activity scenario; (3) assess at least one health outcome (i.e. epidemiological measure or monetization); (4) quantify the attributable health burden of the respective scenario.

RESULTS

Thirty-two studies were included, studying predominantly European Sea shipping/ port-sourced emissions with health impacts for global or respective European populations. Also, Global, Asian, North American and Australian Sea shipping/ port-sourced emissions were studied, with attributable health impacts for global or respective populations. The health outcome predominantly studied was mortality (all-cause, cause-specific, loss in life expectancy, years of life lost (YLLs)), but also morbidity (disease cases, hospital admissions, years lived with disability (YLDs)), disability-adjusted life-years (DALYs), restricted activity days and work loss days. The highest air pollution concentrations were identified along major shipping routes and ports, and the strongest health impacts occurred among respective riparian populations. Globally, ∼265,000 premature deaths were projected for 2020 (∼0.5% of global mortality) attributable to global shipping-sourced emissions. Emission control scenarios studied were predominantly sulphur fuel content caps and NO_x emission reduction scenarios, consisting of technological interventions, cleaner fuels or fuel switches, and were assessed as effective in reducing shipping-sourced emissions, and hence, health burdens.

CONCLUSIONS

Our review positions maritime transport an important source of air pollution and health risk factor, which needs more research and policy attention and rigorous emission control efforts, as shipping-sourced emissions are projected to increase with increases in global trade and shipping volumes.

NO2 exposure contributes to cardiac hypertrophy in male mice through apoptosis signaling pathways

Nitrogen dioxide (NO₂) is one of the most common indoor and outdoor air pollutants. Inhalation of NO₂ is associated with an increased risk of health problems, especially cardiovascular diseases. However, the underlying pathogenic mechanisms still remain unclear. In this study, we exposed C57BL/6J mice to NO₂ (2.5 ppm, 5 h/d) for 28 days and found that NO₂ inhalation induced cardiac dysfunction in male mice, but not in female mice, including left ventricular dilation and cardiac systolic dysfunction. Pathological staining showed that NO₂ inhalation induced eccentric hypertrophy with enlarged individual cardiomyocytes, dilated left ventricle, and thinning of the left ventricular wall in male mice. The transcriptional analysis suggested that NO₂ exposure could disrupt Ca²⁺ homeostasis, actin cytoskeletal reorganization, myocardial contractility, and vascular dilation in male mice. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated that differentially expressed genes (DEGs) were closely associated with the apoptotic signaling pathways. These findings suggested that NO₂ exposure caused cardiac eccentric hypertrophy and cardiac dysfunction through apoptotic signaling pathways, and contributed to cardiotoxicity.

Short-term health impacts related to ozone in China before and after implementation of policy measures: A systematic review and meta-analysis

This paper presents a meta-analysis of the impacts of short-term exposure to ozone (O₃) on three health endpoints: all-cause, cardiovascular, and respiratory mortality in China. All relevant studies from January 1990 to December 2021 were searched from four databases. After screening, 30 studies were included for the meta-analysis. The results showed that a significant rise of 0.41 % (95 % confidence interval (CI): 0.35 %-0.48 %) in all-cause, 0.60 % (95 % CI: 0.51 %-0.68 %) in cardiovascular and 0.45 % (95 % CI: 0.28 %-0.62 %) in respiratory mortality for each 10 μg m^-3 increase in the maximum daily 8 h average O₃ concentration (MDA8 O₃). Moreover, results stratified by heterogeneous time periods before and after implementing a policy measure in 2013, showed that the pooled effects for all-cause and respiratory mortality before were greater than those after, while the pooled effects for cardiovascular mortality before 2013 were slightly smaller than those after. The finding that short-term exposure to O₃ was positively related to the three health endpoints was validated by means of a sensitivity analysis. Furthermore, we did not observe any publication bias. Our results present an updated and better understanding of the relationship between short-term exposure to O₃ and the three health endpoints, while providing a reference for further assessment of the impact of short-term O₃ exposure on human health.

Maternal NO2 exposure disturbs the long noncoding RNA expression profile in the lungs of offspring in time-series patterns

Gestation is a sensitive window to nitrogen dioxide (NO₂) exposure, which may disturb fetal lung development and lung function later in life. Animal and epidemiological studies indicated that long noncoding RNAs (lncRNAs) participate in abnormal lung development induced by environmental pollutant exposure. In the present study, pregnant C57BL/6J mice were exposed to 2.5 ppm NO₂ (mimicking indoor occupational exposure) or clean air, and lncRNAs expression profiles in the lungs of offspring mice were determined by lncRNA-seq on embryonic day 13.5 (E13.5), E18.5, postnatal day 1 (P1), and P14. The lung histopathology examination of offspring was performed, followed by weighted gene coexpression network analysis (WGCNA), prediction of lncRNAs-target genes, and the biological processes enrichment analysis of lncRNAs. Our results indicated that maternal NO₂ exposure induced hypoalveolarization on P14 and differentially expressed lncRNAs showed a time-series pattern. Following WGCNA and enrichment analysis, 2 modules participated in development-related pathways. Importantly, the expressions of related genes were altered, some of which were confirmed to be related to abnormal vascular development and even lung diseases. The research points out that the maternal NO₂ exposure leads to abnormal lung development in offspring that might be related to altered lncRNAs expression profiles with time-series-pattern.

Short-term effect of ambient ozone pollution on respiratory diseases in western China

Ambient air pollution has been regarded as an important cause of the morbidity and mortality of respiratory diseases. In the current work, a total of 469,490 respiratory emergency room (ER) visits in Lanzhou, China from Jan 1, 2013 to Dec 31, 2016 were collected. A generalized additive model (GAM) was used to investigate the association between O₃ and respiratory ER visits for the different gender and age subgroups. The results showed that: (a) with per inter-quartile range (IQR) (31 µg/m³) increase in O₃, the greatest relative risk (RR) of respiratory ER visits for the total was 1.014 (95% CI 1.008-1.020) at lag 4 days. Females and 16-to-45-year-olds were relatively more sensitive to O₃; (b) the significant lag effects were found in single-day lag models, with the highest RR values for different groups were observed at lag 3-lag 5 days. The multi-day cumulative lag effects were stronger for the total; (c) in the multiple-pollutant models, the effects of O₃ were generally increased when introducing other pollutants (PM₁₀, PM_2.5, SO₂ and NO₂) for adjustment. This study demonstrated that short-term exposure to O₃ increased the RR of respiratory ER visits in Lanzhou, China.

Health effects of exposure to sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide between 1980 and 2019: A systematic review and meta-analysis

The burden of disease attributed to the indoor exposure to sulfur dioxide (SO₂ ), nitrogen dioxide (NO₂ ), ozone (O₃ ), and carbon monoxide (CO) is not clear, and the quantitative concentration-response relationship is a prerequisite. This is a systematic review to summarize the quantitative concentration-response relationships by screening and analyzing the polled effects of population-based epidemiological studies. After collecting literature published between 1980 and 2019, a total of 19 health outcomes in 101 studies with 182 health risk estimates were recruited. By meta-analysis, the leave-one-out sensitivity analysis and Egger's test for publication bias, the robust and reliable effects were found for SO₂ (per 10 μg/m³ ) with chronic obstructive pulmonary diseases (COPD) (pooled relative risks [RRs] 1.016, 95% CI: 1.012-1.021) and cardiovascular diseases (CVD) (RR 1.012, 95%CI: 007-1.018), respectively. NO₂ (per 10 μg/m³ ) had the pooled RRs for childhood asthma, preterm birth, lung cancer, diabetes, and COPD by 1.134 (1.084-1.186), 1.079 (1.007-1.157), 1.055 (1.010-1.101), 1.019 (1.009-1.029), and 1.016 (1.012-1.120), respectively. CO (per 1 mg/m³ ) was significantly associated with Parkinson's disease (RR 1.574, 95% CI: 1.069-2.317) and CVD (RR 1.024, 95% CI: 1.011-1.038). No robust effects were observed for O₃ . This study provided evidence and basis for further estimation of the health burden attributable to the four gaseous pollutants.

