Environmental Science and Pollution Research

, Volume 26, Issue 18, pp 18876–18885 | Cite as

Effect and threshold of PM2.5 on population mortality in a highly polluted area: a study on applicability of standards

  • Runze Ye
  • Liangliang Cui
  • Xiumiao Peng
  • Kunkun Yu
  • Fang Cheng
  • Yakun Zhu
  • Chongqi JiaEmail author
Research Article


For assessing the effect and threshold of PM2.5 on mortality in highly polluted areas and further studying the standard applicability, daily data on meteorological factors, air pollutants, and mortality were obtained in Jinan, China, from 2011 to 2017. A generalized additive model (GAM) and a distributed lag non-linear model (DLNM) were employed to assess the nonlinearity and the hysteresis of associations. We further explored the breakpoints to evaluate the existence of the threshold. The correlation between mortality and PM2.5 was nonlinear. The impact of average PM2.5 on non-accidental mortality (RR = 1.11; 95% CI = 1.06, 1.16), cardiovascular disease (CVD) mortality (RR = 1.17; 95% CI = 1.10, 1.24), and respiratory disease (RD) mortality (RR = 1.17; 95% CI = 1.10, 1.24) reached the highest in the current day (lag 0). The excess risks of PM2.5 at secondary standard level to non-accidental, CVD, and RD mortality are 8.79% (95% CI = 3.84, 13.98), 14.41% (95% CI = 7.79, 21.43), 15.35% (95% CI = 1.76, 30.74), respectively. The saturation points exist in highly polluted areas. Above the saturation points of 247 μg/m3 for non-accidental mortality, 245 μg/m3 for CVD mortality, and 250 μg/m3 for RD mortality, the model of all three relationships presented a harvesting effect. This study underscores the necessity of the ongoing efforts of reducing particulate air pollution and the adjustment of the standards in seriously polluted areas to adapt to regional conditions. At the same time, for highly polluted areas, it is advocated to strengthen personal protection to decrease the saturation point and control the concentration of pollutants as much as possible, which will substantially save more cost that benefits the public.


Particulate matter Public health Cardiovascular diseases Respiratory tract diseases 



Cardiovascular disease


Respiratory disease


Air Quality Index


Air Pollution Index


Generalized additive model


Distributed Lag Non-linear Model


Particulate matter


Total suspended particulate


International Classification Diseases 10th Version


Daily average temperature


Daily maximum temperature


Daily minimum temperature


Relative humidity


Funding information

This work was funded by grants from the Medicine and Technology Development Plan Project of Shandong Province (2015WS0435).

Supplementary material

11356_2019_4999_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)


