Ambient Particulate Matter Exposure and Under-Five and Maternal Deaths in Asia

The Asian region is one of the major emission sources of air pollution. Although ambient PM_2.5 has been linked to several health risks in high-, low-, and middle-income countries, the further analysis of type impact is still rare but significant. The PM_2.5 distribution retrieved from MODIS (Moderate Resolution Imaging Spectroradiometer) aerosol optical depth products within 16 years thus explored the associations between under-five and maternal mortality for 45 countries in Asia. Both the nonparametric (Generalized Additive Mixed-Effect) and parametric (Generalized Linear Mixed-Effect) models were employed to analyze the collected datasets. The results show that the levels of PM_2.5 in Asian sub-regions were higher than the Global Air Quality Standards. Biomass PM_2.5 concentrations was associated with increased the rate of under-five (Incidence Rate Ratio, IRR = 1.29, 95% CI, 1.13-1.47) and maternal (IRR = 1.09, 95% CI: 1.08-1.10) deaths in Asia. Anthropogenic PM_2.5 was associated with increased rate of under-five deaths in Asia by 12%. The nonparametric method revealed that dust PM_2.5 was positively associated with the under-five (β = 0.04, p < 0.001) and maternal (β = 0.07, p < 0.001) deaths in Asia. The rate of maternal deaths was increased by biomass/dust (IRR = 1.64, 95% CI: 1.63-1.65) and anthropogenic/dust (IRR = 1.22, 95% CI: 1.19-1.26) mixture types. In summary, long-term exposure to different types of ambient PM_2.5 in high concentration increased the rate of under-five and maternal deaths, suggesting that policies focusing on preventive and control measures is imperative for developing an improved maternal, newborn, and child health in Asia.