Temporal variations in ambient particulate matter reduction associated short-term mortality risks in Guangzhou, China: A time-series analysis (2006-2016).

Numerous studies have reported associations between ambient particulate matter (PM) and daily mortality; however, little is known about temporal variations in ambient air pollution associated mortality risks, particularly in developing countries with limited long time-series air monitoring data. In present study, we assessed the associations and temporal relationships between ambient PM and daily mortality in Guangzhou, China, during 2006-2016. With this unique 11-year dataset, we related daily concentrations of PM with aerodynamic diameter < 2.5 μm (PM), between 2.5 and 10 μm (PM) and <10 μm (PM) to daily mortality in Guangzhou. We applied overdispersed Poisson regression with adjustment for time trend and potential confounding factors. Multiple level sensitivity analyses were conducted to examine the robustness of main results. Between 2006 and 2016, annual concentrations of PM decreased by 50.8% to 27.0 μg/m, of PM by 27.6% to 16.2 μg/m, and of PM by 44.1% to 43.3 μg/m in Guangzhou. In this study, per 10 μg/m increases in mean concentrations at current day and 6 prior days of death (lag06), we observed increases in total mortality risks of 0.55% (95% Confidence Interval (CI): 0.24%, 0.86%) for PM, 0.99% (95%CI: 0.48%, 1.50%) for PM, and 0.44% (95%CI: 0.22%, 0.65%) for PM. Stronger associations were observed for ambient PM on cardio-respiratory mortality and people at age ≥ 65 years. Despite drastic reductions in annual PM levels, PM associated cardiovascular and respiratory mortality risks remained significant at 1.26% (95%CI: 0.19%, 2.35%) and 1.91% (95%CI: 0.25%, 3.60%) during 2014-2016. Further, PM and PM associated respiratory mortality risks showed increasing trend over time (p-value = 0.03 for PM). In summary, though ambient PM levels decreased substantially in Guangzhou in recent years, PM and PM associated cardio-respiratory mortality risks remained significant and respiratory mortality risks even increased. Our findings provide strong rationale for continuation of ambient air pollution control effort for public health protection in the future.