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Spatiotemporal assessment of mortality attributable to ambient PM2.5 exposure in Taiwan during 2008–2015

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In this study, we quantified the spatiotemporal burden of mortality attributable to ambient fine particulate matter (PM2.5, which is defined as a mass of particles with an aerodynamic dry diameter of ≤ 2.5 μm) in Taiwan during 20082015. Hourly concentrations of PM2.5 were obtained from the Taiwan Air Quality Monitoring Network. According to geographical and climatic characteristics, the Taiwan Environmental Protection Administration has divided Taiwan into seven air quality regions (AQRs): the North (four districts), Chu-Miao (two districts), Central (three districts), Yun-Chia-Nan (three districts), Kao-Ping (two districts), Yilan (one district), and Hua-Tung (two districts) regions. Demographic information and mortality data were acquired from the Department of Household Registration and National Death Registry of Taiwan, respectively. The World Health Organization’s (WHO) AirQ+ software was used to estimate the mortality attributable to exposure to PM2.5 for specific causes of deaths, specifically from ischemic heart disease (IHD), cerebrovascular disease (stroke), lung cancer (LC), and chronic obstructive pulmonary disease (COPD). The results indicated that nationally, the annual mean concentration of PM2.5 decreased from 2008 (30.75 μg m−3) to 2015 (20.07 μg m−3). Moreover, the population-attributable fraction (PAF) of cause-specific mortality due to PM2.5 exposure for IHD, stroke, LC, and COPD decreased from 21.72%, 30.31%, 15.97%, and 13.04%, respectively, in 2008 to 17.40%, 18.18%, 10.77%, and 9.09%, respectively, in 2015. Geographic variation was observed in the PM2.5 concentration and PAF. High PM2.5 levels and PAF of mortality due to PM2.5 were observed in southwestern and central Taiwan. Moreover, cardiovascular and cerebrovascular disease (IHD and stroke) accounted for the majority of the premature deaths related to PM2.5. Stroke was the largest contributor in PM2.5-related premature mortality; however, IHD instead of stroke became the largest contributor in the Yilan AQR in 2010, 2012, and 20142015 and in the Hua-Tung AQR in 20122015 with relatively low PM2.5 levels (less than 19 μg m−3). In Taiwan, ambient PM2.5 contributed substantially to the burden of disease. Our results could aid authorities in determining the effectiveness of current air pollution control strategies and plans.

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  1. Apte JS, Marshall JD, Cohen AJ, Brauer M (2015) Addressing global mortality from ambient PM2.5. Environ Sci Technol 49(13):8057–8066

  2. Bell ML (2012) HEI health review committee. Assessment of the health impacts of particulate matter characteristics. Res Rep Health Eff Inst 161:5–38

  3. Burnett RT, Pope CA 3rd, Ezzati M, Olives C, Lim SS, Mehta S, Shin HH, Singh G, Hubbell B, Brauer M, Anderson HR, Smith KR, Balmes JR, Bruce NG, Kan H, Laden F, Prüss-Ustün A, Turner MC, Gapstur SM, Diver WR, Cohen A (2014) An integrated risk function for estimating the global burden of disease attributable to ambient fine particulate matter exposure. Environ Health Perspect 122(4):397–403

  4. Cheng FY, Hsu YC, Lin PL, Lin TH (2013) Investigation of the effects of different land use and land cover patterns on mesoscale meteorological simulations in the Taiwan area. J Appl Meteorol Climatol 52(3):570–587

  5. Chou CC, Hsu WC, Chang SY, Chen WN, Chen MJ, Huang WR, Huang SH, Tsai CY, Chang SC, Lee CT, Liu SC (2017) Seasonality of the mass concentration and chemical composition of aerosols around an urbanized basin in East Asia. JGR Atmospheres 122(3):2026–2042

