Ambient air pollution, smog episodes and mortality in Jinan, China.

We aimed to assess the acute effects of ambient air pollution and weather conditions on mortality in the context of Chinese smog episodes. A total of 209,321 deaths were recorded in Jinan, a large city in eastern China, during 2011-15. The mean concentrations of daily particulate matter ≤10 μm (PM10), fine particulate matter (PM2.5), sulfur dioxide (SO2) and nitrogen dioxide (NO2) were 169 μg/m3, 100 μg/m3, 77 μg/m3, and 54 μg/m3, respectively. Increases of 10 μg/m3 in PM10, PM2.5, SO2 and NO2 were associated with 1.11% (95% CI 0.96-1.26%), 0.71% (95% CI 0.60-0.82%), 1.69% (95% CI 1.56-1.83%), and 3.12% (95% CI 2.72-3.53%) increases in daily non-accidental mortality rates, respectively. Moreover, the risk estimates for these 4 pollutants were higher in association with respiratory and cardiovascular mortality. The effects of all the evaluated pollutants on mortality were greater in winter than in summer. Smog episodes were associated with a 5.87% (95% CI 0.16-11.58%) increase in the rate of overall mortality. This study highlights the effect of exposure to air pollution on the rate of mortality in China.