The Effect Of Air Pollution On Mortality

Objective To evaluate the effect of ambient air pollutants(PM2.5)on mortality and the public health effects of the air pollution control policy in Beijing-Tianjin-Hebei(BTH)region.Method Difference-in-differences and instrumental variable are used for this quasi-natural experiment design.The air pollution data are from the monitoring sites administered by the MEP,and the mortality data are from the national death cause registry system.The data are matched at county level with monthly average.The intervention group includes 16 districts from BTH region,and the control group includes 11 districts in Henan and 27 districts in Liaoning.14 districts in major cities on the Fenwei plain was also considered in the search for the final control group.The intervention period is from Jun.2014 to Dec.2017;Stata15.1 is used for analysis。Result Compared with control districts,the monthly average concentration of PM2.5 in intervention districts reduced by 12.87 μg/m3(95%CI:-18.13～-7.60)after implementing the air pollution control policy,the monthly average age standardized mortality rate due to non-accidental causes and the cardio-cerebrovascular and respiratory(CVR)diseases reduced by 8.26%(95%CI:-4.36%～-12.01%)and 10.92%(95%CI:-6.88%～-14.79%)respectively,and the mortality rate due to non-CVR has no statistically significant reduction.With an reduction of PM2.5 by 10 μg/m3,the monthly average age standardized mortality rate due to non-accidental causes and CVR diseases reduced by 5.79%(95%CI:1.92%～9.80%)and 9.15%(95CI:4.55%～13.95%)respectively,and the mortality rates due to non-CVR,cancer,injury have no statistically significant reduction.For gender issue,with an reduction of PM2.5 by 10μg/m3,the monthly average age standardized mortality rate due to non-accidental causes has no statistically significant reduction among male and reduced by7.74%(95%CI:3.34%～12.33%)among female,and the CVR mortality reduced by 7.78%(95CI:3.29%～12.47%)among male and 10.14%(95%CI:5.11%～15.41%)among female;For age issue,with an reduction of PM2.5 by 10 μ g/m3,the monthly average age standardized mortality rate due to non-accidental causes reduced by 29.74%(95/CI:6.83%～57.58%)among 0-14 age group,5.88%(95%CI:2.00%～9.92%)among elderly group,the non-CVR mortality only reduced among 0-14 age group by 26.50%(95CI:8.17%～47.93%),and the CVR mortality reduced most among elderly group by 9.79%(95C1:5.17%～14.61%).Conclusion The strengthened air pollution control policy implemented in BTH region during Jun.2014 to Dec.2017 significantly reduced the monthly average concentration of PM2.5 and the mortality rates due to non-accidental causes and CVR;The study supports the causal relationship between PM2.5 and mortality due to non-accidental causes and CVR diseases,and the effects of PM2.5 on mortality vary between gender and age etc.