Fine particulate matter associated mortality burden of lung cancer in Hebei Province, China

The association between fine particulate matter (PM_2.5 ) and lung cancer (LC) mortality in China is limited. The Beijing-Tianjin-Hebei region is infamous for serious air pollution. Seven of the top 10 cities with the worst air quality are located in Hebei Province. Thus, we explored the effect of 10 years of PM_2.5 on the LC mortality rate in Hebei Province.

We quantified associations between LC mortality and PM_2.5 and estimated the LC mortality burden attributed to PM_2.5 with predicted county level LC deaths in 2014.

The 10-year PM_2.5 LC mortality associations were non-linear, with thresholds of 63 μg/m³ overall, 69 μg/m³ for men, 68 μg/m³ for women, 66 μg/m³ for those aged 30-64 years, and 62 μg/m³ for those aged ≥ 65 years. The relative risks for these groups were 1.09 (95% confidence interval [CI] 1.08-1.10), 1.06 (95% CI 1.03-1.10), 1.20 (95% CI 1.10-1.26), 1.07 (95% CI 1.05-1.11), and 1.10 (95% CI: 1.07-1.13), respectively. There were 2525 (95% CI 2265-2780) LC deaths attributed to 10-year PM_2.5 in 2014, at fractions of 8.3% (95% CI 7.4-9.1%) overall, 5.7% (95% CI 2.8-9.4%) for men, 16.7% (95% CI: 8.3-21.6%) for women, 6.5% (95% CI 4.7-10.3%) for those aged 30-64 years, and 9.1% (95% CI 6.4-11.5%) for those aged ≥ 65 years.

Our results suggest that a reduction in the PM_2.5 exposure levels below thresholds would prevent a substantial number of LC deaths in Hebei Province.