Ambient Particulate Matter Exposure and Under-Five and Maternal Deaths in Asia.

The Asian region is one of the major emission sources of air pollution. Although ambient PM has been linked to several health risks in high-, low-, and middle-income countries, the further analysis of type impact is still rare but significant. The PM distribution retrieved from MODIS (Moderate Resolution Imaging Spectroradiometer) aerosol optical depth products within 16 years thus explored the associations between under-five and maternal mortality for 45 countries in Asia. Both the nonparametric (Generalized Additive Mixed-Effect) and parametric (Generalized Linear Mixed-Effect) models were employed to analyze the collected datasets. The results show that the levels of PM in Asian sub-regions were higher than the Global Air Quality Standards. Biomass PM concentrations was associated with increased the rate of under-five (Incidence Rate Ratio, IRR = 1.29, 95% CI, 1.13-1.47) and maternal (IRR = 1.09, 95% CI: 1.08-1.10) deaths in Asia. Anthropogenic PM was associated with increased rate of under-five deaths in Asia by 12%. The nonparametric method revealed that dust PM was positively associated with the under-five ( = 0.04, < 0.001) and maternal ( = 0.07, < 0.001) deaths in Asia. The rate of maternal deaths was increased by biomass/dust (IRR = 1.64, 95% CI: 1.63-1.65) and anthropogenic/dust (IRR = 1.22, 95% CI: 1.19-1.26) mixture types. In summary, long-term exposure to different types of ambient PM in high concentration increased the rate of under-five and maternal deaths, suggesting that policies focusing on preventive and control measures is imperative for developing an improved maternal, newborn, and child health in Asia.