Strategies towards PM2.5 attainment for non-compliant cities in China: A case study

Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study

BACKGROUND

Particulate matter (PM) is detrimental to the respiratory and circulatory systems. However, no study has evaluated the lag effects of weekly exposure to fine PM during the period from preconception to delivery on the risk of hypertensive disorders of pregnancy (HDPs).

OBJECTIVE

We set out to investigate the lag effect windows of PM on the risk of HDPs on a weekly scale.

METHODS

Data from women with de novo HDPs and normotensive pregnant women who were part of the Peking University Retrospective Birth Cohort, based on the hospital information system of Tongzhou district, were obtained for this study. Meteorological data and data on exposure to fine PM were predicted by satellite remote sensing data based on maternal residential address. The de novo HDP group consisted of pregnant women who were diagnosed with gestational hypertension or preeclampsia. Fine PM was defined as PM2.5 and PM1. The gestational stage of participants was from preconception (starting 12 weeks before gestation) to delivery (before the 42nd gestational week). A distributed-lag nonlinear model (DLNM) was nested in a Cox regression model to evaluate the lag effects of weekly PM exposure on de novo HDP hazard by controlling the nonlinear relationship of exposure-reaction. Stratified analyses by employment status (employed or unemployed), education level (higher or lower), and parity (primiparity or multiparity) were performed.

RESULTS

A total of 22,570 pregnant women (mean age 29.1 years) for whom data were available between 2013 and 2017 were included in this study. The prevalence of de novo HDPs was 6.7% (1520/22,570). Our findings showed that PM1 and PM2.5 were significantly associated with an elevated hazard of HDPs. Exposure to PM1 during the 5th week before gestation to the 6th gestational week increased the hazard of HDPs. A significant lag effect of PM2.5 was observed from the 1st week before gestation to the 6th gestational week. The strongest lag effects of PM1 and PM2.5 on de novo HDPs were observed at week 2 and week 6 (hazard ratio [HR] 1.024, 95% CI 1.007-1.042; HR 1.007, 95% CI 1.000-1.015, respectively, per 10 μg/m3 increase). The stratified analyses indicated that pregnant women who were employed, had low education, and were primiparous were more vulnerable to PM exposure for de novo HDPs.

CONCLUSIONS

Exposure to PM1 and PM2.5 was associated with the risk of de novo HDPs. There were significant lag windows between the preconception period and the first trimester. Women who were employed, had low education, and were primiparous were more vulnerable to the effects of PM exposure; more attention should be paid to these groups for early prevention of de novo HDPs.

Spatiotemporal characteristics of PM2.5 and ozone concentrations in Chinese urban clusters

Despite China's public commitment to emphasise air pollution investigation and control, trends in PM_2.5 and ozone concentrations in Chinese urban clusters remain unclear. This study quantifies the spatiotemporal variations in PM_2.5 and surface ozone at the scale of Chinese urban clusters by using a long-term integrated dataset from 2015 to 2020. Nonlinear Granger causality testing was used to explore the spatial association patterns of PM_2.5 and ozone pollution in five megacity cluster regions. The results show a significant downward trend in annual mean PM_2.5 concentrations from 2015 to 2020, with a decline rate of 2.8 μg m^-3 yr^-1. By contrast, surface ozone concentrations increased at a rate of 2.1 μg m^-3 yr^-1 over the 6 years. The annual mean PM_2.5 concentrations in urban clusters show significant spatial clustering characteristics, mainly in Beijing-Tianjin-Hebei (BTH), Fenwei Plain (FWP), Northern slope of Tianshan Mountains urban cluster (NSTM), Sichuan Basin urban cluster (SCB), and Yangtze River Delta (YRD). Surface ozone shows severe summertime pollution and distributional variability, with increased ozone pollution in major urban clusters. The highest increases were observed in BTH, Yangtze River midstream urban cluster (YRMR), YRD, and Pearl River Delta (PRD). Nonlinear Granger causality tests showed that PM_2.5 was a nonlinear Granger cause of ozone, further supporting the literature's findings that PM_2.5 reduction promoted photochemical reaction rates and stimulated ozone production. The nonlinear test statistic passed the significance test in magnitude and statistical significance. FWP was an exception, with no significant long-term nonlinear causal link between PM_2.5 and ozone. This study highlights the challenges of compounded air pollution caused primarily by ozone and secondary PM_2.5. These results have implications for the design of synergistic pollution abatement policies for coupled urban clusters.