  6. Cohen AJ, Brauer M, Burnett R, Anderso HR, Frostad J, Estep K, Balakrishnan K, Brunekreef B, Dandona L, Dandona R, Feigin V, Freedman G, Hubbell B, Jobling A, Kan H, Knibbs L, Liu Y, Martin R, Morawska L, Pope CA 3rd, Shin H, Straif K, Shaddick G, Thomas M, van Dingenen R, van Donkelaar A, Vos T, Murray CJL, Forouzanfar MH (2017) Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet 389:1907–1918

  7. Department of Household Registration (2016) Ministry of the Interior. Population by sex and 5-year age group for counties and cities. https://www.ris.gov.tw/en/web/ris3-english/end-of-year. Accessed 21 Dec 2017

  8. Dominici F, Peng RD, Bell ML, Pham L, McDermott A, Zeger SL, Samet JM (2006) Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA 295:1127–1134

  9. Environmental Protection Administration, Executive Yuan, ROC (2015) Environmental policy monthly 12 of ROC (Taiwan), Taipei

  10. Environmental Protection Administration, Executive Yuan, ROC (2016) Air quality annual report of ROC (Taiwan), Taipei

  11. Environmental Protection Administration, Executive Yuan, ROC (2017) Environmental resource database of ROC (Taiwan), Taipei

  12. Global Burden of Disease 2016 Risk factors collaborators (2017) Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet 390:1345–1422

  13. Ho WY, Tseng KH, Liou ML, Chan CC, Wang CH (2018) Application of positive matrix factorization in the identification of the sources of PM2.5 in Taipei City. Int J Environ Res Public Health 15(7):1305. https://doi.org/10.3390/ijerph15071305

  14. Hutcheon JA, Chiolero A, Hanley JA (2010) Random measurement error and regression dilution bias. BMJ 340:c2289

  15. Hwang SL, Guo SE, Chi MC, Chou CT, Lin YC, Lin CM, Chou YL (2016) Association between atmospheric fine particulate matter and hospital admissions for chronic obstructive pulmonary disease in southwestern Taiwan: a population-based study. Int J Environ Res Public Health 13(4):1–9

  16. Hwang SL, Lin YC, Guo SE, Chi MC, Chou CT, Lin CM (2017a) Emergency room visits for respiratory diseases associated with ambient fine particulate matter in Taiwan in 2012: a population-based study. Atmos Pollut Res 8:465–473

  17. Hwang SL, Lin YC, Guo SE, Chou CT, Lin CM, Chi MC (2017b) Fine particulate matter on hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in southwestern Taiwan during 2006-2012. Int J Environ Health Res 27(2):95–105

  18. Hwang SL, Lin YC, Lin CM, Hsiao KY (2017c) Effects of fine particulate matter and its constituents on emergency room visits for asthma in southern Taiwan during 2008-2010: a population-based study. Environ Sci Pollut Res Int 24(17):15012–15021

  19. Kuo YM, Hung HF, Yang TT (2007) Chemical compositions of PM2.5 in residential homes of southern Taiwan. Aerosol Air Qual Res 7(3):403–416

  20. Li MH, Fan LC, Mao B, Yang JW, Choi AM, Cao WJ, Xu JF (2016) Short term exposure to ambient fine particulate matter (PM2.5) increases hospitalizations and mortality of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Chest 149(2):447–458

  21. Lo WC, Ku CC, Chiou ST, Chan CC, Chen CL, Lai MS, Lin HH (2017a) Adult mortality of diseases and injuries attributable to selected metabolic, lifestyle, environmental, and infectious risk factors in Taiwan: a comparative risk assessment. Popul Health Metrics 15(1):17. https://doi.org/10.1186/s12963-017-0134-4 eCollection 2017

  22. Lo WC, Shie RH, Chan CC, Lin HH (2017b) Burden of disease attributable to ambient fine particulate matter exposure in Taiwan. J Formos Med Assoc 116:32–40