Identification of Health Effects of Complex Air Pollution in China

After the Chinese government introduced a series of policies to strengthen the control of air pollution, the concentration of particulate matter has decreased, but the concentration of ozone has increased, and the problem of complex air pollution still exists, posing a serious threat to public health. Therefore, disentangling the health effect of multi-pollutants has been a long-discussed challenge in China. To evaluate the adverse effects of complex air pollution, a generalized additive model was used to assess the health risks of different pollution types in eight metropolises in different climates in China from 2013 to 2016. Instead of directly introducing multiple pollutant concentrations, we integrated the concentration levels of PM_2.5, NO₂, and O₃ into a set of predictors by grouping methods and divided air pollution into three high single-pollutant types and four high multi-pollutant types to calculate mortality risk in different types. The comprehensive results showed that the impact of high multi-pollutant types on mortality risk was greater than that of high single-pollutant types. Throughout the study period, the high multi-pollutant type with high PM_2.5, NO₂, and O₃ and the high multi-pollutant type with high PM_2.5 and NO₂ were more associated with death, and the highest RRs were 1.129 (1.080, 1.181) and 1.089 (1.066, 1.113), respectively. In addition, the pollution types that most threaten people are different in different cities. These differences may be related to different pollution conditions, pollutant composition, and indoor-outdoor activity patterns in different cities. Seasonally, the risk of complex air pollution is greater in most cities in the warm season than in the cold season. This may be caused by the modifying effects of high temperature on pollutants in addition to different indoor-outdoor activity patterns in different seasons. The results also show that calculating the effect of individual air pollutants separately and adding them together may lead to an overestimation of the combined effect. It further highlights the urgency and need for air pollution health research to move towards a multi-pollutant approach that considers air pollution as a whole in the context of atmospheric abatement and global warming.

Modification effects of ambient temperature on ozone-mortality relationships in Chengdu, China

A multitude of epidemiological studies have demonstrated that both ambient temperatures and air pollution are closely related to health outcomes. However, whether temperature has modification effects on the association between ozone and health outcomes is still debated. In this study, three parallel time-series Poisson generalized additive models (GAMs) were used to examine the effects of modifying ambient temperatures on the association between ozone and mortality (including non-accidental, respiratory, and cardiovascular mortality) in Chengdu, China, from 2014 to 2016. The results confirmed that the ambient high temperatures strongly amplified the adverse effects of ozone on human mortality; specifically, the ozone effects were most pronounced at > 28 °C. Without temperature stratification conditions, a 10-μg/m³ increase in the maximum 8-h average ozone (O_3-8hmax) level at lag01 was associated with increases of 0.40% (95% confidence interval [CI] 0.15%, 0.65%), 0.61% (95% CI 0.27%, 0.95%), and 0.69% (95% CI 0.34%, 1.04%) in non-accidental, respiratory, and cardiovascular mortality, respectively. On days during which the temperature exceeded 28 °C, a 10-μg/m³ increase in O_3-8hmax led to increases of 2.22% (95% CI 1.21%, 3.23%), 2.67% (95% CI 0.57%, 4.76%), and 4.13% (95% CI 2.34%, 5.92%) in non-accidental, respiratory, and cardiovascular mortality, respectively. Our findings validated that high temperature could further aggravate the health risks of O_3-8hmax; thus, mitigating ozone exposure will be brought into the limelight especially under the context of changing climate.

Effect of ambient O3 on mortality due to circulatory and respiratory diseases in a high latitude city of northeast China

In recent years, O₃ pollution had been worsening in China and became a major challenge for human health. To evaluate the O₃ effects on circulatory and respiratory mortality in Harbin, a high latitude city of northeast China, we applied a time-series study from 2014 to 2016. After collecting data and adjusting for the effects of confounders, we built the generalized additive model to assess the associations between O₃ and mortality at different lag days. The results showed that an interquartile-range (IQR) increase in O₃ concentration corresponded to excess risk (ER) of 2.00% (95%CI: - 0.25-4.30%) for circulatory mortality at lag 0 and 8.02% (95%CI: 4.18-12.01%) for respiratory mortality at lag 2 days in the single-pollutant model. Stratified analysis showed that O₃ had a greater effect on females than on males. The effect of O₃ exposure on circulatory mortality was stronger during the warm period, while the opposite trend was founded for respiratory mortality. The sensitivity analysis showed that the effects of O₃ were relatively independent and the major results were robust.

New Insights into Prenatal NO2 Exposure and Behavioral Abnormalities in Male Offspring: Disturbed Serotonin Metabolism and Delayed Oligodendrocyte Development

Epidemiological studies show that prenatal exposure to nitrogen dioxide (NO₂) might cause behavioral abnormalities in childhood. However, toxicological mechanisms for such effects remain unclear, and it is still difficult to define adverse outcome pathways linking exposures to behavioral phenotypes. In this study, by exposing pregnant mice to NO₂ (2.5 ppm, 5 h/day) throughout gestation, we provided the first experimental evidence that prenatal NO₂ exposure did cause anxiety- and depression-like behaviors in weaning male offspring but not females. Specifically, the behavioral abnormalities were associated with abnormal myelination and the alterations attributed to the delayed oligodendrocyte (OL) development in the fetus and the early stage after birth. The expression of platelet-derived growth factor receptor α (Pdgfr-α) and Olig2 significantly decreased in the NO₂ group at E13.5 and E15.5, and the expression of Olig2, adenomatous polyposis coli colon (Cc1), and myelin basic protein (Mbp) was reduced in offspring at PNDs 1, 7, and 21. We performed the targeted metabolomic analysis of neurotransmitters in the placenta and found that prenatal exposure to NO₂ disturbed the metabolism of placental neurotransmitters. Serotonin (5-HT) was transferred from the placenta to the fetus at E10.5, and its accumulation in the fetal forebrain might affect oligodendrocyte progenitor cell (OPC) differentiation and OL maturation and eventually be involved in behavioral abnormalities. Our findings provide new insights into the association between prenatal NO₂ exposure with anxiety- and depression-like behaviors in male offspring.

Trends and characteristics of ozone and nitrogen dioxide related health impacts in Chinese cities

Ambient ozone pollution has been becoming severe and attributed to considerable health impacts in China. Nitrogen dioxide (NO₂) is involved in atmospheric ozone production while also affecting public health directly. Joint control ozone and NO₂ pollution would be of significance. This study quantitatively assessed the health impact attributed to ambient ozone and NO₂ pollution in 338 Chinese cities from 2015 to 2020. The results reveal the generally opposite trends of ozone- and NO₂-related health impacts in China. From 2015-2020, respiratory and chronic obstructive pulmonary disease (COPD) health impacts attributed to ozone in 338 cities increased by 65.30% and 63.98%. The NO₂-attributed health impacts decreased by 24.80% and 24.62%. In 2020, the ozone- and NO₂-related respiratory health impacts were 3.96 million DALYs (disability-adjusted life years) and 1.47 million DALYs. High health impacts are concentrated in big cities and city clusters. In 2020, the sum of ozone- and NO₂-related respiratory health impacts in the top 20 cities was 0.98 million DALYs and 0.44 million DALYs, accounting for 24.70% and 30.24% of the 338 cities. The population attribution fraction analysis identified the increasing distributional consistency of ozone and NO₂-related health impacts, emphasizing the necessity and possible efficiency of ozone-NO₂ joint control. Emission source analysis based on gridded data provided a reference for understanding health impacts and developing targeted strategies.

