Exposure-response functions for health effects of ambient air pollution applicable for China – a meta-analysis

Assessing the benefits of projects and policies to reduce air pollution requires quantitative knowledge about the relationship between exposure to air pollution and public health. This article proposes exposure-response functions for health effects of PM10 and SO2 pollution in China. The functions are based on Chinese epidemiological studies, and cover mortality, hospital admissions, and chronic respiratory symptoms and diseases. We derive the following coefficients for acute effects: a 0.03% (S.E. 0.01) and a 0.04% (S.E. 0.01) increase in all-cause mortality per μg/m3 PM10 and SO2, respectively, a 0.04% (S.E. 0.01) increase in cardiovascular deaths per μg/m3 for both PM10 and SO2, and a 0.06% (S.E. 0.02) and a 0.10% (S.E. 0.02) increase in respiratory deaths per μg/m3 PM10 and SO2, respectively. For hospital admissions due to cardiovascular diseases the obtained coefficients are 0.07% (S.E. 0.02) and 0.19% (S.E. 0.03) for PM10 and SO2, respectively, whereas the coefficients for hospital admissions due to respiratory diseases are 0.12% (S.E. 0.02) and 0.15% (S.E. 0.03) for PM10 and SO2, respectively. Exposure-response functions for the impact of long-term PM10 levels on the prevalence of chronic respiratory symptoms and diseases are derived from the results of cross-sectional questionnaire surveys, and indicate a 0.31% (S.E. 0.01) increase per μg/m3 in adults and 0.44% (S.E. 0.02) per μg/m3 in children. With some exceptions, Chinese studies report somewhat lower exposure-response coefficients as compared to studies in Europe and USA.