Air pollution and cancer daily mortality in Hangzhou, China: an ecological research

• Published in: BMJ open Vol. 14; no. 6; p. e084804
• Main Authors: Cheng, Zongxue, Qin, Kang, Zhang, Yan, Yu, Zhecong, Li, Biao, Jiang, Caixia, Xu, Jue
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 10.06.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Adolescent; Adult; Aged; Air Pollutants - adverse effects; Air Pollutants - analysis; Air pollution; Air Pollution - adverse effects; Child; china; China - epidemiology; Chronic illnesses; Disease; Environmental Exposure - adverse effects; epidemiologic studies; Female; Gender differences; Health surveillance; Humans; Humidity; Industrialized nations; Lung cancer; Male; Middle Aged; Mortality; Neoplasms - mortality; Nitrogen dioxide; Nitrogen Dioxide - adverse effects; Nitrogen Dioxide - analysis; Outdoor air quality; Particulate Matter - adverse effects; Particulate Matter - analysis; Pollutants; Public Health; Seasons; Sex Factors; Sulfur Dioxide - adverse effects; Sulfur Dioxide - analysis; Trends; Young Adult; China; china; epidemiologic studies; public health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2024-084804

BackgroundLong-term exposure to air pollution has been linked to cancer incidence. However, the evidence is limited regarding the effect of short-term exposure to air pollution on cancer mortality.ObjectivesThis study aimed to investigate associations between short-term exposure to air pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter <10 mm (PM10) and PM2.5) and cancer daily mortality.MethodsThis study used air quality, meteorological and daily cancer death data from 2014 to 2019 in Hangzhou, China. Generalised additive models (GAM) with quasi-Poisson regression were used to analyse the associations between air pollutants and cancer mortality with adjustment for confounding factors including time trends, day of week, temperature and humidity. Then, we conducted stratified analyses by sex, age, season and education. In addition, stratified analyses of age, season and education were performed within each sex to determine whether sex difference was modified by such factors.ResultsAfter adjusting for potential confounders, the GAM results indicated a statistically significant relationship between increased cancer mortality and elevated air pollution concentrations, but only in the female population. For every 10 μg/m3 rise in pollutant concentration, the increased risk of cancer death in females was 6.82% (95% CI 3.63% to 10.10%) for SO2 on lag 03, and 2.02% (95% CI 1.12% to 2.93%) for NO2 on lag 01 and 0.89% (95% CI 0.46% to 1.33%) for PM10 on lag 03 and 1.29% (95% CI 0.64% to 1.95%) for PM2.5 on lag 03. However, no statistically significant association was found among males. Moreover, the differences in effect sizes between males and females were more pronounced during the cold season, among the elderly and among subjects with low levels of education.ConclusionsIncreased cancer mortality was only observed in females with rising concentrations of air pollutants. Further research is required to confirm this sex difference. Advocate for the reduction of air pollutant emissions to protect vulnerable groups.