Fine particulate matter air pollution and under-5 children mortality in China: A national time-stratified case-crossover study. (15th January 2022)

• Record Type: Journal Article
• Authors: He, Chunhua; Liu, Cong; Chen, Renjie; Meng, Xia; Wang, Weidong; Ji, John; Kang, Leni; Liang, Juan; Li, Xiaohong; Liu, Yuxi; Yu, Xue; Zhu, Jun; Wang, Yanping; Kan, Haidong
• Is Part Of: Environment international. Volume 159(2022)
• Publication Date: 2022-01-15
• Subjects: Fine particulate matter -- Under-5 mortality -- Cause-specific mortality -- Case-crossover study; Environmental protection -- Periodicals; Environmental health -- Periodicals; Environmental monitoring -- Periodicals; Environmental Monitoring -- Periodicals; Environnement -- Protection -- Périodiques; Hygiène du milieu -- Périodiques; Environnement -- Surveillance -- Périodiques; Environmental health; Environmental monitoring; Environmental protection; Periodicals; 333.705
• DOI: 10.1016/j.envint.2021.107022
• Languages: English
• ISSNs: 0160-4120

Abstract

Graphical abstract: Highlights: Limited evidence on short-term exposure to PM2.5 and under-5 mortality in China. A national case-crossover study and use of satellite-based exposure model. PM2.5 was associated a 1.15% (95%CI: 0.65%, 1.65%) increase in under-5 mortality. Cause-specific mortality from diarrhea, pneumonia, digestive diseases, and preterm birth. Supra-linear concentration-response curve with steeper slope in lower concentrations. Abstract: Background: Under-5 mortality rate is an important indicator in Millennium Development Goals and Sustainable Development Goals. To date, no nationally representative studies have examined the effects of fine particulate matter (PM2.5 ) air pollution on under-5 mortality. Objective: To investigate the association of short-term exposure to PM2.5 with under-5 mortality from total and specific causes in China. Methods: We used the national Maternal and Child Health Surveillance System to identify under-5 mortality cases during the study period of 2009 to 2019. We adopted a time-stratified case-crossover study design at the individual level to capture the effect of short-term exposure to daily PM2.5 on under-5 mortality, using conditional logistic regression models. Results: A total of 61, 464 under-5 mortality cases were included. A 10 μg/m 3 increase in concentrations of PM2.5 on lag 0–1 d was significantly associated with a 1.15% (95%confidence interval: 0.65%, 1.65%) increase in under-5 mortality. Mortality from diarrhea, pneumonia, digestive diseases, and preterm birth were significantly associated with exposure to PM2.5 . The effect estimates were larger for neonatal mortality (<28 days), female children, and in warm seasons. We observed steeper slopes in lower ranges (<50 μg/m 3 ) of the concentration-response curve between PM2.5 and under-5 mortality, and positive associations remained below the 24-h PM2.5 concentration limit recommended by WHO Air Quality Guidelines and China Air Quality Standards. Conclusions: This nationwide case-crossover study in China demonstrated that acute exposure to PM2.5 may significantly increase the risk of under-5 mortality, with larger effects for neonates, female children, and during warm seasons. Relevant control strategies are needed to remove this roadblock to achieving under-5 mortality targets in developing countries.