| [Objective]To analyze the daily average concentration of air pollutants and particulate matter in Fuzhou City at the low concentration control point of the National Air Pollution(Smog)Health Impact Monitoring Project to obtain the overall air quality of Fuzhou City.To clarify the characteristics and regularity the main causes of death of residents due to particulate matter(PM2.5,PM10)in a relatively low-concentration polluted city(Fuzhou)in China(non-accidental total deaths,respiratory?circulatory diseases deaths,which cardiovascular and cerebrovascular diseases deaths under the circulatory system);In Fuzhou a“furnace city”characterized by high temperature,we observe the risk of the major cause of death in Fuzhou,and identify the risk characteristics of the main cause of death of residents in high and low temperature;Furthermore,in Fuzhou,a city characterized by low-concentration pollution and high temperature,the interaction of particulate matter and extreme temperatures(high temperature,low temperature,heat waves)on the main causes of death of residents will be explored,and potential health risks to residents main causes of death of particulate matter at extreme temperatures(high temperature,low temperature,heat waves)will be evaluated.We aim to provide a scientific reference for reducing the impact of particulate pollution and adverse temperature conditions on the health of residents in Fuzhou[Methods]1.We collect the data including particulate matter,weather conditions and deaths in Fuzhou from 2016 to 2019;2.We use spearman correlation to analyze the correlation between air pollutants and weather conditions.Exposure-response model was established to analyze the relationship between particulate matter and the deaths by using R 4.0.1 software;A generalized additive model was established and non-parametric smoothing functions was uesed to control the long-term trend of time,short-term fluctuations and meteorological factors and other mixed factors by using R 4.0.1 software,based on the above.we study the impact of particulate matter on total non-accidental?respiratory diseases and circulatory diseases deaths;3.In order to intuitively describe the impact of the non-linear variables temperature on the death of residents,our study established a"cross basis"function of temperature and incorporated it into the GAM model.We used the dlnm software package bulid a distributed lag non-linear model(DLNM).We construct the model by controlling long-term trends,short-term fluctuations,meteorological conditions and air pollutants,and then choose the best degree of freedom refer to the Akaike information criterion(AIC).We determines the most suitable temperature which is the minimum mortality temperature(MMT)by fitting the dose-response relationship between temperature and death,and then calculate the relative risk of death for every1? change in temperature relative to MMT;4.The R 4.0.1 software GAM module is used to establish a two-independent three-dimensional model to qualitatively assess whether particulate matter and temperature have an interactive effect on the death risk of residents.Furthermore,the temperature stratification model based on the time series Poisson Generalized Additive Model quantitatively evaluates whether particulate matter has significant significance to the death risk of residents from the main cause of death under different temperature stratification conditions;5.We choose the definition of heat wave refer to the World Meteorological Organization(the highest temperature is higher than 32?and lasts for 3 days or more),and the GAM module of R 4.0.1 software is used to establish the Poisson Generalized Additive Model(GAM)interaction model of particulate matter and heat wave,and evaluate will the interaction of particulate matter and heat waves increase the risk of death?[Results]1.During the study period,the average levels of PM2.5and PM10are25.99±13.12ug/m3,59.84±27.28ug/m3,It meets the national secondary standards(residential living standards),but all exceeds the WHO guideline value standards.The WHO compliance rate of average daily level is 55.30%and 39.22%respectively;2.The exposure response curve of the impact of atmospheric particulates on the death of the population shows a linear and non-threshold trend.There is a obvious connection between particulate matter and total non-accidental respiratory diseases,circulatory diseases deaths.There are differences in the impact of particulate matter on deaths from the main cause of death(Death risk ranking:respiratory>circulatory>non-accidental).Among them,particulate matter has the largest effect on the respiratory diseases deaths,and the impact of PM2.5on the population death is biger than that of PM10;And the effect size(ER)obtained in this study(1%-3%)is larger than that of high concentration areas in China(0%-1%).The impact effect values of non-accidental total deaths,respiratory diseases deaths,circulatory diseases deaths and cerebrovascular diseases deaths for every 10ug/m3increase in PM2.5levels were 2.27%(95%CI:0.54%-4.03%),3.68%(95%CI:0.11%-7.38%),2.39%(95%CI:0.55%-4.26%),3.23%(95%CI:0.46%-6.07%);The risk values of non-accidental total,respiratory diseases deaths,circulatory diseases and cerebrovascular diseases deaths for every 10ug/m3increase in PM10concentration were 1.28%(95%CI:0.68%-1.88%)?1.79%(95%CI:0.51%-3.09%)?1.42%(95%CI:0.5%-2.34%)?2.27%(95%CI:0.71%-3.85%);3.The exposure response curve of the impact of temperature on residents deaths basically shows a"U"shape.The minimum death risk temperature(MMT value)corresponding to the total non-accidental,circulatory,cardiovascular disease and cerebrovascular disease deaths are 24?,23?,20?and 21?MMT values are not the same.Both high temperature and low temperature will cause non-accidental total,circulatory system diseases,and cardiovascular diseases deaths;The 3D and contour maps show that the high temperature affects death with a strong and short