Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea

Objectives: Excess mortality associated with long -term exposure to fine particulate matter (PM2.5) has been documented. However, research on the disease burden following short -term exposure is scarce. We investigated the cause-specific mortality burden of shortterm exposure to PM2.5 by considering the potential non-linear concentration-response relationship in Korea. Methods: Daily cause-specific mortality rates and PM2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM2.5 concentrations below 15 mu g/m3. Overall deaths at- tributable to short -term PM2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM2.5 exposure. Results: Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovas- cular, and 708 respiratory deaths were attributed to short -term exposure to PM2.5. The estimated number of all-cause excess deaths due to short -term PM2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472). Conclusions: Our findings indicate an association between short -term PM2.5 exposure and various mortality rates (all-cause, non-acci- dental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short -term exposure to PM2.5.