Association between chronic respiratory diseases and the attributable risk of long-term exposure to atmospheric particulate matters among middle-aged and elderly Chinese population

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• This study determines the attributable risk of long-term PMs exposure to CRD. • Novel PMs estimate models have been developed to accurately assess individuals exposure. • Prolonged PM exposure is linked to a heightened risk of CRDs in middle-aged and elderly individuals. • Residents in rural areas and exposed to biomass fuels exhibit more prominent associations. • The PAF of COPD associated with PMs is highest, followed by asthma and chronic bronchitis. Chronic respiratory diseases (CRDs) mainly consist of chronic obstructive pulmonary disease (COPD), asthma and chronic bronchitis. The attributable risks of CRDs associated with long-term exposure to ambient particulate matters (PMs, aerodynamic diameter ≤1, 2.5 and 10 µm: PM 1 , PM 2.5 and PM 10 ) are unclear, particularly in developing countries. We determined the association between long-term exposure to PMs and CRDs in the middle-aged and elderly Chinese population and their corresponding population-attributable fractions (PAF). We conducted a COPD Surveillance study in Guangdong, China. We derived the averaged 722-day exposure estimates of PM 1 , PM 2.5 and PM 10 at 1 km × 1 km resolution at individual residential addresses between 2013 and 2019. The associations between PMs and CRDs were estimated by logistic regression models. We calculated the PAF of CRDs attributable to long-term PM exposures. We included 7371 participants aged 40 years or greater, among whom 1430 (19.40%), 736 (9.99%), 731 (9.92%) and 313 (4.25%) had CRDs, COPD, chronic bronchitis and asthma, respectively. Each 10 µg/m 3 increment of PMs was positively associated with the proportion of patients with CRDs, COPD, chronic bronchitis and asthma. The associations were more prominent in participants residing in rural areas and exposed to biomass fuel. The PAF of CRDs associated with PM 1 , PM 2.5 and PM 10 was 19.09% (95%CI: 12.41%∼25.02%), 18.98% (95%CI: 12.90%∼24.90%) and 21.40% (95%CI: 13.84%∼27.67%), respectively. The PAF of COPD associated with PMs was highest, followed by asthma and chronic bronchitis. In summary, ambient PM exposure is linked to a heightened risk of CRDs and accounts substantially for CRDs among the middle-aged and elderly population.