Attributable risk is an important indicator for planning and evaluating public health interventions. However, most current measures of the attributable risk of air pollutants have not considered temporal relationships between exposure and risk. More importantly, limited information is available regarding the attributable risk due to ambient air pollutants in basin regions like the Sichuan Basin, China. To quantify the association between PM10 and deaths in the Basin region, we used a measure proposed recently within the framework of the distributed lag non-linear model to estimate the attributable risk in Chengdu, China. Meanwhile, we examined the association between PM10 and years of life lost (YLL). Our analysis showed that population-attributable fractions for non-accidental, respiratory, and cardiovascular mortality were 0.569% (95% CI: −3.474%, 4.374%), 0.695% (95% CI: −5.260%, 6.457%), and 0.631% (95% CI: −6.973%, 7.390%), respectively. On average, a 1μg/m3 increase in PM10 was associated with cumulative increases of 0.26893, 0.30437, and 0.21924 YLL for non-accidental, respiratory, and cardiovascular mortality, respectively, referring to 20μg/m3. In addition, we found an inverse U-shaped pattern for the cumulative risk with 350μg/m3 as the reverse point. With a 1μg/m3 increase in PM10, YLL changed more significantly than mortality. Moreover, PM10 demonstrated remarkable effects on YLL among men and the elderly.

Large and growing literature has explored whether temperature modified the effect of particular matter (PM) on mortality, but results of the modification effect are inconsistent. In this study, we reviewed information from 29 studies to get the qualitative evidence of the modification effects of temperature on PM to mortality, and the data from 16 of the 29 studies were extracted to conduct a meta-analysis. Temperatures were grouped into three level: “low”, “middle” and “high” according to the original studies. The random effect model was used in the meta-analysis with the relative risk (RR) as the measure indicator. The RRs (95% confidence intervals, CIs) for non-accidental death, cardiovascular death and respiratory death per 10 μg/m3 increase in PM10 were 1.004 (1.003, 1.006), 1.005 (1.003,1.007), and 1.005 (1.000,1.010) in the low temperature level, 1.005 (1.004,1.006), 1.005 (1.004,1.007), and 1.008 (1.006, 1.010) in the middle temperature level, and 1.012 (1.010, 1.015), 1.016 (1.010, 1.022) and 1.019 (1.010,1.028) in the high temperature level, respectively. In conclusion, moderate evidence exists that temperature modifies the effect of PM10 on mortality. The effect of PM10 on respiratory death was the greatest, while the effect on non-accidental death was the smallest in the same temperature level. In addition, the effects of PM10 on all the three kinds of mortality were the biggest in the high-temperature level, and the smallest in the low-temperature level.

Background: Although studies from many countries have estimated the impact of ambient temperature on mortality, few have compared the relative impacts of heat and cold on health, especially in basin climate cities. We aimed to quantify the impact of ambient temperature on mortality, and to compare the contributions of heat and cold in a large basin climate city, i.e., Chengdu (Sichuan Province, China); Methods: We estimated the temperature-mortality association with a distributed lag non-linear model (DLNM) with a maximum lag-time of 21 days while controlling for long time trends and day of week. We calculated the mortality risk attributable to heat and cold, which were defined as temperatures above and below an “optimum temperature” that corresponded to the point of minimum mortality. In addition, we explored effects of individual characteristics; Results: The analysis provides estimates of the overall mortality burden attributable to temperature, and then computes the components attributable to heat and cold. Overall, the total fraction of deaths caused by both heat and cold was 10.93% (95%CI: 7.99%–13.65%). Taken separately, cold was responsible for most of the burden (estimate 9.96%, 95%CI: 6.90%–12.81%), while the fraction attributable to heat was relatively small (estimate 0.97%, 95%CI: 0.46%–2.35%). The attributable risk (AR) of respiratory diseases was higher (19.69%, 95%CI: 14.45%–24.24%) than that of cardiovascular diseases (11.40%, 95%CI: 6.29%–16.01%); Conclusions: In Chengdu, temperature was responsible for a substantial fraction of deaths, with cold responsible for a higher proportion of deaths than heat. Respiratory diseases exert a larger effect on death than other diseases especially on cold days. There is potential to reduce respiratory-associated mortality especially among the aged population in basin climate cities when the temperature deviates beneath the optimum. The result may help to comprehensively assess the impact of ambient temperature in basin cities, and further facilitate an appropriate estimate of the health consequences of various climate-change scenarios.

Exposure to ambient air pollution has been clearly linked to adverse reproductive outcome and fecundation index, but its effects on male semen quality are still uncertain. In this study, we reviewed information from ten studies to get the qualitative evidence of the influence of the ambient air pollution on sperm quality and collected data from six of the ten studies to conduct meta-analysis. The original studies classified participants into different exposure levels and the highest and lowest expose levels were chosen as high expose and low expose groups, respectively. The random-effect model was used in the meta-analysis with the weight mean difference (WMD) as the measure indicator. The WMDs (95% confidence intervals, CIs) of sperm volume, sperm count, semen concentration, sperm progressive motility, total motility, and normal morphology were 0.09 (-0.04, 0.23), 0.46 (-4.47, 5.39), -8.21 (-20.38, 3.96), -7.76 (-16.26, 0.74), -7.61 (-16.97, 1.74) and -3.40 (-7.42, 0.62), respectively. In conclusion, although the differences are not statistically significant between the two groups, the overall trends and evidence from this review indicate the chronic exposure to ambient pollutants at high level may alter men sperm quality.

The effect modification of meteorological factors on the association between ambient Sulphur dioxide (SO2) and mortality is critical for designing intervention policy. Existing studies did not result in consistent conclusions on the effect modification, and Years of life lost (YLLs) was rarely used as a health impact indicator to examine the modifying effect. This study aims to estimate the mean air temperature and relative humidity modification effects on the impact of SO2 on daily mortality and YLLs in Chengdu, China. Mortality, YLLs, air pollution and meteorological data were collected for 2011-2014. Three analytical approaches based on generalized additive models (GAMs) were used, including bivariate response surface model, product term model, and stratification model. We found that the effects of SO2 on mortality and YLLs depended on temperature at various lags, but did not depend on relative humidity. SO2 exhibited larger adverse effects on mortality in high temperature level (22.8-29.4°C) days than in low temperature level (-0.3-9.3°C) days, with a 10μg/m3 increment in SO2, non-accidental death increased by 0.8% (0.001, 0.015)at low temperature level, but increased by 1.4% (0.005, 0.024) at high temperature level. On the contrary, SO2 showed greater adverse effects on YLLs in low temperature days than in high temperature days, with a 10μg/m3 increment in SO2, non-accidental YLL increased by 40.580 (31.478, 49.682) at high temperature level, but increased by -2.703 (-14.668, 9.261) at low temperature level. We concluded that the effect of SO2 on mortality and YLLs may depend on temperature in Chengdu, China. Our results highlight the importance of considering the interaction between SO2 and temperature on health outcomes in future research. Also, policy makers should enhance the emission control of SO2 in extreme temperature days in Chengdu.