The burden of sulfur dioxide pollution on years of life lost from chronic obstructive pulmonary disease: A nationwide analysis in China.

BACKGROUND Sulfur dioxide (SO2) is one of the major gaseous pollutants in China and other developing countries. Few multicity studies have been done to examine the short-term effect of SO2 on cause-specific years of life lost (YLL). This study was designed to investigate the burden of chronic obstructive pulmonary disease (COPD) associated with SO2 exposure. METHODS A 5-year time-series study was conducted in 48 Chinese cities from 2013 to 2017. Generalized additive models were first used to estimate the city-specific relationship. Then, random-effects meta-analyses were applied to pool the estimates. Furthermore, the roles of potential modifiers and the related economic loss estimated by the method of value per statistical life year were also evaluated. RESULTS The annual mean concentration of SO2 was 27.1 μg/m3. A 10 μg/m3 increase in 4-day moving average (lag03) of SO2 concentration was associated with 0.83% (95% CI: 0.13%, 1.53%) relative increment in YLL from COPD, and relevant percent change of mortality was 0.78% (95% CI: 0.16%, 1.41%). Moreover, a significantly higher effect was observed in the warm season, particularly in the south region. SO2 exposure was estimated to account for 1.89% of the total economic loss due to YLL from COPD. CONCLUSIONS Our findings showed a positive association between short-term exposure to SO2 and YLL from COPD and highlighted the importance of continuous control of SO2 pollution to reduce corresponding attributable disease burden.