  1. Baldasano J, Valera E, Jimenez P (2003) Air quality data from large cities. Sci Total Environ 307:141–165. CrossRefGoogle Scholar
  2. Brook RD, Franklin B, Cascio W, Hong YL, Howard G, Lipsett M, Luepker R, Mittleman M, Samet J, Smith SC, Tager I (2004) Air pollution and cardiovascular disease - a statement for healthcare professionals from the expert panel on population and prevention science of the American Heart Association. Circulation 109:2655–2671. CrossRefGoogle Scholar
  3. Brook RD, Rajagopalan S, Rd PC, Brook JR, Bhatnagar A, Diezroux AV, Holguin F, Hong Y, Luepker RV, Mittleman MA (2010) Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 121:2331–2378CrossRefGoogle Scholar
  4. Chan SH, Van Hee VC, Bergen S, Szpiro AA, DeRoo LA, London SJ, Marshall JD, Kaufman JD, Sandler DP (2015) Long-term air pollution exposure and blood pressure in the sister study. Environ Health Perspect 123:951–958. CrossRefGoogle Scholar
  5. Chen C, Zhu P, Lan L, Zhou L, Liu R, Sun Q, Ban J, Wang W, Xu D, Li T (2018) Short-term exposures to PM2.5 and cause-specific mortality of cardiovascular health in China. Environ Res 161:188–194CrossRefGoogle Scholar
  6. Chen R, Yin P, Meng X, Liu C, Wang L, Xu X, Ross JA, Tse LA, Zhao Z, Kan H (2017) Fine particulate air pollution and daily mortality: a nationwide analysis in 272 Chinese cities. Am J Respir Crit Care Med 196:73–81CrossRefGoogle Scholar
  7. Cheng S, Yang L, Zhou X, Wang Z, Zhou Y, Gao X, Nie W, Wang X, Xu P, Wang W (2011) Evaluating PM2.5 ionic components and source apportionment in Jinan, China from 2004 to 2008 using trajectory statistical methods. J Environ Monit 13:1662–1671. CrossRefGoogle Scholar
  8. China Meteorological News Agency (2013) Season. China Meteorological News Agency, BeijingGoogle Scholar
  9. Chinese Research Academy of Environmental Sciences (2012): Ambient air quality standards. China Environ Sci Press, 71–71Google Scholar
  10. Cui L, Conway GA, Jin L, Zhou J, Zhang J, Li X, Zhou L, Li T, Zhang J (2017) Increase in medical emergency calls and calls for central nervous system symptoms during a severe air pollution event, January 2013, Jinan City, China. Epidemiology 28(Suppl 1):S67–S73. CrossRefGoogle Scholar
  11. Dockery DW, Pope CA, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG Jr, Speizer FE (1993) An association between air pollution and mortality in six U.S. cities. N Engl J Med 329:1753–1759. CrossRefGoogle Scholar
  12. Dominici F (2003) Shape of the exposure-response relation and mortality displacement in the NMMAPS database. Revised Anal Time-Series Stud Air Poll Health 25:418–419Google Scholar
  13. Elliott CT, Copes R (2011) Burden of mortality due to ambient fine particulate air pollution (PM2.5) in interior and northern BC. Can J Public Health-Revue Canadienne De Sante Publique 102:390–393Google Scholar
  14. Fang D, Wang Q, Li H, Yu Y, Lu Y, Qian X (2016) Mortality effects assessment of ambient PM2.5 pollution in the 74 leading cities of China. Sci Total Environ 569-570:1545–1552. CrossRefGoogle Scholar
  15. Gardner B, Ling F, Hopke PK, Frampton MW, Utell MJ, Zareba W, Cameron SJ, Chalupa D, Kane C, Kulandhaisamy S, Topf MC, Rich DQ (2014) Ambient fine particulate air pollution triggers ST-elevation myocardial infarction, but not non-ST elevation myocardial infarction: a case-crossover study. Part Fibre Toxicol 11:1. CrossRefGoogle Scholar
  16. Gasparrini A, Armstrong B, Kenward MG (2011) Distributed lag non-linear models. Stat Med 29:2224–2234. CrossRefGoogle Scholar
  17. Geneva S (2016): World Health Organization: International classification of diseases (ICD)Google Scholar
  18. Ji D, Li L, Wang Y, Zhang J, Cheng M, Sun Y, Liu Z, Wang L, Tang G, Hu B (2014) The heaviest particulate air-pollution episodes occurred in northern China in January, 2013: insights gained from observation. Atmos Environ 92:546–556. CrossRefGoogle Scholar
  19. Jinan Provincial Bureau of Statistics (2018): Jinan statistical yearbookGoogle Scholar
  20. Kaufman JD, Adar SD, Barr RG, Budoff M, Burke GL, Curl CL, Daviglus ML, Roux AVD, Gassett AJ, Jacobs DR Jr, Kronmal R, Larson TV, Navas-Acien A, Olives C, Sampson PD, Sheppard L, Siscovick DS, Stein JH, Szpiro AA, Watson KE (2016) Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the multi-ethnic study of atherosclerosis and air pollution): a longitudinal cohort study. Lancet 388:696–704. CrossRefGoogle Scholar
  21. Landrigan PJ, Fuller R, Acosta NJR, Adeyi O, Arnold R, Basu N(N), Baldé AB, Bertollini R, Bose-O'Reilly S, Boufford JI, Breysse PN, Chiles T, Mahidol C, Coll-Seck AM, Cropper ML, Fobil J, Fuster V, Greenstone M, Haines A, Hanrahan D, Hunter D, Khare M, Krupnick A, Lanphear B, Lohani B, Martin K, Mathiasen KV, McTeer MA, Murray CJL, Ndahimananjara JD, Perera F, Potočnik J, Preker AS, Ramesh J, Rockström J, Salinas C, Samson LD, Sandilya K, Sly PD, Smith KR, Steiner A, Stewart RB, Suk WA, van Schayck OCP, Yadama GN, Yumkella K, Zhong M (2018) The lancet commission on pollution and health. Lancet 391:462–512. CrossRefGoogle Scholar
