Investigations On The Association Of PM_2.5 And O₃ With The Disease Burden Of Specific Respiratory Diseases

Research background and purpose:Air pollution is the most important environmental factor threatening the health of the population,causing a serious national economic burden.It is specifically important to confirm the relationship between air pollutants and respiratory diseases.This study explores the health effects of PM_2.5and O₃in Yibin city as a representative of the study population,searches for susceptible populations,and calculates the potential gain in life expectancy（PGLE）that can be obtained assuming PM_2.5and O₃concentrations meet specific standards to quantify the health benefits.This will provide motivation and specific basis for relevant pollution control departments to develop relevant air pollution management programs and increase public participation in air pollution control.Materials and Methods:In this research,air environmental quality data and the data of meteorology,including the daily average PM_2.5and O₃concentrations as well as the average temperature,relative air pressure and average humidity in Yibin City from 2014 to 2020,were collected.Information on patients with respiratory diseases including COPD and lung cancer was also collected,including the age,gender,and disease classification of patients.The relationship between PM_2.5and O₃concentrations and disease-specific years of life lost（YLL）was analyzed using a Generalized Additive Model（GAM）with adjustments for other conditions such as temporal trends and meteorological factors to reduce the influence of confounding factors on the results,and an attribution fraction（AF）was calculated.The PGLE obtained assuming that PM_2.5and O₃meet the World Health Organization air quality standards（WHO AQG）and the Chinese national secondary standards were also calculated.Results:1.The average annual concentrations of PM_2.5,PM₁₀and SO₂of air pollutants in Yibin from 2014 to 2020 showed a decreasing trend,the concentrations of NO₂and CO showed a first upward and then downward trend,and the concentration of O₃showed an increasing trend.The 24-hour average concentrations of PM_2.5,PM₁₀,SO₂,CO,NO₂and the daily maximum 8-hour average concentrations of O₃during the study period were 47.54μg/m³,74.16μg/m³,16.11μg/m³,0.90 mg/m³,30.76μg/m³and 48.18μg/m³,respectively.2.2014-2020 YLL for COPD in Yibin City totaled 205337.5 years,117490.1 years,87847.4 years,1455561.5 years and 59776 years for males,females,>65 years and≤65years,respectively.YLL for lung cancer totaled 198100.7 years,137721.7 years,60379years,70975.7 years and 127125 years for males,females,>65 years and≤65 years,respectively.YLL for both COPD and lung cancer were more for males than females;YLL for COPD were more for those>65 years than those≤65 years;YLL for lung cancer were less for those>65 years than those≤65 years.The YLL for lung cancer was less in>65 year olds than in≤65 year olds.3.The results of YLL analysis of PM_2.5on COPD and lung cancer showed that for every 10μg/m³increase in PM_2.5concentration,the YLL of COPD increased by1.85（95%CI:1.70,2.00）years,with the maximum effect value at the cumulative lag of0-1 days（lag01）.The YLL for lung cancer increased by 0.53（95%CI:0.37,0.68）years for each 10μg/m³increase in PM_2.5concentration,with the largest effect at the day of exposure（lag0）.4.The results of YLL analysis of O₃on COPD and lung cancer showed that for every 10μg/m³increase in O₃concentration,the YLL of COPD increased by1.55（95%CI:1.23,1.87）years,with the largest effect value at the cumulative lag of 0-1days（lag01）.For each 10μg/m³increase in O₃concentration,the YLL for lung cancer increased by 0.81（95%CI:0.50,1.11）years,with the largest effect at the day of exposure（lag0）.5.Subgroup analysis showed that PM_2.5had a more pronounced effect on men and those≤65 years old in the COPD population,and on women and those>65 years old in the lung cancer population.In the COPD population,O₃was more pronounced for females and those≤65 years old;in the lung cancer population,O₃was more pronounced for females and those>65 years old.6.When PM_2.5was referenced by WHO AQG and Chinese air quality secondary standards,the PGLE for COPD and lung cancer were 0.74（95%CI:0.68,0.80）years,0.36（95%CI:0.26,0.47）years and 0.13（95%CI:0.11,0.14）years,0.06（95%CI:0.04,0.08）years,respectively.When O₃was referenced by WHO AQG and Chinese air quality secondary standards,the PGLE for COPD and lung cancer were 0.01（95%CI:0.01,0.01）years,0.01（95%CI:0.00,0.01）years and 0.00（95%CI:0.00,0.00）years,and0.00（95%CI:0.00,0.00）years,respectively.Conclusions:This study showed that short-term exposure to atmospheric pollutants PM_2.5and O₃increased YLL of COPD and lung cancer,and according to subgroup analysis,among the COPD population,men and≤65 years old were PM_2.5sensitive;women and≤65years old were O₃sensitive.In the lung cancer population,women and those aged>65years were sensitive to PM_2.5;women and those aged>65 years were sensitive to O₃.When PM_2.5and O₃were referenced by WHO AQG,the PGLE obtained for both COPD and lung cancer populations were significantly higher than the PGLE at national secondary standard concentrations.this study provides motivation and scientific basis for relevant pollution control departments to develop management plans regarding air pollution,increases public participation in air pollution control,and also provides research ideas for other researchers.