Time series analysis of ambient air pollution effects on daily mortality

Although the growths of ambient pollutants have been attracting public concern, the characteristic of the associations between air pollutants and mortality remains elusive. Time series analysis with a generalized additive model was performed to estimate the associations between ambient air pollutants and mortality outcomes in Shenzhen City for the period of 2012-2014. The results showed that nitrogen dioxide (NO₂)-induced excess risks (ER) of total non-accidental mortality and cardiovascular mortality were significantly increased (6.05% (95% CI 3.38%, 8.78%); 6.88% (95% CI 2.98%, 10.93%), respectively) in interquartile range (IQR) increase analysis. Also, these associations were strengthened after adjusting for other pollutants. Moreover, similar associations were estimated for sulfur dioxide (SO₂), particulate matter with an aerodynamic diameter of <10 μm (PM₁₀), and total non-accidental mortality. There were significant higher ERs of associations between PM₁₀ and mortality for men than women; while there were significant higher ERs of associations between PM₁₀/NO₂ and mortality for elders (65 or elder) than youngers (64 or younger). Season analyses showed that associations between NO₂ and total non-accidental mortality were more pronounced in hot seasons than in warm seasons. Taken together, NO₂ was positively associated with total non-accidental mortality and cardiovascular mortality in Shenzhen even when the concentrations were below the ambient air quality standard. Policy measures should aim at reducing residents' exposure to anthropogenic NO₂ emissions.