An Evaluation of Risk Ratios on Physical and Mental Health Correlations due to Increases in Ambient Nitrogen Oxide (NOx) Concentrations

Nitrogen oxides (NOx) are gaseous pollutants contributing to pollution in their primary form and are also involved in reactions forming ground-level ozone and fine particulate matter. Thus, NOx is of great interest for targeted pollution reduction because of this cascade effect. Primary emissions originate from fossil fuel combustion making NOx a common outdoor and indoor air pollutant. Numerous studies documenting the observed physical health impacts of NOx were reviewed and, where available, were summarized using risk ratios. More recently, the literature has shifted to focus on the mental health implications of NOx exposure, and a review of the current literature found five main categories of mental health-related conditions with respect to NOx exposure: common mental health disorders, sleep, anxiety, depression, and suicide. All the physical and mental health effects with available risk ratios were organized in order of increasing risk. Mental health concerns emerged as those most influenced by NOx exposure, with physical health impacts, such as asthma, only beginning to surface as the fourth highest risk. Mental health conditions occupied seven of the top ten highest risk health ailments. The results summarized in this narrative review show that there are clear positive correlations between NOx and negative physical and mental health manifestations, thus strengthening the argument in support of the reduction in ambient NOx levels.

A Time-Series Study for Effects of Ozone on Respiratory Mortality and Cardiovascular Mortality in Nanchang, Jiangxi Province, China

Objective

Most evidence comes from studies show that ambient ozone(O₃) pollution has become a big issue in China. Few studies have investigated the impact of ozone spatiotemporal patterns on respiratory mortality and cardiovascular mortality in Nanchang city. Thus, this study aimed to explore the health effect of ozone exposure on respiratory mortality and cardiovascular mortality in Nanchang, Jiangxi Province.

Methods

Using the daily mortality data, atmospheric routine monitoring data and meteorological data in Nanchang from 2014 to 2020, we performed a generalized additive model (GAM) based on the poisson distribution in which time-series analysis to calculate the risk correlation between respiratory mortality and cardiovascular mortality and ozone exposure level (8h average ozone concentration, O₃-8h). Besides, analyses were also stratified by season, age and sex.

Results

In the single-pollutant model, for every 10 μg/m³ increase in ozone, respiratory mortality increased 1.04% with 95% confidence interval (CI) between 0.04 and 1.68%, and cardiovascular mortality increased 1.26% (95%CI: 0.68 ~ 1.83%). In the multi-day moving average lag model, the mortality of respiratory diseases and cardiovascular diseases reached a relative risk peak on the cumulative lag5 (1.77%,95%CI: 0.99 ~ 2.57%) and the cumulative lag3 (1.68%,95%CI: 0.93 ~ 2.45%), respectively. The differences were statistically significant (P < 0.05). Results of the stratified analyses showed the effect value of respiratory mortality in people aged ≥65 years was higher than aged <65 years, whereas the greatest effect of cardiovascular mortality in people aged <65 years than aged ≥65 years. Ozone had a more profound impact on females than males in respiratory diseases and cardiovascular diseases. In winter and spring, ozone had a obvious impact on respiratory mortality, and effects of ozone pollution on cardiovascular mortality were stronger in summer and winter. There was a statistically significant difference of respiratory mortality in winter and spring and of cardiovascular mortality in summer and winter (P < 0.05).

Conclusions

In the long run, the more extreme the pollution of ozone exposure, the higher the health risk of residents' respiratory mortality and cardiovascular mortality. Therefore, the government should play an important role in the prevention and control ways of decreasing and eliminating the ozone pollution to protect the resident's health. The findings provide valuable data for further scientific research and improving environmental policies in Nanchang city.

Coordinated health effects attributable to particulate matter and other pollutants exposures in the North China Plain

Hebei Province, located in the North China Plain (NCP) and encircling Beijing and Tianjin, has been suffering from severe air pollution. The monthly average fine particulate matter (PM_2.5) concentration was up to 276 μg/m³ in Hebei Province, which adversely affects human health. However, few studies evaluated the coordinated health impact of exposure to PM (PM_2.5 and PM₁₀) and other key air pollutants (SO₂, NO₂, CO, and surface ozone (O₃)). In this study, we systematically analyzed the health risks (both mortality and morbidity) due to multiple air pollutants exposures in Hebei Province. The economic loss associated with these health consequences was estimated using the value of statistical life (VSL) and cost of illness (COI) methods. Our results show the health burden and economic loss attributable to multiple ambient air pollutants exposures in Hebei Province is substantial. In 2017, the total premature mortality from multiple air pollutants exposures in Hebei Province was 69,833 (95% CI: 55,549-83,028), which was 2.9 times higher than that of the Pearl River Delta region (PRD). Most of the potential economic loss (79.65%) was attributable to premature mortality from air pollution. The total economic loss due to the health consequences of multiple air pollutants exposures was 175.16 (95% CI: 134.61-224.61) billion Chinese Yuan (CNY), which was 4.92% of Hebei Province's annual gross domestic product (GDP). Thus, the adverse health effects and economic loss caused by exposure to multiple air pollutants should be seriously taken into consideration. To alleviate these damages, Hebei's government ought to establish more stringent measures and regulations to better control air pollution.

Air pollutant spatiotemporal evolution characteristics and effects on human health in North China

North China, the political, economic, and cultural center of China, has been greatly harmed by frequent air pollution incidents. Therefore, it is vital to study air pollution characteristics and clarify their impact on human health. In this study, we first analyzed the spatiotemporal variations of air pollutants (PM_2.5, PM₁₀, CO, SO₂, NO₂, and O₃) in North China from 2016 to 2019. Then, the air quality index (AQI), aggregate air quality index (AAQI), and health risk based air quality index (HAQI) were used to assess health risks. Based on these, the AirQ_2.2.3 model was used to quantify health effects. The results showed that the major pollutant in the cities surrounding Beijing was PM_2.5, while PM₁₀ dominated in distant cities. Annual concentrations decreased (except for O₃), which is related to governmental emission reduction policies. However, O₃ concentrations increased owing to the complex precursor emissions. The AQI underestimated air pollution, while the AAQI and HAQI were accurate; the latter indicated that 55% of the study region population was exposed to polluted air. The AirQ_2.2.3 model quantified the total mortality proportions attributable to PM_2.5, PM₁₀, SO₂, CO, NO₂, and O₃, which were 1.87%, 3.12%, 1.11%, 1.40%, 4.19%, and 2.52%, respectively. In high concentrations, PM₁₀ and PM_2.5 pose significant health risks. The health effects of SO₂, NO₂, CO, and O₃ at lower concentrations were more obvious, indicating that the expected mortality rate due to low concentrations of some pollutants was much higher than that due to high concentrations of other pollutants.

Machine learning-based estimation of ground-level NO2 concentrations over China

Most current scientific research on NO₂ remote sensing focuses on tropospheric NO₂ column concentrations rather than ground-level NO₂ concentrations; however, ground-level NO₂ concentrations are more related to anthropogenic emissions and human health. This study proposes a machine learning estimation method for retrieving the ground-level NO₂ concentrations throughout China based on the tropospheric NO₂ column concentrations from the TROPOspheric Monitoring Instrument (TROPOMI) and multisource geographic data from 2018 to 2020. This method adopts the XGBoost machine learning model characterized by a strong fitting ability and complex model structure, which can explain the complex nonlinear and high-order relationships between ground-measured NO₂ and its influencing factors. The R² values between the retrievals and the validation and test datasets are 0.67 and 0.73, respectively, which suggests that the proposed method can reliably retrieve the ground-level NO₂ concentrations across China. The distribution characteristics, seasonal variations and interannual differences in ground-level NO₂ concentrations are further analyzed based on the retrieval results, demonstrating that the ground-level NO₂ concentrations exhibit significant geographical and seasonal variations, with high concentrations in winter and low concentrations in summer, and the highly polluted regions are concentrated mainly in Beijing-Tianjin-Hebei (BTH), the Yangtze River Delta (YRD), the Pearl River Delta (PRD), Cheng-Yu District (CY) and other urban agglomerations. Finally, the interannual variation in the ground-level NO₂ concentrations indicates that pollution decreased continuously from 2018 to 2020.

