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BioMed Research International
Volume 2017, Article ID 5806185, 15 pages
Review Article

Concentration-Response Relationship between PM2.5 and Daily Respiratory Deaths in China: A Systematic Review and Metaregression Analysis of Time-Series Studies

1Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden
2Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
3Department of Cardiology, Shanghai Changzheng Hospital, Shanghai 200003, China
4Health Outcomes and Economic Evaluation Research Group, Department of Learning, Information, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
5Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
6Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
7Department of Health Statistics, Second Military Medical University, Shanghai, China
8Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 701 82 Örebro, Sweden

Correspondence should be addressed to Xin Fang; es.ik@gnaf.nix and Xiaofei Ye; nc.ude.umms@iefoaixey

Received 9 May 2017; Revised 28 July 2017; Accepted 7 August 2017; Published 16 October 2017

Academic Editor: Anna Karakatsani

Copyright © 2017 Mengying Ren et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The association between the particulate matters with aerodynamic diameter ≤ 2.5 μm (PM2.5) and daily respiratory deaths, particularly the concentration-response pattern, has not been fully examined and established in China. We conducted a systematic review of time-series studies to compile information on the associations between PM2.5 concentration and respiratory deaths and used metaregression to assess the concentration-response relationship. Out of 1,957 studies screened, eleven articles in English and two articles in Chinese met the eligibility criteria. For single-day lags, per 10 μg/m3 increase in PM2.5 concentration was associated with 0.30 [95% confidence interval (CI): 0.10, 0.50] percent increase in daily respiratory deaths; for multiday lags, the corresponding increase in respiratory deaths was 0.69 (95% CI: 0.55, 0.83) percent. Difference in the effects was observed between the northern cities and the south cities in China. No statistically significant concentration-response relationship between PM2.5 concentrations and their effects was found. With increasingly wider location coverage for PM2.5 data, it is crucial to further investigate the concentration-response pattern of PM2.5 effects on respiratory and other cause-specific mortality for the refinement and adaptation of global and national air quality guidelines and targets.