  22. Li Y, Ma Z, Zheng C, Shang Y (2015) Ambient temperature enhanced acute cardiovascular-respiratory mortality effects of PM 2.5 in Beijing, China. Int J Biometeorol 59:1761–1770CrossRefGoogle Scholar
  23. Mills N, Donaldson K, Pw BN, Macnee W, Cassee F, Sandstrom T, Blomberg A, Newby D (2009) Adverse cardiovascular effects of air pollution. Nat Clin Pract Cardiovasc Med 115:36–44. CrossRefGoogle Scholar
  24. Muggeo VMR (2008) Segmented: an R package to fit regression models with broken-line relationships. R News:20–25Google Scholar
  25. Naess O, Nafstad P, Aamodt G, Claussen B, Rosland P (2007) Relation between concentration of air pollution and cause-specific mortality: four-year exposures to nitrogen dioxide and particulate matter pollutants in 470 neighborhoods in Oslo, Norway. Am J Epidemiol 165:435–443. CrossRefGoogle Scholar
  26. National Bureau of Statistics of China (2012-2018): China statistical yearbookGoogle Scholar
  27. Peel KRS, Jennifer L (2010) Mind the gap. Environ Health Perspect 118:1643–1645. CrossRefGoogle Scholar
  28. Pun VC, Kazemiparkouhi F, Manjourides J, Suh HH (2017) Long-term PM2.5 exposure and respiratory, cancer, and cardiovascular mortality in older US adults. Am J Epidemiol 186:961–969. CrossRefGoogle Scholar
  29. Pope CA 3rd (2000) Epidemiology of fine particulate air pollution and human health: biologic mechanisms and who’s at risk? Environ Health Perspect 108:713–723. CrossRefGoogle Scholar
  30. Ren M, Fang X, Li M, Sun S, Pei L, Xu Q, Ye X, Cao Y (2017) Concentration-response relationship between PM2.5 and daily respiratory deaths in China: a systematic review and metaregression analysis of time-series studies. Biomed Res Int 2017:1–15Google Scholar
  31. Schwartz J, Zanobetti A (2000) Using meta-smoothing to estimate dose-response trends across multiple studies, with application to air pollution and daily death. Epidemiology 11:666–672. CrossRefGoogle Scholar
  32. Schwartz J, Laden F, Zanobetti A (2002) The concentration-response relation between PM2.5 and daily deaths. Environ Health Perspect 110:1025–1029. CrossRefGoogle Scholar
  33. da Silva AMC, Mattos IE, Freitas SR, Longo KM, Hacon SS (2010) Particulate matter (PM2.5) of biomass burning emissions and respiratory diseases in the south of the Brazilian Amazon. Revista Brasileira de Epidemiologia 13:337–351. CrossRefGoogle Scholar
  34. Steven R (2004) Biologically plausible particulate air pollution mortality concentration-response functions. Environ Health Perspect 112:309–313. CrossRefGoogle Scholar
  35. Sun Y, Zhou X, Wai K, Yuan Q, Xu Z, Zhou S, Qi Q, Wang W (2013) Simultaneous measurement of particulate and gaseous pollutants in an urban city in North China plain during the heating period: implication of source contribution. Atmos Res 134:24–34. CrossRefGoogle Scholar
  36. World Health Organization (2005): WHO Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide: global update 2005Google Scholar
  37. Yu HL, Chien LC (2016) Short-term population-based non-linear concentration-response associations between fine particulate matter and respiratory diseases in Taipei (Taiwan): a spatiotemporal analysis. J Expo Sci Environ Epidemiol 26:197–206. CrossRefGoogle Scholar
  38. Yuan S, Xu W, Liu Z (2015): A study on the model for heating influence on PM2.5 emission in Beijing China. In: Sun Y , Pei J (editors), 9th international symposium on heating, ventilation and air conditioning. Procedia Engineering, pp. 612–620Google Scholar
  39. Zhang Y, Peng M, Yu C, Zhang L (2017) Burden of mortality and years of life lost due to ambient PM10 pollution in Wuhan, China. Environ Pollut 230:1073–1080. CrossRefGoogle Scholar
  40. Zhao MJ, Geng XY, Cui LL, Zhou JW, Zhang J (2017) Association between ambient PM(l0)/PM(2.5) concentration and outpatient department visits due to respiratory disease in a hospital in Jinan, 2013-2015: a time series analysis. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 38:374–377. Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Runze Ye
    • 1
  • Liangliang Cui
    • 2
  • Xiumiao Peng
    • 2
  • Kunkun Yu
    • 2
  • Fang Cheng
    • 1
  • Yakun Zhu
    • 1
  • Chongqi Jia
    • 1
    Email author
  1. 1.Department of Epidemiology, School of Public HealthShandong UniversityJinanPeople’s Republic of China
  2. 2.Department of Environmental HealthJinan Municipal Center for Disease Control and PreventionJinanPeople’s Republic of China

Personalised recommendations