Fine particulate matter associated mortality burden of lung cancer in Hebei Province, China

Background The association between fine particulate matter (PM2.5) and lung cancer (LC) mortality in China is limited. The Beijing‐Tianjin‐Hebei region is infamous for serious air pollution. Seven of the top 10 cities with the worst air quality are located in Hebei Province. Thus, we explored the effect of 10 years of PM2.5 on the LC mortality rate in Hebei Province. Methods We quantified associations between LC mortality and PM2.5 and estimated the LC mortality burden attributed to PM2.5 with predicted county level LC deaths in 2014. Results The 10‐year PM2.5 LC mortality associations were non‐linear, with thresholds of 63 μg/m3 overall, 69 μg/m3 for men, 68 μg/m3 for women, 66 μg/m3 for those aged 30–64 years, and 62 μg/m3 for those aged ≥ 65 years. The relative risks for these groups were 1.09 (95% confidence interval [CI] 1.08–1.10), 1.06 (95% CI 1.03–1.10), 1.20 (95% CI 1.10–1.26), 1.07 (95% CI 1.05–1.11), and 1.10 (95% CI: 1.07–1.13), respectively. There were 2525 (95% CI 2265–2780) LC deaths attributed to 10‐year PM2.5 in 2014, at fractions of 8.3% (95% CI 7.4–9.1%) overall, 5.7% (95% CI 2.8–9.4%) for men, 16.7% (95% CI: 8.3–21.6%) for women, 6.5% (95% CI 4.7–10.3%) for those aged 30–64 years, and 9.1% (95% CI 6.4–11.5%) for those aged ≥ 65 years. Conclusion Our results suggest that a reduction in the PM2.5 exposure levels below thresholds would prevent a substantial number of LC deaths in Hebei Province.