Impact of comprehensive air pollution control policies on six criteria air pollutants and acute myocardial infarction morbidity, Weifang, China: A quasi-experimental study.

Comprehensive air pollution control policies may reduce pollutant emissions. However, the impact on disease morbidity of the change for the concentration of air pollutants following the policies has been insufficiently studied. We aim to assess the impact of comprehensive air pollution control policies on the levels of six criteria air pollutants and acute myocardial infarction (AMI) morbidity in Weifang, China. This study performed an interrupted time series analysis. The linear model with spline terms and generalized additive quasi-Poisson model were used to estimate the immediate change from 2016 to 2019 in the daily concentration of six air pollutants (PM2.5, PM10, SO2, NO2, O3, and, CO) and AMI incident cases (Age ≥35) associated with the implementation of air pollution control policies in Weifang, respectively. After the implementation of air pollution control policies, air quality in Weifang had been improved. Specifically, the daily concentrations of PM2.5, PM10, SO2, and, CO immediately decreased by 27.9 % (95 % CI: 6.6 % to 44.3 %), 32.9 % (95 % CI: 17.5 % to 45.5 %), 14.6 % (95 % CI: 0.4 % to 26.8 %), and 33.9 % (95 % CI: 22.0 % to 44.0 %), respectively. In addition, the policies implementation was also associate with the immediate decline in the AMI morbidity (-6.5 %, 95 % CI: -10.4 % to -2.3 %). And subgroup analyses indicate that the health effects of the policy intervention were only observed in female (-9.4 %, 95 % CI: -14.4 % to -4.2 %) and those aged ≥65 years (-10.5 %, 95 % CI: -14.6 % to -6.2 %). During the final 20 months of the study period, the policy intervention was estimated to prevent 1603 (95 % CI: 574 to 2587) cases of incident AMI in Weifang. Our results provide strong rationale that the policy intervention significantly reduced ambient pollutant concentrations and AMI morbidity, which highlighted the importance for a comprehensive and rigorous air pollution control policy in regions with severe air pollution.

The effects of temperature on human mortality in a Chinese city: burden of disease calculation, attributable risk exploration, and vulnerability identification.

Few studies have examined the attributable fraction (AF) of temperature to mortality and Years of Life Lost (YLL), especially in developing countries. This study aims to explore the short-term effect of the cold and hot temperatures on the cause-specific YLL and mortality, discover the attributable contributions from the temperature variations, and identify the vulnerable populations in Weifang, China. Daily registered death information and meteorological data over the period 2010-2016 were obtained in Weifang, a northern Chinese city. Generalized additive Poisson and Gaussian regression models were used to assess the impacts of temperatures on both mortality and YLL, explore the AF of the temperature variations on mortality, after adjusting for other covariates. Both hot and cold temperatures have had significant negative impacts on cause-specific mortality counts and YLL, with heat presented an acute and short effect and the cold temperatures had delayed effects and lasted for several days. In terms of the attributable fraction calculations, the contributions from cold effects was higher than that of hot effects on non-accidental, cardiovascular, and respiratory deaths (YLL 10.88 vs. 1.23%, 19.58 vs. 1.71%, and 14.47 vs. 3.05%; mortality 13.97 vs. 1.65%, 19.20 vs. 1.59%, and 14.89 vs. 3.09%), respectively. The elderly and women and people with low education level were the most vulnerable. The findings will provide important scientific evidences and policy implications for developing adaptation strategies to reduce the adverse effect of cold and hot exposure in Weifang, in terms of resource allocation, healthcare workforce capacity building, and community health education, especially for the vulnerable groups.