duration.The RR value is the highest on the same day,and its impact lasts for 2 to 3 days.The high temperature has an impact on the risk of death from circulatory and cardiovascular and cerebrovascular diseases respectively on the same day.And after a lag of 10 days,the effect showed again,and the low temperature effect is slow and lasting.Relative to high temperature,respiratory diseases death is significantly affected by low temperature.We further define the high and low temperature as P90and P10 of the annual temperature respectively,and conclude that the effects of high temperature on total non-accidental,circulatory system disease and cardiovascular system disease death on the day are 1.09(95%CI:1.05-1.12),1.1(95%CI:1.05-1.15),1.2(95%CI:1.09-1.32).For the death of the circulatory system,the effect of high temperature reappears after a 13-day lag,with an RR value of 1.04(95%CI:1.01-1.07).The characteristics of the impact of low temperature on the death of residents are relatively slow.The impact usually occurs within 3-5 days.The RR value gradually rises and then declines,and the impact continues about 1-2 weeks.Respiratory system deaths are not significantly affected by high temperature.Low temperature has a significant impact on respiratory system deaths.Its impact is manifested in lag5,with an RR value of 1.1(95%CI:1.01-1.19),which disappears after three days,and then at lag13-lag14 appears again;4.The three-dimensional graph of the dual independent variables of particulate matter and temperature shows that particulate matter and temperature have inconsistent interactions on deaths from different causes of death.High temperature may strengthen the impact of particulate matter on non-accidental and circulatory diseases deaths.For non-accidental,circulatory and cardiovascular diseases deaths,temperature is a main factor.But for cerebrovascular diseases deaths,the impact of particulate matter is a main factor..Respiratory diseases death is more sensitive by the synergistic effect of low temperature and particulate matter.The results of a further generalized additive layered model show that at high temperatures,every 10ug/m3rise in PM2.5and PM10is significantly associated with cerebrovascular diseases death and the difference between it and the low temperature layer is statistically significant.The ER were 30.45%(95%CI:1.03%-68.44%)and 13.07%(95%CI:0.60%-27.08%)respectinely.The interaction between PM2.5and high temperature has a greater risk of death from cerebrovascular diseases in residents than PM10.In the case of high temperature,PM2.5and PM10have a higher risk of death(ER)from cerebrovascular system diseases(30.45%?13.07%.)than PM2.5and PM10alone(3.23%?2.27%);5.Heat waves and particulate matter have significant effects on the circulatory diseases deaths.The ER values are 8.21%(95%CI:0.32%-16.72%)and 3.84%(95%CI:0.28%-7.54%).Compared with the non-heat wave layer,the particulate matter in the heat wave layer has a stronger effect on the death of circulatory system diseases and the difference is statistically significant.The interaction between PM2.5and heat waves has a greater risk of death from circulatory system diseases than PM10.The synergistic effect of heat wave and particulate matter on residents'circulatory system disease death risk is biger than that of high temperature,and the synergistic effect of heat wave and PM2.5,PM10on residents circulatory system death risk(ER)(8.21%,3.84%)is greater than PM2.5and PM10alone(ER)(2.39%,1.42%).[Conclusion]1.According to the?Air Quality Standards?,the air quality in the urban area of Fuzhou City is good,and it is a relatively low-concentration polluted area in China.However,under the guideline value standard from WHO,the pollution of particulate matter cannot be contempted;2.The impact of atmospheric particulate matter on the death of residents in Fuzhou is linear and there is no threshold,that is,low-concentration particulate matter still has a risk of death.PM2.5and PM10are similar whether they act alone or interact with extreme temperatures(high temperature,heat waves),the risk of PM2.5impact is biger than that of PM10.And the interactive effects between PM2.5,PM10,and high temperature,and heat wave on the death risk of residents is greater than when PM2.5and PM10act alone.3.In Fuzhou City,a relatively low-concentration pollution area in China,the effect of particulate matter on the non-accidental death,circulation and death risks of cardiovascular and cerebrovascular diseases has different characteristics.The effect size(ER)(1%-3%)of the risk of death is significantly higher than that of high pollution areas in China(0%-1%).4.This study comprehensively and systematically reveals the characteristics of the influence of temperature on the risk of death from different main causes of death in Fuzhou City,the"stove city".The exposure-response curve between air temperature and non-accidental total,circulatory,cardiovascular and cerebrovascular diseases death is a non-linear shape.Both high and low temperatures will enhance the risk of main cause death The effect of high temperature is fast and short,while the effect of low temperature is slow and lasting.Secondly,the characteristics of the impact of temperature on the main causes of death and other causes of death risk are different.High temperature has a more obvious impact on the risk of non-accidental total death,circulatory and cardiovascular system diseases,while low temperature has a more obvious impact on the risk of death from respiratory diseases.5.High temperature and heat waves are important factors influencing the risk of death from the main cause of death of residents,but they have various effects on different causes of death.For non-accidental,circulatory and cardiovascular diseases deaths,temperature plays a leading role,but for cerebrovascular system deaths,the impact of particulate matter plays a leading role. |
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