Acute effects of ambient nitrogen oxides and interactions with temperature on cardiovascular mortality in Shenzhen, China

BACKGROUND

Though inconsistent, acute effects of ambient nitrogen oxides on cardiovascular mortality have been reported. Whereas, interactive roles of temperature on their relationships and joint effects of different indicators of nitrogen oxides were less studied. This study aimed to extrapolate the independent roles of ambient nitrogen oxides and temperature interactions on cardiovascular mortality.

METHODS

Data on mortality, air pollutants, and meteorological factors in Shenzhen from 2013 to 2019 were collected. Three indicators including nitric oxide (NO), nitrogen dioxide (NO₂), and nitrogen oxides (NO_X) were studied. Adjusted generalized additive models (GAMs) were applied to analyse their associations with cardiovascular mortality in different groups.

RESULTS

The average daily concentrations of NO, NO₂, and NO_X were 11.7 μg/m³, 30.7 μg/m³, and 53.2 μg/m³, respectively. Significant associations were shown with each indicator. Cumulative effects of nitrogen oxides were more obvious than distributed lag effects. Males, population under 65 years old, and population with stroke-related condition were more susceptible to nitrogen oxides. Adverse effects of nitrogen oxides were more significant at low temperature. Impacts of NO₂ on cardiovascular mortality, and NO on stroke mortality were the most robust in the multi-pollutant models, whereas variations were shown in the other relationships.

CONCLUSIONS

Low levels of nitrogen oxides showed acute and adverse impacts and the interactive roles of temperature on cardiovascular mortality. Cumulative effects were most significant and joint effects of nitrogen oxides required more attention. Population under 65 years old and population with stroke-related health condition were susceptible, especially days at lower temperature.

Short-term effect of fine particulate matter and ozone on non-accidental mortality and respiratory mortality in Lishui district, China

Background

In recent years, air pollution has become an imminent problem in China. Few studies have investigated the impact of air pollution on the mortality of the middle-aged and elderly people. Therefore, this study aims to evaluate the impact of PM_2.5 (fine particulate matter) and O₃ (ozone) on non-accidental mortality and respiratory mortality of the middle-aged and elderly people in Lishui District of Nanjing and provide the evidence for potential prevention and control measures of air pollution.

Method

Using daily mortality and atmospheric monitoring data from 2015 to 2019, we applied a generalized additive model with time-series analysis to evaluate the association of PM_2.5 and O₃ exposure with daily non-accidental mortality and respiratory mortality in Lishui District. Using the population attributable fractions to estimate the death burden caused by short-term exposure to O₃ and PM_2.5。.

Result

For every 10 μg/m³ increase in PM_2.5, non-accidental mortality increased 0.94% with 95% confidence interval (CI) between 0.05 and 1.83%, and PM_2.5 had a more profound impact on females than males. For every 10 μg/m³ increase in O₃, respiratory mortality increased 1.35% (95% CI: 0.05, 2.66%) and O₃ had a more profound impact on males than females. Compared with the single pollutant model, impact of the two-pollutant model on non-accidental mortality and respiratory mortality slightly decreased. In summer and winter as opposed to the other seasons, O₃ had a more obvious impact on non-accidental mortality. The population attributable fractions of non-accidental mortality were 0.84% (95% CI:0.00, 1.63%) for PM_2.5 and respiratory mortality were 0.14% (95% CI:0.01, 0.26%) for O₃. For every 10 μg/m³ decrease in PM_2.5, 122 (95% CI: 6, 237) non-accidental deaths could be avoided. For every 10 μg/m³ decrease in O₃, 10 (95% CI: 1, 38) respiratory deaths could be avoided.

Conclusion

PM_2.5 and O₃ could significantly increase the risk of non-accidental and respiratory mortality in the middle-aged and elderly people in Lishui District of Nanjing. Exposed to air pollutants, men were more susceptible to O₃ damage, and women were more susceptible to PM_2.5 damage. Reduction of PM_2.5 and O₃ concentration in the air may have the potential to avoid considerable loss of lives.

Spatial analysis of the effects of PM2.5 on hypertension among the middle-aged and elderly people in China

Hypertension is currently one of the most common chronic diseases with high global prevalence associated with a huge social and economic burden. In recent years, air pollution has become a focus of research, especially the effects of PM2.5 on hypertension. However, few studies have considered the spatial properties of the sample; thus, the results might be unreliable. Based on the China Health and Retirement Longitudinal Study (CHARLS) and the Environmental Status Bulletin for each province in China, we used the extended shared component model (SCM) to fit the spatial variation of hypertension risk and to reveal the impact of PM2.5 on hypertension in males and females. Our results revealed that the crude prevalence of hypertension for the whole population in China was 32.74% in 2015, with the prevalence in men experiencing slightly higher than that in women (32.92% vs. 32.58%). We found that the distribution of hypertension prevalence exhibited obvious spatial aggregation for the whole population in China (Moran's I = 0.39, P = 0.001), with similar results in both men (Moran's I = 0.18, P = 0.027) and women (Moran's I = 0.52, P = 0.001). Furthermore, the smoothed results obtained using the SCM indicated that some eastern and central provinces had relatively higher hypertension risk, while the risk in southeastern provinces was much lower. The risk was also relatively lower in most western provinces, except for some northwestern regions. Notably, our results showed that PM2.5 was a risk factor for hypertension, and the impact of PM2.5 on women was slightly greater than that on men, with odds ratios (OR) of 1.063 (1.041, 1.086) and 1.048 (1.025, 1.071), respectively. Our findings suggest the existence of distinct spatial differences in the prevalence of hypertension and small sex-related differences in the risk of hypertension in China.

Ambient NO2 exposure sex-specifically impairs myelin and contributes to anxiety and depression-like behaviors of C57BL/6J mice

NO₂ is a common indoor and outdoor air pollutant, but its health effects are still controversial. Beside respiratory injury, more epidemiological studies show that inhalation of NO₂ is associated with an increased risk of anxiety and depression. However, the causal relationship at the molecular level remains unclear. In the present study, we exposed adult C57BL/6J mice to NO₂ (2.5 ppm, 5 h/day) for four weeks, and found anxiety and depression-like behaviors in male mice, but not female mice. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment indicated that differentially expressed genes (DEGs) in the prefrontal cortex and cerebellum were closely associated with signal transduction pathways, such as axon guidance. Importantly, NO₂ inhalation damaged the ultrastructure of myelin sheath and caused the abnormal expression of related genes in males, which partially contributed to mental disorders. We also found that prolactin (Prl), through its anti-inflammatory activity and remyelination, might play a major role in the sex-specific neurobehavioral disorder in male mice caused by NO₂ exposure.

