Objective To quantitatively evaluate the association between short-term exposure to ambient carbon monoxide (CO) and asthma mortality at a nationwide level in China.
Methods Based on asthma mortality data from the 605 surveillance points of the National Disease Surveillance System from 2015 to 2020, combined with the residential address of each asthma death case and atmospheric CO pollution data from ChinaHighAirPollutants (CHAP) dataset individual exposure estimation was performed by using the bi-linear interpolation method. Time-stratified case-crossover design was conducted to investigate the exposure-response relationship between short-term CO exposure and asthma mortality via the conditional logistic regression model.
Results There is a significant association between short-term CO exposure and increased asthma mortality. The highest effective value of CO exposure was observed on 5-day cumulative lag (lag04 d), with an odds ratio of 1.101 (95% confidence interval: 1.024-1.184). The exposure-response curve showed that the risk of asthma mortality tended to increase with the increase of CO mass concentration. The sensitivity analysis of the samples before COVID-19 pandemic (2015-2019) and two-pollutant model showed that the association between CO mass concentration and increased risk of asthma mortality remained basically consistent with the main model.
Conclusion Short-term exposure to ambient CO was positively associated with asthma mortality among the population in China, suggesting that the Chinese government should continue to promote relevant decision-making and measures for air pollution prevention and control and further reduce the mass concentration of ambient CO, which is of great significance to reduce asthma mortality.
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