Association between PM2.5 Exposure and All-Cause, Non-Accidental, Accidental, Different Respiratory Diseases, Sex and Age Mortality in Shenzhen, China

Background: China is at its most important stage of air pollution control. Research on the association between air pollutants and human health is very important and necessary. The purpose of this study was to evaluate the association between PM2.5 concentrations and residents' mortality and to compare the effect of PM2.5 on the different diseases, accidental deaths, sex or age of residents from high polluted areas with less polluted areas. Methods: The semi-parametric generalized additive model (GAM) with Poisson distribution of time series analysis was used. The excess risk (ER) of mortality with the incremental increase of 10 mu g/m(3) in PM2.5 concentration was calculated. Concentration-response relationship curves and autocorrelation between different lags of PM2.5 were also evaluated. Results: PM2.5 exposure was significantly associated with the mortality of residents. The strongest ERs per 10 mu g/m(3) increase in PM2.5 were 0.74% (95% CI: 0.11-1.38%) for all-cause, 0.67% (95% CI: 0.01-1.33%) for non-accidental, 1.81% (95% CI: 0.22-3.42%) for accidental, 3.04% (95% CI: 0.60-5.55%) for total respiratory disease, 6.38% (95% CI: 2.78-10.11%) for chronic lower respiratory disease (CLRD), 8.24% (95% CI: 3.53-13.17%) for chronic obstructive pulmonary disease (COPD), 1.04% (95% CI: 0.25-1.84%) for male and 1.32% (95% CI: 0.46-2.19%) for elderly. Furthermore, important information on the concentration-response relationship curves was provided. Conclusions: PM2.5 can increase the risk of residents' mortality, even in places with less air pollution and developed economy in China.