Analysis of Ozone Pollution Characteristics and Influencing Factors in Northeast Economic Cooperation Region, China

The increase in tropospheric ozone (O3) concentration has become one of the factors restricting urban development. This paper selected the important economic cooperation areas in Northeast China as the research object and collected the hourly monitoring data of pollutants and meteorological data in 11 cities from 1 January 2015 to 31 December 2019. The temporal and spatial variation trend of O3 concentration and the effects of meteorological factors and other pollutants, including CO (carbon monoxide), SO2 (sulfur dioxide), NO2 (nitrogen dioxide), and PM2.5 and PM10 (PM particles with aerodynamic diameters less than 2.5 μm and 10 μm) on ozone concentration were analyzed. At the same time, the variation period of O3 concentration was further analyzed by Morlet wavelet analysis. The results showed that the O3 pollution in the study area had a significant spatial correlation. The spatial distribution showed that the O3 concentration was relatively high in the south and low in the northeast. Seasonally, the O3 concentration was the highest in spring, followed by summer, and the lowest in winter. The diurnal variation of O3 concentration presented a “single peak” pattern. O3 concentration had a significant positive correlation with temperature, sunshine duration, and wind speed and a significant anticorrelation with CO, NO2, SO2, and PM2.5 concentration. Under the time scale of a = 9, 23, O3 had significant periodic fluctuation, which was similar to those of wind speed and temperature.

Spatiotemporal assessment of health burden and economic losses attributable to short-term exposure to ground-level ozone during 2015-2018 in China

BACKGROUND

Ground-level ozone (O3) pollution is currently the one of the severe environmental problems in China. Although existing studies have quantified the O3-related health impact and economic loss, few have focused on the acute health effects of short-term exposure to O3 and have been limited to a single temporal and spatial dimension.

METHODS

Based on the O3 concentration obtained from ground monitoring networks in 334 Chinese cities in 2015-2018, this study used a two-stage exposure parameter weighted Log-linear exposure-response function to estimate the cause-specific mortality for short-term exposure to O3.

RESULTS

The value of statistical life (VSL) method that were used to calculate the economic loss at the city-level. Our results show that in China, the national all-cause mortality attributed to O3 was 0.27(95% CI: 0.14-0.55) to 0.39 (95% CI: 0.20-0.67) million across 2015-2018. The estimated economic loss caused by O3 was 387.76 (95% CI: 195.99-904.50) to 594.08 (95% CI: 303.34-1140.65) billion CNY, accounting for 0.52 to 0.69% of total reported GDP. Overall, the O3 attributed health and economic burden has begun to decline in China since 2017. However, highly polluted areas still face severe burden, and undeveloped areas suffer from high GDP losses.

CONCLUSIONS

There are substantial health impacts and economic losses related to short-term O3 exposure in China. The government should pay attention to the emerging ozone pollution, and continue to strengthen the intervention in traditional priority areas while solving the pollution problem in non-priority areas.

Regional Policies Targeting Residential Solid Fuel and Agricultural Emissions Can Improve Air Quality and Public Health in the Greater Bay Area and Across China

Air pollution exposure is a leading public health problem in China. The majority of the total air pollution disease burden is from fine particulate matter (PM2.5) exposure, with smaller contributions from ozone (O3) exposure. Recent emission reductions have reduced PM2.5 exposure. However, levels of exposure and the associated risk remain high, some pollutant emissions have increased, and some sectors lack effective emission control measures. We quantified the potential impacts of relevant policy scenarios on ambient air quality and public health across China. We show that PM2.5 exposure inside the Greater Bay Area (GBA) is strongly controlled by emissions outside the GBA. We find that reductions in residential solid fuel use and agricultural fertilizer emissions result in the greatest reductions in PM2.5 exposure and the largest health benefits. A 50% transition from residential solid fuel use to liquefied petroleum gas outside the GBA reduced PM2.5 exposure by 15% in China and 3% within the GBA, and avoided 191,400 premature deaths each year across China. Reducing agricultural fertilizer emissions of ammonia by 30% outside the GBA reduced PM2.5 exposure by 4% in China and 3% in the GBA, avoiding 56,500 annual premature deaths across China. Our simulations suggest that reducing residential solid fuel or industrial emissions will reduce both PM2.5 and O3 exposure, whereas other policies may increase O3 exposure. Improving particulate air quality inside the GBA will require consideration of residential solid fuel and agricultural sectors, which currently lack targeted policies, and regional cooperation both inside and outside the GBA.

Short-term effects of ambient nitrogen dioxide on years of life lost in 48 major Chinese cities, 2013-2017

BACKGROUND

Evidence on the acute effect of short-term exposure to nitrogen dioxide (NO₂) on years of life lost (YLL) is rare, especially in multicity setting.

METHODS

We conducted a time series study among 48 major Chinese cities covering more than 403 million people from 2013 to 2017. The relative percentage changes of NO₂-YLL were estimated by generalized additive models in each city, then were pooled to generate average effects using random-effect models. In addition, stratified analyses by individual demographic factors and temperature as well as meta-regression analyses incorporating city-specific air pollutant concentrations, meteorological conditions, and socioeconomic indicators were performed to explore potential effect modification.

RESULTS

A 10 μg/m³ increase in two-day moving average (lag01) NO₂ concentration was associated with 0.64% (95% CI: 0.47%, 0.81%), 0.47% (95% CI: 0.27%, 0.68%), and 0.68% (95% CI: 0.34%, 1.02%) relative increments in YLL due to nonaccidental causes, cardiovascular diseases (CVD), and respiratory diseases (RD), respectively. These associations were generally robust to the adjustment of co-pollutants, except for NO₂-CVD that might be confounded by fine particulate matter. The increased YLL induced by NO₂ were more pronounced in elderly people, hotter days, and cities characterized by less severe air pollution or higher temperature.

CONCLUSIONS

Our results demonstrated robust evidence on the associations between NO₂ exposure and YLL due to nonaccidental causes, CVD, and RD, which provided novel evidence to better understand the disease burden related to NO₂ pollution and to facilitate allocation of health resources targeting high-risk subpopulation.

The short-term effect of PM2.5/O3 on daily mortality from 2013 to 2018 in Hefei, China

This research intends to explore the short-term impacts of PM_2.5/O₃ on daily death in Hefei from 2013 to 2018. Data on daily death of Hefei residents, meteorological factors, and air pollutants were collected from Jan 1, 2013, to Dec 31, 2018. The correlation between PM_2.5/O₃ and daily death in Hefei during the research period was studied by time series analysis. From 2013 to 2018, there were 61,683 non-accidental deaths, including 27,431 cardiovascular deaths, 5587 respiratory deaths, 20,921 malignant tumor deaths, and 1674 diabetes deaths, in Hefei. Annual mean concentrations of PM_2.5, PM₁₀, NO₂, SO₂, CO, and O₃ in Hefei were 66.18, 92.37, 39.75, 15.39, 930, and 79.08 μg m^-3, respectively. An increase of 10 μg m^-3 in PM_2.5 was related with 0.53% (95% CI 0.31-0.75%), 0.93% (95% CI 0.60-1.26%), 0.90% and (95% CI 0.23-1.57%) increase in non-accidental, cardiovascular and respiratory diseases mortality, respectively. The association between ozone and mortality was not significant. In cold seasons, PM_2.5 had a stronger effect on the deaths resulting from non-accidental, cardiovascular, and respiratory diseases. The effect of O₃ on deaths was not significantly different between the cold season and the warm season. Women and the elders (over 65 years) were at high risk of being affected by PM_2.5/O₃. Short-term exposure to PM_2.5 was positively correlated with increased deaths due to non-accidental, cardiovascular and respiratory diseases in Hefei. Females and elders were more vulnerable to PM_2.5/O₃ exposure. No significant associations were observed between ozone and deaths from non-accidental, cardiovascular, respiratory, malignant tumors, and diabetes diseases.

