Health Effects of PM2.5 Exposure in China from 2004 to 2018: A Systematic Review and Meta-Analysis

In order to comprehensively evaluate the impact of fine particulate matter (PM2.5) exposure on public health in China, and to obtain a quantitative concentration–response relationship, the literature published in multiple databases from 1980 to 2019 was searched to obtain studies on the health effects of PM2.5 on the Chinese population in this paper. According to the inclusion and exclusion criteria, 67 studies were included in the research, which covered the study period from 2004 to 2018. A systematic review shows that there are 30 diseases and 46 health effect outcomes with clear concentration–response relationships with PM2.5 in China. Seven health effects were investigated by meta-analysis. For each 10 μg/m3 increase in PM2.5, the combined overall random-effects relative risk (RR) of non-accidental mortality, mortality due to cardiovascular disease, and mortality due to respiratory disease was 1.006 (95% CI = 1.004, 1.007), 1.007 (95% CI = 1.005, 1.008), and 1.008 (95% CI = 1.006, 1.010), respectively. The RR of hospital admission due to cardiovascular disease and respiratory disease was 1.006 (95% CI = 0.999, 1.014) and 1.006 (95% CI = 1.003, 1.010), respectively. In terms of outpatient visits, a 10 μg/m3 increase in PM2.5 corresponds to a 1.004 (95% CI = 1.002, 1.006) and 1.008 (95% CI = 1.005, 1.010) RR for cardiovascular disease and respiratory disease, respectively.