Short-Term Relationship Between Air Pollution and Mortality from Respiratory and Cardiovascular Diseases in China, 2008–2020

Most existing epidemiological studies on the impact of air pollution on noncommunicable diseases have focused on urban areas, rather than nationwide studies that include rural areas. This study utilized a time-stratified case-crossover study that included deaths registered in the National Mortality Surveillance System from 2008 to 2020. Atmospheric particulate matter (PM₁₀ and PM_2.5), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and carbon monoxide (CO) were evaluated via the National Nested Air Quality Prediction Modeling System. Conditional logistic regression was used to assess the associations between short-term air pollution exposure and the risk of respiratory disease and cardiovascular disease (CVD) mortality. There were increases in the risk of respiratory diseases (0.12%, 0.10%, 0.10%, 0.05%, and 0.40%) and CVDs (0.08%, 0.07%, 0.03%, 0.02%, and 0.22%) for each 10 μg/m³ increase in the concentrations of PM₁₀, PM_2.5, NO₂, and SO₂, respectively, and for each 1 mg/m³ increase in the concentration of CO, which may be associated with the participants' characteristics. The results of these national analyses indicate that ambient air pollutants are significantly associated with increased risks of respiratory disease and CVD death in both urban and rural areas, which is critical for air pollution control, especially in low- and middle-income areas.