Endogenous melatonin mediation of systemic inflammatory responses to ozone exposure in healthy adults

BACKGROUND/AIM

Melatonin is a free radical scavenger and an anti-inflammatory biomolecule. Air pollution exposure has been associated with increased inflammatory responses. We hypothesize that endogenous melatonin plays a role in inflammatory responses to air pollution exposure.

METHODS

We tested this hypothesis in a cohort of 53 healthy adults (22-52 years old, 16 women), none of whom were on melatonin supplementation. Early morning urine and fasting blood were collected from each participant longitudinally up to three times. We analyzed urinary 6-sulfatoxymelatonin (aMT6s), as a surrogate of circulating melatonin, and pro- and anti-inflammatory cytokines in the plasma samples. Indoor and outdoor air pollutants were measured and combined with participants' time-activity patterns to calculate personal exposure to O₃, PM_2.5, NO₂, and SO₂ averaged over 12-hour, 24-hour, 1-week, and 2-week periods prior to biospecimen collection, respectively. Linear mixed-effects models were used to examine the relationships among urinary aMT6s, personal pollutant exposure, and plasma cytokines. A mediation analysis was conducted to examine the role of aMT6s in the relationships between pollutant exposures and inflammatory cytokines.

RESULTS

One interquartile range (4.2 ppb) increase in 2-week O₃ exposure was associated with a -26.2% (95% CI: -43.9% to -2.8%) decrease in aMT6s. Within the range of endogenous aMT6s concentrations (0.5-53.0 ng/ng creatinine) across the participants, increased aMT6s was associated with decreased pro-inflammatory cytokines including IL-1β, IL-8, IL-17A, IFN-γ, and TNF-α. These cytokines were significantly and positively associated with 2-week average O₃ exposure. Furthermore, 7.4% to 17.4% of the O₃-cytokine associations were mediated by aMT6s. We did not find similar effects for the other pollutants.

CONCLUSIONS

Pro-inflammatory responses to O₃ exposure in the preceding 2 weeks partly resulted from the depletion of endogenous melatonin by O₃.

Health impacts of long-term ozone exposure in China over 2013-2017

Increasing ozone concentrations are becoming a severe problem for air pollution in China and have an adverse impact on human health. Here we evaluate premature deaths attributable to long-term exposure to ambient ozone in China between 2013 and 2017 with an air quality model at 5 km resolution and the latest estimates of the relative risk to health. We use a modified inverse distance weighting method to bias-correct the key model-simulated ozone metrics. We find that on a 5-year average basis there are 186,000 (95% Confidence Interval: 129,000-237,000) respiratory deaths and 125,000 (42,000-204,000) cardiovascular deaths attributable to ozone exposure. Sichuan exhibits the largest per capita respiratory mortality (0.31‰) among all provinces. We find that there are 73,000 (51,000-93,000) premature respiratory deaths in urban areas, accounting for 39% of total deaths. Between 2013 and 2017 the population-weighted annual average maximum daily 8-h average ozone (AMDA8) and premature respiratory deaths increased by 14% and 31%, respectively, at a national level. Changes in precursor emissions explain most of these increases, with differences in meteorology accounting for 21% and 16% respectively. Interannual variations in population-weighted ozone and premature respiratory deaths at a provincial level are much larger than those at a national level, particularly in northern, central and eastern China. These findings emphasize that ozone should be an important focus of future air quality policies in China, and tighter controls of precursor emissions are urgently needed.

Air pollution characteristics and human health risks in key cities of northwest China

Air pollution events occur frequently in northwest China, which results in serious detrimental effects on human health. Therefore, it is essential to understand the air pollution characteristics and assess the risks to humans. In this study, we analyzed the pollution characteristics of criteria pollutants in six key cities in northwest China from 2015 to 2018. We used the air quality index (AQI), aggregate AQI (AAQI), and health-risk based AQI (HAQI) to assess the health risks and determine the proportion of people exposed to air pollution. Additionally, on this basis, the AirQ_2.2.3 model was used to quantify the health effects of the pollutants. The results showed that PM₁₀ pollution occurred mainly in spring and winter and was caused by frequent dust storms. PM_2.5 pollution was caused mainly by anthropogenic activities (especially coal-fired heating in winter). Because of a series of government policies and pollutant reduction measures, PM_2.5, SO₂, NO₂, and CO concentrations showed a downward trend during the study period (except for a small increase in the case of NO₂ in some years.). However, O₃ showed high concentrations due to the high intensity of solar radiation in summer and inadequate emission reduction measures. The air quality levels based on their classification were generally higher than the Chinese ambient air quality standard classified by the AQI index. We also found that the higher the AQI index was, the more serious the air pollution classified based on the AAQI and HAQI indices was. The HAQI index could better reflect the impact of pollutants on human health. Based on the HAQI index, 20% of the population in the study area was exposed to polluted air. The total mortality values attributable to PM₁₀, PM_2.5, SO₂, O₃, NO₂, and CO, quantified by the AirQ_2.2.3 model, were 3.00%, 1.02%, 1.00%, 4.22%, 1.57%, and 0.95% (Confidence Interval:95%), respectively; the attributable proportions of mortality for respiratory system and cardiovascular diseases were consistent with the change rule of total mortality, because the number of deaths attributable to the latter was greater than that for the former. According to the exposure reaction curves of pollutants, PM₁₀ and PM_2.5 still showed a large change at high concentrations. However, the tendencies of SO₂, NO₂, CO, and O₃ were more obvious under low concentration exposure, which indicated that the expected mortality rate due to lower air pollution concentrations was much higher than the mortality due to high air pollution concentrations.

Pollution zone identification research during ozone pollution processes

Identifying an ozone pollution zone during the pollution processes is significant for ozone pollution management and environmental health risk assessment. However, few studies have focused on ozone pollution zone identification during pollution processes. A spatial-temporal clustering framework for identifying pollution zones during ozone pollution processes was initially proposed in this study, and an ozone pollution process in China in May 2017 was selected as a case. The results showed that the framework can help selecting one more accurate method to identify the pollution zone according to the pollution characteristics of air pollution process. In addition, different ozone pollution zone identification methods work well in different scenarios: The self-organizing map (SOM) method was suitable for identifying the zone with the duration of pollution between 24 and 48 h, the image fusion based on wavelet transform (IFbWT) method for the zone with the duration of pollution over 48 h and the Apriori method for the zone with obvious boundaries between high-value and low-value ozone concentrations. The proposed procedure can also be applied to identify the pollution zone of the pollution process of other pollutants.

The Impact of the Wuhan Covid-19 Lockdown on Air Pollution and Health: A Machine Learning and Augmented Synthetic Control Approach

We quantify the impact of the Wuhan Covid-19 lockdown on concentrations of four air pollutants using a two-step approach. First, we use machine learning to remove the confounding effects of weather conditions on pollution concentrations. Second, we use a new augmented synthetic control method (Ben-Michael et al. in The augmented synthetic control method. University of California Berkeley, Mimeo, 2019. https://arxiv.org/pdf/1811.04170.pdf) to estimate the impact of the lockdown on weather normalised pollution relative to a control group of cities that were not in lockdown. We find NO2 concentrations fell by as much as 24  μ g/m3 during the lockdown (a reduction of 63% from the pre-lockdown level), while PM10 concentrations fell by a similar amount but for a shorter period. The lockdown had no discernible impact on concentrations of SO2 or CO. We calculate that the reduction of NO2 concentrations could have prevented as many as 496 deaths in Wuhan city, 3368 deaths in Hubei province and 10,822 deaths in China as a whole.