  23. Lu F, Xu D, Cheng Y, Dong S, Guo C, Jiang X, Zheng X (2015) Systematic review and meta-analysis of the adverse health effects of ambient PM2.5 and PM10 pollution in the Chinese population. Environ Res 136:196–204

  24. Mudu P, Gapp C, Dunbar M (2016) AirQ+ 1.0 example of calculations. World Health Organization

  25. Nie D, Chen M, Wu Y, Ge X, Hu J, Zhang K, Ge P (2018) Characterization of fine particulate matter and associated health burden in Nanjing. Int J Environ Res Public Health 15(4):602. https://doi.org/10.3390/ijerph15040602

  26. Samoli E, Stafoggia M, Rodopoulou S, Ostro B, Alessandrini E, Basagaña X, Díaz J, Faustini A, Gandini M, Karanasiou A, Kelessis AG, Le Tertre A, Linares C, Ranzi A, Scarinzi C, Katsouyanni K, Forastiere F MED-PARTICLES Study group(2014) Which specific causes of death are associated with short term exposure to fine and coarse particles in southern Europe? Results from the MEDPARTICLES project. Environ Int 67:54–61

  27. Song C, He J, Wu L, Jin T, Chen X, Li R, Ren P, Zhang L, Mao H (2017) Health burden attributable to ambient PM2.5 in China. Environ Pollut 223:575–586

  28. Tsai HH, Yuan CS, Hung CH, Lin C (2011) Physicochemical properties of PM2.5 and PM2.5–10 at inland and offshore sites over southeastern coastal region of Taiwan strait. Aerosol Air Qual Res 11(6):664–678

  29. Tsai YI, Sopajaree K, Kuo SC, Hsin TY (2015) Chemical composition and size-fractionated origins of aerosols over a remote coastal site in southern Taiwan. Aerosol Air Qual Res 15(7):2549–2570

  30. Tseng CY, Lin SL, Mwangi JK, Yuan CS, Wu YL (2016) Characteristics of atmospheric PM2.5 in a densely Populated City with multi-emission sources. Aerosol Air Qual Res 16(9):2145–2158

  31. Wang Q, Wang J, He MZ, Kinney PL, Li T (2018) A county-level estimate of PM2.5 related chronic mortality risk in China based on multi-model exposure data. Environ Int 110:105–112

  32. World Health Organization (2016a) Ambient air pollution: a global assessment of exposure and burden of disease

  33. World Health Organization (2016b) Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide. Available online: http://apps.who.int/iris/bitstream/10665/69477/1/WHO_SDE_PHE_OEH_06.02_eng.pdf (accessed on 15 October 2016)

  34. Xie W, Li G, Zhao D, Xie X, Wei Z, Wang W, Wang M, Li G, Liu W, Sun J, Jia Z, Zhang Q, Liu J (2015) Relationship between fine particulate air pollution and ischaemic heart disease morbidity and mortality. Heart 101(4):257–263

  35. Zhao H, LiW GY, Li J, Wang H (2014) Exposure to particular matter increases susceptibility to respiratory Staphylococcus aureus infection in rats via reducing pulmonary natural killer cells. Toxicology 325:180–188

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The authors received funding support from the Chang Gung Memorial Hospital, Taiwan (CMRPF6I0011, CGRPF6G0011, CGRPF6G0012).

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Correspondence to Su-Lun Hwang.

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This study was approved by the Institutional Review Board (IRB) of Chang Gung Medical Foundation (201701930B0, 201700448B0).

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Hwang, S., Lin, Y., Hsiao, K. et al. Spatiotemporal assessment of mortality attributable to ambient PM2.5 exposure in Taiwan during 2008–2015. Air Qual Atmos Health 13, 233–245 (2020). https://doi.org/10.1007/s11869-019-00788-4

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  • Fine particulate matter
  • Burden of disease
  • Mortality
  • Population-attributable fraction
  • Geographic variation