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Public Health and Air Pollution in Asia (PAPA): A Multicity Study of Short-Term Effects of Air Pollution on Mortality
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BACKGROUND AND OBJECTIVES: Although the deleterious effects of air pollution from fossil fuel combustion have been demonstrated in many Western nations, fewer studies have been conducted in Asia. The Public Health and Air Pollution in Asia (PAPA) project assessed the effects of short-term exposure to air pollution on daily mortality in Bangkok, Thailand, and in three cities in China: Hong Kong, Shanghai, and Wuhan. METHODS: Poisson regression models incorporating natural spline smoothing functions were used to adjust for seasonality and other time-varying covariates that might confound the association between air pollution and mortality. Effect estimates were determined for each city and then for the cities combined using a random effects method. RESULTS: In individual cities, associations were detected between most of the pollutants [nitrogen dioxide, sulfur dioxide, particulate matter < or = 10 microm in aerodynamic diameter (PM(10)), and ozone] and most health outcomes under study (i.e., all natural-cause, cardiovascular, and respiratory mortality). The city-combined effects of the four pollutants tended to be equal or greater than those identified in studies conducted in Western industrial nations. In addition, residents of Asian cities are likely to have higher exposures to air pollution than those in Western industrial nations because they spend more time outdoors and less time in air conditioning. CONCLUSIONS: Although the social and environmental conditions may be quite different, it is reasonable to apply estimates derived from previous health effect of air pollution studies in the West to Asia.
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![Figure 3 Excess risk (%) of mortality [point estimates (95% CIs)] for a 10-μg/m3 increase in average concentration of lag 0–1 days for three age groups.](/paper-figures/52076873a95a4929a862884fe367598d/public-health-and-air-pollution-in-asia-papa-a-multicity-study-of-short-term-figure-3.jpg)
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“In accordance with our finding, previous studies also supported the linear association between ozone and mortality in Chinese cities (Wong et al., 2008; Yang et al., 2012).”
From Acute effect of ozone exposure on daily mortality in seven cities of Jiangsu Province, China: no clear evidence for threshold (2017) · cites this paper as Wong et al., 2008
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Self-citation
Metadata
- Authors
- Wong, C.-M., Vichit-Vadakan, N., Kan, H., & Qian, Z.
- Affiliations
- University of Hong Kong (HK)
- Faculty of Public Health, Thammasat University, Pathumthani, Thailand
- National Institutes of Health (US)
- Pennsylvania State University (US)
- Corresponding author
- Wong, Chit-Ming
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2008-07-09
- Volume
- 116
- Issue
- 9
- Pages
- 1195-1202
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC2535622
- OpenAlex
- W2165456540
- Cited by
- 476
- References
- 22
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 20 · 2023: 19 · 2022: 40 · 2021: 31 · 2020: 33 · 2019: 32 · 2018: 28 · 2017: 31 · 2016: 26 · 2015: 28 · 2014: 29 · 2013: 31 · 2012: 33
- FWCI
- 15.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor, 3460 d)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- U.S. Environmental Protection Agency
- Health Effects Institute
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Keywords
- air pollution, short-term exposure, mortality, cardiovascular mortality, respiratory mortality, natural death, nitrogen dioxide, sulfur dioxide, particulate matter, ozone, Asian cities, Bangkok, Hong Kong, Shanghai, Wuhan, fossil fuel combustion, exposure assessment
- MeSH terms
- Aged, Air Pollution, Asia, Dose-Response Relationship, Drug, Humans, Middle Aged, Public Health
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