Inflammatory and oxidative stress responses of healthy adults to changes in personal air pollutant exposure

Exposure to air pollutants has been associated with respiratory and cardiovascular mortality, but the underlying molecular mechanisms remain inadequately understood. We aimed to examine molecular-level inflammatory and oxidative stress responses to personal air pollutant exposure. Fifty-three healthy adults aged 22-52 were measured three times for their blood inflammatory cytokines and urinary malondialdehyde (MDA, an oxidative stress biomarker) within 2 consecutive months. Pollutant concentrations monitored indoors and outdoors were combined with the time-activity data to calculate personal O₃, PM_2.5, NO₂, and SO₂ exposures averaged over 12 h, 24 h, 1 week, and 2 weeks, respectively, prior to biospecimen collection. Inflammatory cytokines and MDA were associated with pollutant exposures using linear mixed-effects models controlling for various covariates. After adjusting for a co-pollutant, we found that concentrations of proinflammatory cytokines were significantly and negatively associated with 12-h O₃ exposures and significantly but positively associated with 2-week O₃ exposures. We also found significant and positive associations of proinflammatory cytokines with 12-h and 24-h NO₂ exposures, respectively. However, we did not find clear associations of PM_2.5 and SO₂ exposure with proinflammatory cytokines and with MDA. The removal of an O₃-generating electrostatic precipitator in the mechanical ventilation systems of the offices and residences of the subjects was associated with significant decreases in IL-1β, IL-2, IL-6, IL-8, IL-17A, and TNF-α. These findings suggest that exposure to O₃ for different time durations may affect systemic inflammatory responses in different ways.

Recent advances in catalytic decomposition of ozone

Ozone (O₃), as a harmful air pollutant, has been of wide concern. Safe, efficient, and economical O₃ removal methods urgently need to be developed. Catalytic decomposition is the most promising method for O₃ removal, especially at room temperature or even subzero temperatures. Great efforts have been made to develop high-efficiency catalysts for O₃ decomposition that can operate at low temperatures, high space velocity and high humidity. First, this review describes the general reaction mechanism of O₃ decomposition on noble metal and transition metal oxide catalysts. Then, progress on the O₃ decomposition performance of various catalysts in the past 30 years is summarized in detail. The main focus is the O₃ decomposition performance of manganese oxides, which are divided into supported manganese oxides and non-supported manganese oxides. Methods to improve the activity, stability, and humidity resistance of manganese oxide catalysts for O₃ decomposition are also summarized. The deactivation mechanisms of manganese oxides under dry and humid conditions are discussed. The O₃ decomposition performance of monolithic catalysts is also summarized from the perspective of industrial applications. Finally, the future development directions and prospects of O₃ catalytic decomposition technology are put forward.

Effect of Lockdown Measures on Atmospheric Nitrogen Dioxide during SARS-CoV-2 in Spain

The disease caused by SARS-CoV-2 has affected many countries and regions. In order to contain the spread of infection, many countries have adopted lockdown measures. As a result, SARS-CoV-2 has negatively influenced economies on a global scale and has caused a significant impact on the environment. In this study, changes in the concentration of the pollutant Nitrogen Dioxide (NO2) within the lockdown period were examined as well as how these changes relate to the Spanish population. NO2 is one of the reactive nitrogen oxides gases resulting from both anthropogenic and natural processes. One major source in urban areas is the combustion of fossil fuels from vehicles and industrial plants, both of which significantly contribute to air pollution. The long-term exposure to NO2 can also cause severe health problems. Remote sensing is a useful tool to analyze spatial variability of air quality. For this purpose, Sentinel-5P images registered from January to April of 2019 and 2020 were used to analyze spatial distribution of NO2 and its evolution under the lockdown measures in Spain. The results indicate a significant correlation between the population’s activity level and the reduction of NO2 values.

Improved risk communications with a Bayesian multipollutant Air Quality Health Index

Establishing an optimal indicator to communicate health risks of multiple air pollutants to public is much important. The Air Quality Health Index (AQHI) has been developed in many countries as a communication tool of multiple air pollutants related health risks. However, the current AQHI is based on the sum of the excess health risks which are typically derived from the single-pollutant statistical models. Such a strategy may overestimate the joint effect of multiple pollutants. We proposed an improved strategy to construct the AQHI based on a Bayesian multipollutant weighted model. Using this strategy, two improved indices - Bayesian multipollutant AQHI (BMP-AQHI) and Bayesian multipollutant AQHI with seasonal specificity (SBMP-AQHI) were calculated to present the multiple pollutants related health risks to the cardiovascular system based on data collected in Chengdu, China during 2013 to 2018. The two improved indices were compared to current Air Quality Index (AQI) and AQHI to evaluate the effectiveness of the improved indices in characterizing multipollutant health risks. The AQI risk classification suggested much smaller health risks than AQHIs. Among three AQHI types, the BMP-AQHI and SBMP-AQHI suggested slightly lower health risks to the cardiovascular system than the current AQHI. In the evaluation analysis, the SBMP-AQHI had the strongest association with the mortality of cardiovascular disease (CVD) (2.66%; 95%CI, 1.57%, 3.76%). In the subgroup analysis, an interquartile increase (IQR) of the SBMP-AQHI was associated with 3.21% (95%CI, 2.06%, 4.38%), 1.34% (95%CI, -0.13%, 2.82%), and 4.20% (95%CI, 2.59%, 5.84%) increases for CVD mortality in the elderly, male, and female subgroups, respectively. The study shows that the improved AQHIs can communicate the health information of multiple air pollutants more efficiently. The study also indicates the necessity to consider seasonal specificity in the construction of the AQHI.

Quantifying public health benefits of PM2.5 reduction and spatial distribution analysis in China

In recent years, particulate matter (PM) air pollution has become a significant and growing public health problem in China. In this study, the daily PM_2.5 exposure level at a spatial resolution of 100 km² was simulated based on the data of 1328 monitoring sites and the Voronoi Neighborhood Averaging (VNA) interpolation method. The results reveal that the daily mean PM_2.5 concentration reduced from 47.82 μg/m³ (2016) to 40.87 μg/m³ (2018), a reduction of 14.53%. We first calculated the heath impacts and economic benefits of this reduction (Scenario 1) by using Environmental Benefits Mapping and Analysis Program (BenMAP). The estimated avoided premature mortalities for all-cause, cardiovascular diseases, respiratory diseases, and lung cancer were in the range of 7214 to 81,681 cases (total of 154,176 cases). The estimated economic benefits based on willingness to pay (WTP) ranged from 3.96 to 44.85 billion RMB (total of 84.66 billion RMB). Moreover, the PM_2.5 concentration in the control scenario was rolled back to the Grade I standards (35 μg/m³, Scenario 2). The avoided deaths are in the range of 58,820 to 590,464 cases (total of 1,217,671 cases). The estimated monetary value of the avoided cases of all health endpoints range from 36.63 to 367.66 billion RMB based on WTP (total of 758.21 billion RMB). In addition, the spatial autocorrelation analysis reveals that the distribution of both avoided premature mortality and economic benefits exhibit a certain spatial aggregation.

Prenatal NO2 exposure and neurodevelopmental disorders in offspring mice: Transcriptomics reveals sex-dependent changes in cerebral gene expression

BACKGROUND

Early-life exposure to nitrogen dioxide (NO₂) is associated with an increased risk of developing a neurodevelopmental disorder during childhood or later in life.

OBJECTIVES

We investigated whether prenatal NO₂ inhalation causes neurodevelopmental abnormalities and cognitive deficits in weanling offspring without subsequent postnatal NO₂ exposure and how this prenatal exposure contributes to postnatal consequences.

METHODS

Pregnant C57BL/6 mice were exposed to air or NO₂ (2.5 ppm, 5 h/day) throughout gestation, and the offspring were sacrificed on postnatal days (PNDs) 1, 7, 14 and 21. We determined the mRNA profiles of different postnatal developmental windows, detected the long noncoding RNA (lncRNA) profiles and cognitive function in weanling offspring, and analyzed the effects of hub lncRNAs on differentially expressed genes (DEGs).

