The short-term impact of ambient air pollution on years of life lost from cancer in Pudong New Area, Shanghai: A time series study

Objectives Previous studies have shown that ambient air pollution was associated with an increased risk of cancer mortality. However, the mortality outcome treated every death equally and ignored the significance of premature death. Methods We conducted a time series study to evaluate the short-term impact of ambient air pollution on years of life lost (YLLs) from cancer in Pudong New Area, Shanghai. Data on air pollutants, meteorological factors, cancer deaths, and years of life lost were collected from 2013 to 2021. In this study, the distributed lag nonlinear model (DLNM) combined with linear (for YLLs) and quasi-Poisson (for mortality) regression models was used to investigate the lag-specific association between air pollution exposure and two outcome indicators of cancer. A stratified analysis was performed according to sex, age, and education. Results For YLLs, per 10 μg/m 3 increase in PM 2.5 , PM 10 , SO 2 , NO 2 , and O 3 exposure was significantly associated with YLL increases of 2.22 (95% CI: 0.71, 3.74), 1.04 (95% CI: 0.17, 1.91), 5.05 (95% CI: 0.74, 9.36), 1.88 (95% CI: 0.09, 3.66), and 0.96 (95% CI: 0.14, 1.78) years on lag0-1, respectively. Marginal differences in impact estimates were observed among men, younger populations, and those with higher education. In addition, the difference in the impact of O 3 exposure on cancer mortality among low- and high-education subgroups was statistically significant. Conclusions Short-term exposure to ambient air pollution was positively associated with increases in YLLs and cancer mortality in Pudong New Area, Shanghai.