The joint health risks of PM2.5 pollution wave and cold spell in eastern China

Based on 1800,669 mortality records collected during 2008–2018, we estimated the mortality risk and identified the vulnerable subpopulations of joint effects of the air pollution wave and the cold spell in eastern China. Here, air pollution waves were defined as daily mean fine particulate matter higher than a threshold (P1/P2/P3/P4: 75/115/120/150 μg/m³) for at least two days. Cold spells were defined as daily mean temperature below a threshold (T1/T2/T3: 10th/5th/2.5th percentile) for at least two days. A quasi-Poisson regression model combined with a distributed lag linear model was used to estimate the city-specific joint effects. When defined by P4T3, the highest pooled relative risks 2.07 (95 %CI: 1.73–2.48) of all-cause mortality was discovered cross Jiangsu province. The strongest relative excess risk due to interaction were observed in Suzhou (P3T3, 4.25, 95 %CI: 3.45–5.23). Generally, higher mortality risks were in cardiovascular disease, respiratory disease, and mental and behavior disorders disease. Moreover, the female, elderly, not married, and higher educated individuals and the residents in coastal and southern cities were more vulnerable to joint events. These findings are crucial for the development of local health and climate policies to reduce the health impacts of extreme weather and air pollution under climate change.