RESULTS

Prenatal NO₂ inhalation significantly impaired cognitive function in the weanling male, but not female, offspring. The male-specific response was coupled with abnormal neuropathologies and transcriptional profiles in the cortex during different postnatal developmental windows. Consistently, Gene Ontology (GO) analysis of the DEGs revealed persistent disruptions in neurodevelopment-associated biological processes and cellular components in the male offspring, and Apolipoprotein E (ApoE) was one of key factors contributing to prenatal exposure-induced male-specific neurological dysfunction. In addition, distinct sex-dependent lncRNA expression was identified in the weanling offspring, and metastasis-associated lung adenocarcinoma transcript 1 (Malat1) acted as a hub lncRNA and was coexpressed with most coding genes in the lncRNA-mRNA coexpressed pairs in the male offspring. Importantly, lncRNA Malat1 expression was elevated, and Malat1 modulated ApoE expression through NF-κB activation during this process.

CONCLUSIONS

Prenatal NO₂ exposure is related to sex-dependent neurocognitive deficits and transcriptomic profile changes in the cortices of the prenatally exposed offspring. Male-specific neurological dysfunction is associated with the constant alteration of genes during postnatal neurodevelopment and their transcriptional modulation by hub lncRNAs.

Relationship between atmospheric pollutants and risk of death caused by cardiovascular and respiratory diseases and malignant tumors in Shenyang, China, from 2013 to 2016: an ecological research

Background:

Air pollutants and their pathogenic effects differ among regions and seasons. We aimed to explore the relationship between fine particulate matter (PM_2.5), sulfur dioxide (SO₂), and ozone-8 hours (O₃-8h) concentrations in heating and non-heating seasons and the associated death risk due to cardiovascular diseases (CDs), respiratory diseases (RDs), and malignant tumors.

Methods:

Data were collected in Shenyang, China, from April 2013 to March 2016. We analyzed the correlation or lagged effect of atmospheric pollutant concentration, meteorological conditions, and death risk due to disorders of the circulatory system, respiratory system, and malignant tumor in heating and non-heating seasons. We also used multivariate models to analyze the association of air pollutants during holidays with the death risk due to the evaluated diseases while considering the presence or absence of meteorological factors.

Results:

An increase in the daily average SO₂ concentration by 10 μg/m³ increased the death risk by CDs, which reached a maximum of 2.0% (95% confidence interval [CI]: 1.3%–2.7%) on lagging day 4 during the non-heating season and 0.2% (95% CI: 0.1%–0.4%) on lagging day 3 during the heating season. The risk of death caused by RDs peaked on lagging day 1 by 0.8% (95% CI: 0.4%–1.2%) during the heating season. An increase in O₃-8h concentration by 10 μg/m³ increased the risk of RD-related death on lagging day 2 by 1.0% (95% CI: 0.4%–1.7%) during the non-heating season, which was significantly higher than the 0.1% (95% CI: 0–0.9%) increase during the heating season. Further, an increase in the daily average PM_2.5 concentration by 10 μg/m³ increased the risk of death caused by RDs by 0.3% and 0.8% during heating and non-heating seasons, respectively, which peaked on lagging day 0. However, air pollution was not significantly associated with the risk of death caused by malignant tumors.

Conclusion:

Short-term exposure to PM_2.5, SO₂, and O₃ during the non-heating season resulted in higher risks of CD-related death, followed by RD-related death.

Spatio-temporal patterns of air pollution in China from 2015 to 2018 and implications for health risks

China has been seriously affected by particulate matter (PM) and gaseous pollutants in the atmosphere. In this study, we systematically analyse the spatio-temporal patterns of PM_2.5, PM₁₀, SO₂, CO, NO₂, and O₃ and the associated health risks, using data collected from 1498 national air quality monitoring sites. An analysis of the averaged data from all the sites indicated that, from 2015 to 2018, annual mean concentrations of PM_2.5, PM₁₀, SO₂ and CO declined by 3.2 μg m^-3, 3.7 μg m^-3, 3.9 μg m^-3, and 0.1 mg m^-3, respectively. In contrast, those of NO₂ and O₃ increased at rates of 0.4 and 3.1 μg m^-3, respectively. Except for O₃, the annual mean concentrations of all pollutants were generally the highest in North China and lowest in the Tibetan Plateau. The concentrations were generally higher in the north of the country than in the south. In all regions of China, the pollutant concentrations were the highest in winter and lowest in summer, except for O₃, which showed an opposite seasonal pattern. Overall, the seasonal mean concentrations of all the pollutants (except for O₃) significantly decreased between the same seasons in 2018 and 2015, whereas the seasonal mean O₃ concentrations generally significantly increased, and/or remained at stable levels in all four seasons except for winter. Diurnal variations of all pollutants (except for O₃) exhibited a bimodal pattern with peaks between 8:00 and 11:00 a.m. and 9:00 and 12:00 p.m., whereas O₃ exhibited a unimodal pattern with maximum values between 5:00 and 7:00 p.m. No significant differences in the daily mean concentrations of all pollutants were found between weekdays and weekends in all regions, except for PM_2.5 and PM₁₀ in Northeast China. In Northwest China and Southeast China, PM_2.5 showed stronger correlations with NO₂ relative to SO₂, suggesting that NO_x emission control may be more effective than SO₂ emission control for alleviating PM_2.5 formation. Compared with 2015, the total PM_2.5-attributable mortality, number of respiratory and cardiovascular diseases, and incidence of chronic bronchitis decreased overall by 23.4%-26.9% in 2018. In contrast, for O₃-attributable deaths, there was an increase of 18.9%. Our study not only improves the understanding of the spatial and temporal patterns of air pollutants in China, but also highlights that synchronous control of PM_2.5 and O₃ pollution should be implemented to achieve dual benefits in protecting human health.

A novel framework for decomposing PM2.5 variation and demographic change effects on human exposure using satellite observations

Human exposure to PM_2.5, represented by population-weighted mean PM_2.5 concentration (c_ρ), declines under three conditions: (1) mean PM_2.5 concentration declines, (2) PM_2.5 concentration within urban areas goes through more of a decrease than within rural areas, or (3) city planning relocates people into cleaner areas. Decomposing these effects on human exposure is essential to guide future environmental policies. The lack of ground PM_2.5 observations limits the assessment of human exposure to PM_2.5 over China. This study proposed a novel diagnostic framework using satellite observations to decompose the variation in c_ρ resulting from change in the mean PM_2.5 concentration, spatial difference in PM_2.5 change, and demographic change. In this framework, we decomposed c_ρ into mean PM_2.5 concentration (c₀) and pollution-population-coincidence induced PM_2.5 exposure (PPCE). We then used this framework to decompose the variation in c_ρ over China within three recent Five-Year Plans (FYPs) (2001-2015). The results showed that the decline in c₀ reduced c_ρ in most provinces within the eleventh and twelfth FYPs. The spatial difference in PM_2.5 change reduced the PPCE and c_ρ in most provinces within the tenth and twelfth FYPs, with the most substantial reduction rate of -3.64 μg m^-3·yr^-1 in Tianjin within the twelfth FYP. Rural-to-urban migration resulting from rapid urbanization, however, increased the PPCE and c_ρ (by as much as 0.22 μg m^-3·yr^-1) in all provinces except Taiwan within all three FYPs. The demographic change reduced c_ρ in Taiwan because of the migration of population into less polluted areas. To better reduce human exposure, it is recommended that control efforts further target populous residential areas and urbanization planning relocates people into less polluted areas. Our decomposition framework paves a new way to decompose the human exposure to other air pollutants in China and other regions.