An Analysis Of The Association Between Air Pollution And The Mortality Of Respiratory Diseases In Liyang From 2009 To 2013

【Background】With the increase of the Chinese total economy and the improvement of industrialization and urbanization, the air pollution is worsening and city haze happen frequently. The burden of respiratory diseases is increasing.【Objective】Based on the concentration of particulate matter, sulfur compounds and nitrogen oxides from 2009 to 2013 in Liyang city, this paper analyzed the trends of the air pollutions, and analyzed the trends of mortality in different pulmonary diseases include lung cancer, pneumonia, pulmonary heart disease and chronic obstructive pulmonary disease(COPD) from 2009 to 2013 in Liyang city. This paper investigates the association between air pollution and the mortality of respiratory disease.【Methods】1.Data Source: Air pollution concentrations, including particulate matter, sulfur compounds and nitrogen oxides, were obtained from air automatic monitoring station of Liyang Environmental Protection Bureau. The data of death cases including lung cancer, pneumonia, pulmonary heart disease and chronic obstructive pulmonary disease(COPD) from 2009 to 2013, was obtained from the national disease surveillance process(DSP) of Liyang monitoring sites. The data were checked every year with public security organs, civil administration bureau, and family planning departments in order to avoid omission. The annual population data was obtained from Liyang public security bureau. All mortality data in the death registry causes are coded by the International Classification of Disease revision 10(ICD10). For this study, four kinds of deaths from pulmonary disease including lung cancer(C33-34), pneumonia(J18、J20), pulmonary heart disease(I27) and chronic obstructive pulmonary disease(COPD)(J43-45、J96)were identified.2. Statistical Analysis Methods: Spearman rank correlation analysis were used in SPSS software version 22(Statistical Product and Service Solutions)to investigate the trends of air pollutions concentration,the associations between air pollution and the mortality of respiratory diseases. The statistical tests effects of P < 0.05 were considered statistically significant. The crude death rate and age-standardised death rate among different year, age and gender were analyzed in SAS software version 9.2(SAS Institute Inc., Cary, NC, USA).The standard population data were utilized from the Fifth Population Census of China( 2000).The crude death rate, standardized mortality rate, age-specific mortality rate and annual percentage change( APC)and 95% confidence intervals(95% CI) were analyzed in Joinpoint Regression Program software version 4.1.1.【Results】 1. The primary air pollution from 2009 to 2013 in Liyang city were particulate matter, sulfur compounds and nitrogen oxides. There were correlations between the average concentration of nitrogen dioxide and year(rs=1.00, P<0.0001). There was no significant growth trend of the annual average concentration of sulfur dioxide and particulate matter during 5 years. 2.There were total up to 21,950 deaths from 2009 to 2013 in Liyang city, among which the pulmonary disease accounted for 20.8 percent(4571/21950). Based on the annually change of four kinds of deaths from pulmonary disease mortality rate, the standardized mortality rate of lung cancer had a high-level fluctuation, the COPD and pneumonia had an obvious upward tendency while the pulmonary heart disease had a slightly descent. The annual average crude death rate of lung cancer, pulmonary heart disease, pneumonia and the COPD were 36.26/100,000 、 22.62/100,000 、 27.51/100,000 and29.92/100,000,respectively. The standardized mortality rate of them were 16.34/100,000、6.30/10,000、7.39/100,000 and 8.28/100,000, respectively. There was no significant change of the lung cancer and pulmonary heart disease, with APC 4.5%(95%CI:-5.3%~14.3%) and-10.0%(95%CI:-33.1%~13.1%), respectively. While of pneumonia and the COPD,obvious upward tendency have been shown, with APC 20.1%(95%CI:9.4%~30.8%) and 69.3%(95%CI:41.5%~97.1%), respectively. The standardized mortality rate of the COPD and pneumonia had an obvious upward tendency, lung cancer had a high-level fluctuation, while the pulmonary heart disease had a slightly descent in Liyang city. 3. There were correlations between the nitrogen dioxide concentration and the standardized mortality rate of pneumonia, COPD in male, pneumonia in female, pneumonia and COPD in total population using Spearman analysis, with rs 0.9,(P=0.019),1( P <0.001),0.9( P=0.037), 0.9( P=0.019)and 0.9(P=0.019), respectively. There were no significant upward tendencies between mortality of other diseases and air pollution concentration.