[The impact of persistent high ambient fine particulate matters exposures on mortality in the 40 districts/counties of China, 2013-2015].

Objective: To investigate the impact of persistent high ambient fine particulate matters (PM(2.5)) exposures on mortality in the polluted areas of 40 districts/counties in China. Methods: Using a convenient sampling method, we selected 40 districts/counties as research sites from the Beijing-Tianjin-Hebei Metropolitan Region, the Yangtze River Delta, the Pearl River Delta, and Heilongjiang, Shanxi, and Sichuan province. The daily concentrations of PM(2.5), meteorological data and population death data from January 1, 2013 to December 31, 2015 were collected. The six persistent PM(2).5 pollution episode scenarios were defined by the average daily concentration of PM(2.5) (75 μg/m(3), P(75) and P(90) of the average daily concentration of each district/county respectively) and the duration (≥2 days or 3 days). Generalized linear models and meta analyses were used to explore the impact of PM(2.5) pollution episodes on mortality in 40 districts/counties. Results: The mean±SD and P(50) (P(25), P(75)) of average daily temperature, relative humidity and PM(2.5) were (15.26±10.48) ℃, 17.20 (7.50, 23.70) ℃, (67.31±19.26)%, 72.00% (57.00%, 81.00%), (72.81±60.93) μg/m(3) and 55.38 (33.77, 91.45) μg/m(3), respectively in 40 districts/counties during 2013-2015. The average number of non-accidental, cardiovascular and cerebrovascular diseases deaths per day were (12±7), (5±4) and (2±2) in each district/county, respectively. When the daily concentrations of PM(2.5) were ≥75 μg/m(3) (≥2 days), ≥P(75) (≥2 days), ≥P(90) (≥2 days), ≥75 μg/m(3) (≥3 days), and ≥P(75) (≥3 days), the excess risk (95%CI) of the total non-accidental deaths and cardiovascular diseases deaths were 1.77% (0.89%,2.66%), 2.69% (1.06%,4.35%), 1.67% (0.59%,2.76%), 2.31% (0.67%, 3.97%), 0.71% (-0.75%, 2.20%), 1.95% (0.08%, 3.86%), 1.15% (0.12%, 2.18%), 1.85% (0.25%, 3.47%), 1.39% (0.15%, 2.64%), 2.29% (0.39%, 4.23%), respectively. Conclusion: Persistently high PM(2.5) exposures were associated with total non-accidental deaths and cardiovascular disease deaths.目的： 探讨大气PM(2.5)持续高暴露对中国40个区/县人群死亡的影响。 方法： 采用方便抽样的方法，在我国京津冀、长江三角洲、珠江三角洲地区及黑龙江、山西、太原、四川选取40个区/县作为研究现场，收集2013年1月1日至2015年12月31日的逐日PM(2.5)浓度、气象资料及人群死亡数据。以PM(2.5)日均浓度值（分别为75 μg/m(3)、各区/县日均浓度值的P(75)和P(90)）和持续时间（≥2 d和≥3 d）定义6种持续高PM(2.5)暴露情景，采用广义线性模型和Meta分析研究持续高PM(2.5)暴露对40区/县人群死亡的影响。 结果： 2013—2015年，40个区/县日均温度为（15.26±10.48）℃，P(50)（P(25)，P(75)）为17.20（7.50，23.70）℃；日均相对湿度为（67.31±19.26）%，P(50)（P(25)，P(75)）为72.00%（57.00%，81.00%）；PM(2.5)日均浓度为（72.81±60.93）μg/m(3)，P(50)（P(25)，P(75)）为55.38（33.77，91.45）μg/m(3)；每个区/县每日非意外总死亡为（12±7）例，心脑血管疾病死亡为（5±4）例，呼吸系统疾病死亡为（2±2）例。PM(2.5)日均浓度值≥75 μg/m(3)且持续≥2 d的暴露情景引起的人群非意外总死亡和心血管疾病死亡的ER（95%CI）值分别为1.77%（0.89%，2.66%）和2.69%（1.06%，4.35%）；PM(2.5)日均浓度值≥P(75)且持续≥2 d的暴露情景引起的人群非意外总死亡和心血管疾病死亡的ER（95%CI）值分别为1.67%（0.59%，2.76%）和2.31%（0.67%，3.97%）；PM(2.5)日均浓度值≥P(90)且持续≥2 d的暴露情景引起的人群非意外总死亡和心血管疾病死亡的ER（95%CI）值分别为0.71%（-0.75%，2.20%）和1.95%（0.08%，3.86%）；PM(2.5)日均浓度值≥75 μg/m(3)且持续≥3 d的暴露情景引起的人群非意外总死亡和心血管疾病死亡的ER（95%CI）值分别为1.15%（0.12%，2.18%）和1.85%（0.25%，3.47%）；PM(2.5)日均浓度值≥P(75)且持续≥3 d的暴露情景引起的人群非意外总死亡和心血管疾病死亡的ER（95%CI）值分别为1.39%（0.15%，2.64%）和2.29%（0.39%，4.23%）。 结论： 持续高PM(2.5)暴露与人群非意外总死亡和心血管疾病死亡存在关联。.