Temporal changes in short-term PM_2.5-cardiorespiratory mortality associations and implications for the health benefits of the clean air action in the Sichuan Basin, 2014-2022.

Authors

Jiayi Chen, Yue Ou, Jian Qian, Jing Zeng, Sheng Li, Junyu Wang, Na Yang, Tao Zhang, Fei Yin, Chenglin Tao, Xinyin Xu, Nan Wang, Menglu Jiang, Ying Deng, Yue Ma

Published in

International archives of occupational and environmental health. Volume 99. Issue 7. Sep 06, 2026. Epub Sep 06, 2026.

Abstract

Evidence remains limited on how PM_2.5-related mortality risk has evolved under sustained air-quality improvement following the implementation of the Clean Air Action (CAA), and how such changes have influenced related health benefits. This study aimed to investigate temporal changes in short-term PM_2.5-related cardiorespiratory mortality associations and to quantify the respective contributions of PM_2.5 concentration reductions and risk changes to mortality outcomes.
We conducted a multi-county time-series study in the Sichuan Basin, China, covering the period from 2014 to 2022. An extended two-stage analytical framework was applied to estimate county -specific PM_2.5-mortality associations, followed by pooled analyses. Longitudinal meta-regression was used to assess annual trends in excess risk (ER), and period-specific analyses were performed across different stages of the CAA. Scenario analyses were conducted to quantify mortality changes attributable to PM_2.5 concentration reductions and to temporal changes in the exposure-response relationship.
A significant nonlinear temporal pattern in ER per 10 μg/m³ increase in PM_2.5 was observed (P < 0.001), characterized by an increase during 2014-2016, a decline during 2017-2019, and an increase again during 2020-2022. Corresponding ERs for the three periods were 0.7% (95% CI: 0.6%-0.9%), 0.4% (95% CI: 0.3%-0.6%), and 1.4% (95% CI: 1.2%-1.6%), respectively. Declining PM_2.5 concentrations were associated with 52,831 fewer cardiorespiratory deaths, whereas changes in ER increased mortality by 10,041 deaths. The later period increase in risk was consistently observed across sexes and was more pronounced among individuals aged 65 years and older.
Temporal increases in short-term PM_2.5-related mortality risk partially offset the health benefits achieved through reductions in PM_2.5 concentrations during the later CAA period. These findings highlight the importance of incorporating time-varying health risk and population vulnerability into evaluations of air quality policies.

PMID:
42701930
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.

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