Study On The Association Between Ambient Air Pollution And Daily Non-accidental Deaths In Hefei,during 2013-2017:A Time-series Study

ObjectiveTo understand the non-accidental deaths of residents in Hefei from 2013 to 2017and the time variation of air pollutants(PM₁₀,NO₂,SO₂,PM_2.5,CO,O₃)concentrations,constructing a time series model to investigate the impact of air pollutants on the unintentional deaths of residents,identify sensitive people.Provide a theoretical basis for government departments to propose strategies to prevent air pollution from affecting residents'health.MethodsObtain the death data of Hefei residents from 2013 to 2017 from Hefei Disease Control Center,and select non-accidental death data according to the death information.The data includes general information such as gender,age,work,and specific causes of death.The daily concentration data of air pollutants in Hefei from2013 to 2017 are from the Hefei Environmental Protection Bureau,including PM₁₀,SO₂,NO₂,PM_2.5,CO?24-hour average daily concentration?and O₃?daily maximum1-hour average concentration?.Obtain the same-day meteorological data?http://data.cma.gov.cn/?from China Meteorological Data Network,including daily average temperature???,daily maximum and minimum temperature???,Daily average relative humidity?%?,daily maximum and minimum relative humidity?%?,daily average pressure?hpa?,daily maximum and minimum pressure?h Pa?,daily average wind speed?m/s?,daily precipitation Amount?mm?.This study analyzes the relationship between air pollutants and deaths of residents by constructing a DLNM model.In the first step,only covariates such as holidays,time trends,and seasonal changes are included in the model to build a basic model.In the second step,various meteorological factors are gradually incorporated into the basic model.After screening,the optimal model is obtained.Finally,the air pollutants are separately included in the optimal model.The excess risk value of each air pollutant to the residents'unintentional death and whether there is a lag effect are analyzed.The data are analyzed by gender,age,education,The work performed a subgroup analysis,and observed the effect of seasonal air pollutants on the non-accidental death of residents according to seasonal stratification.Finally,analyze the impact of air pollutants on different diseases according to the specific cause of death.ResultsThe number of non-accidental deaths was 9,185,9681,9949,10345,and 11,228.It can be seen that the number of non-accidental deaths has been increasing year by year in Hefei.In the single day lag effect,PM₁₀,NO₂,PM_2.5and co had the greatest influence on the death of non accidental diseases on the lag day?lag0?.The risk of death of non accidental diseases increased by 1.50%?95%CI:0.54%?2.47%?,2.51%?95%CI:1.32%?3.72%?,0.98%?95%CI:0.06%?1.90%?with each increase of IQR(PM₁₀:55?g/m³,NO₂:22?g/m³,PM_2.5:45.02?g/m³,Co:400?g/m³),1.93%?95%CI:0.92%?2.95%?,while SO₂and O₃in lag1 and lag2 had the greatest impact on non accidental death.For each IQR?SO₂:10?g/m³,O₃:58.06?g/m³?,the risk of non accidental death increased by 1.02%?95%CI:0.33%?1.71%?and 1.23%?95%CI:0.40%?2.07%?.In the multi day cumulative lag effect,we can find that PM₁₀,NO₂,SO₂,PM_2.5,CO and O₃in lag0-4,lag0-3,lag0-5,lag0-1,lag0-2and lag0-5,respectively,have the greatest impact on non accidental death.For each IQR,the risk of non accidental death increases by 3.19%?95%CI:1.22%?5.20%?,4.68%?95%CI:2.57%?6.83%?,4.07%?95%CI:1.26%?6.96%?1.38%?95%CI:0.02%?2.76%?,2.98%?95%CI:1.28%?4.71%?and 5.16%?95%CI:1.24%?9.23%?.PM₁₀,NO₂,SO₂,PM_2.5,CO and O₃all have significant effects on cardiovascular disease death,but only NO₂and CO have effects on respiratory system disease death.In the multi pollutant model,we can find that SO₂and PM_2.5have no statistical significance?P>0.05?when other air pollutants are included in the most lagged effect days;PM₁₀,NO₂,CO and O₃have a more stable impact on the death of non accidental diseases of residents?P<0.05?,but they will reduce the effect.In the subgroup analysis,we found that PM₁₀,NO₂,SO₂,and CO all increased the risk of unintentional death in male and female.We did not find statistically significant differences in the risk of unintentional death in male with PM_2.5and O₃?P>0.05?.),But O₃can significantly affect the mortality risk of women's unintentional death?P<0.05?.PM₁₀,PM_2.5,CO and O₃significantly increased the risk of non-accidental death of residents aged?65 years,but there was no statistical significance for the risk of non-accidental death of residents aged<65 years?P>0.05?.Will increase the risk of non-accidental death of residents aged?65 and<65 years?P<0.05?.Blue-collar and low-education groups are more vulnerable to air pollutants.In the seasonal grouping,the excess risk effect value of PM₁₀and SO₂on non-accidental death in summer,autumn,and winter was statistically significant?P<0.05?;the excess risk effect value of NO₂on non-accidental death in spring,summer,and winter was statistically significant.?P<0.05?,PM₁₀,NO₂and SO₂all had the highest effect value in summer,and the excess risk effect value of CO on non-accidental death was statistically significant in all four seasons?P<0.05?;PM_2.5and O₃were not unexpected the effect of death excess risk was not statistically significant in the four seasons.Conclusions1.From 2013 to 2017,the non-accidental mortality rate of residents in Hefei increased year by year,and the concentration of air pollutants showed a downward trend year by year.2.The main air pollutants in Hefei are PM₁₀and PM_2.5,followed by NO₂and SO₂.3.With the increase of air pollutants,the risk of non accidental death of residents also increased.The relationship between them is linear and no threshold was found.4.In the subgroup analysis,women,?65 years old,blue-collar workers,and low-education degree were more sensitive to air pollutants.5.This study suggests that there is a seasonal difference in air pollutants'non-accidental deaths.