Dataset Information

Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM_2.5 Targets.

ABSTRACT: This time-series study collects data on stroke-related mortality, years of life lost (YLL), air pollution, and meteorological conditions in 96 Chinese cities from 2013 to 2016 and proposes a three-stage strategy to generate the national and regional estimations of avoidable YLL, gains in life expectancy and stroke-related population attributable fraction by postulating that the daily fine particulate matter (PM_2.5) has been kept under certain standards. A total of 1 318 911 stroke deaths are analyzed. Each 10 µg m^-3 increment in PM_2.5 at lag₀₃ is associated with a city-mean increase of 0.31 (95% CI: 0.19, 0.44) years of life lost from stroke. A number of 914.11 (95% CI: 538.28, 1288.94) years of city-mean life lost from stoke could be avoided by attaining the WHO's Air Quality Guidelines (AQG) (25 µg m^-3). Moreover, by applying the AQG standard, 0.11 (0.08, 0.15) years of life lost might be prevented for each death, and about 0.91% (95% CI: 0.62%, 1.19%) of the total years of life lost from stroke might be explained by the daily excess PM_2.5 exposure. This study indicates that stroke patients can have a longer life expectancy if stricter PM_2.5 standards are put in place, especially ischemic stroke patients.

SUBMITTER: Ruan Z

PROVIDER: S-EPMC7713556 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM<sub>2.5</sub> Targets.

Ruan Zengliang Z Qi Jinlei J Yin Peng P Qian Zhengmin Min ZM Liu Jiangmei J Liu Yunning Y Yang Yin Y Li Huan H Zhang Shiyu S Howard Steven W SW Lin Hualiang H Wang Lijun L

Global challenges (Hoboken, NJ) 20201013 12

This time-series study collects data on stroke-related mortality, years of life lost (YLL), air pollution, and meteorological conditions in 96 Chinese cities from 2013 to 2016 and proposes a three-stage strategy to generate the national and regional estimations of avoidable YLL, gains in life expectancy and stroke-related population attributable fraction by postulating that the daily fine particulate matter (PM<sub>2.5</sub>) has been kept under certain standards. A total of 1 318 911 stroke dea ...[more]

PMID: 33304609

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Project description:Ambient particulate matter of aerodynamic diameter less than 2.5 microns PM2.5) levels in Delhi routinely exceed World Health Organization (WHO) guidelines and Indian National Ambient Air Quality Standards (NAAQS) for acceptable levels of daily exposure. Only a handful of studies have examined the short-term mortality effects of PM in India, with none from Delhi examining the contribution of PM2.5.ObjectivesWe aimed to analyze the association between short-term PM2.5 exposures and daily nonaccidental mortality in Delhi, India.MethodsUsing generalized additive Poisson regression models, we examined the association between daily PM2.5 exposures and nonaccidental mortality between June 2010 and December 2016. Daily exposures to PM2.5 were estimated using an ensemble averaging technique developed by our research group, and mortality data were obtained from the Municipal Corporations of Delhi and the New Delhi Municipal Council.ResultsMedian exposures to PM2.5 were 91.1 µg/m3 (interquartile range = 68.9, 126.2), with minimum and maximum exposures of 21.4 µg/m3 and 276.7 µg/m3, respectively. Total nonaccidental deaths recorded in Delhi during the study period were 700,512. Each 25 µg/m3 increment in exposure was associated with a 0.8% (95% confidence intervals [CI] = 0.3, 1.3%) increase in daily nonaccidental mortality in the study population and a 1.5% (95% CI = 0.8, 2.2%) increase in mortality among those with 60 years of age or over. The exposure-response relationship was nonlinear in nature, with relative risk rising rapidly before tapering off above 125 µg/m3. Meeting WHO guidelines for acceptable levels of exposure over the study period would have likely averted 17,526 (95% CI = 6,837, 25,589) premature deaths, with older and male populations disproportionately affected.DiscussionThis study provides robust evidence of the impact of short-term exposure to PM2.5 on nonaccidental mortality with important considerations for various stakeholders including policymakers and physicians. Most importantly, we find that reducing exposures significantly below current levels would substantially decrease the mortality burden associated with PM2.5.

Project description:BackgroundMuch of the current evidence of associations between long-term PM2.5 and health outcomes relies on national or regional analyses using exposures derived directly from regulatory monitoring data. These findings could be affected by limited spatial coverage of monitoring data, particularly for time periods before spatially extensive monitoring began in the late 1990s. For instance, Pope et al. (2009) showed that between 1980 and 2000 a 10 μg/m3 reduction in PM2.5 was associated with an average 0.61 year (standard error (SE) = 0.20) longer life expectancy. That analysis used 1979-1983 averages of PM2.5 across 51 U.S. Metropolitan Statistical Areas (MSAs) computed from about 130 monitoring sites. Our reanalysis re-examines this association using modeled PM2.5 in order to assess population- or spatially-representative exposure. We hypothesized that modeled PM2.5 with finer spatial resolution provides more accurate health effect estimates compared to limited monitoring data.MethodsWe used the same data for life expectancy and confounders, as well as the same analysis models, and investigated the same 211 continental U.S. counties, as Pope et al. (2009). For modeled PM2.5, we relied on a previously-developed point prediction model based on regulatory monitoring data for 1999-2015 and back-extrapolation to 1979. Using this model, we predicted annual average concentrations at centroids of all 72,271 census tracts and 12,501 25-km national grid cells covering the contiguous U.S., to represent population and space, respectively. We averaged these predictions to the county for the two time periods (1979-1983 and 1999-2000), whereas the original analysis used MSA averages given limited monitoring data. Finally, we estimated regression coefficients for PM2.5 reduction on life expectancy improvement over the two periods, adjusting for area-level confounders.ResultsA 10 μg/m3 decrease in modeled PM2.5 based on census tract and national grid predictions was associated with 0.69 (standard error (SE) = 0.31) and 0.81 (0.29) -year increases in life expectancy. These estimates are higher than the estimate of Pope et al. (2009); they also have larger SEs likely because of smaller variability in exposure predictions, a standard property of regression. Two sets of effect estimates, however, had overlapping confidence intervals.ConclusionsOur approach for estimating population- and spatially-representative PM2.5 concentrations based on census tract and national grid predictions, respectively, provided generally consistent findings to the original findings using limited monitoring data. This finding lends additional support to the evidence that reduced fine particulate matter contributes to extended life expectancy.

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Dataset Information

Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM_2.5 Targets.

Publications

Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM<sub>2.5</sub> Targets.

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Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM2.5 Targets.

Publications

Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM&lt;sub&gt;2.5&lt;/sub&gt; Targets.

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OmicsDI is part of the ELIXIR infrastructure

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Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM_2.5 Targets.

Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM<sub>2.5</sub> Targets.