Zhonghua Liu Xing Bing Xue Za Zhi · Oct 10, 2026

Association between fine particulate matter exposure and all-cause and cardiovascular mortality in urban and rural elderly population in Beijing

By Wan YH, Du SY, Chen SM et al.

Objective: To understand the association between PM2.5 exposure and all-cause and cardiovascular disease (CVD) mortality in elderly populations in urban and rural areas of Beijing. Methods: Based on the Beijing Elderly Comprehensive Health Cohort Study, a total of 3 472 study participants with complete baseline data were enrolled according to the inclusion and exclusion criteria, and the information about their survival and mortality outcomes were obtained by follow up. Annual average PM2.5 exposure values were matched using remote sensing grid data and grouped by tertiles. Multivariate Cox proportional hazards regression models were used to analyze the associations between PM2.5 exposure and all-cause as well as CVD mortality. Restricted cubic splines, subgroup analyses, and sensitivity analyses were performed to verify the robustness of the results. Additionally, the interaction between outdoor physical activity and PM2.5 exposure was evaluated. Results: The average annual PM2.5 concentration in living area of the study participants was 79.80 μg/m³ from 2010 to 2014 , much higher than the national grade Ⅱ limit (35 μg/m³). After adjusting for confounding factors, for each 1 μg/m³ increase in PM2.5 concentration, the risk for all-cause mortality increased by 5.3% (HR=1.053, 95%CI: 1.026-1.080), and the risk for CVD mortality increased by 4.6% (HR=1.046, 95%CI: 1.001-1.100). Subgroup analysis revealed a significant interaction between outdoor physical activity level and PM2.5 concentration on all-cause mortality (P=0.022). In the group without outdoor physical activity, each 1 μg/m³ increase in PM2.5 concentration was associated with an 8.7% increase of risk for all-cause mortality (HR=1.087, 95%CI:1.042-1.134); whereas in the group with outdoor physical activity, the risk increased by 2.6% (HR=1.026, 95%CI: 1.001-1.062). In the group with outdoor physical activity, compared with the reference group, the study participants in the highest PM2.5 T₃ group had a 52.3% increased risk for all-cause mortality (HR=1.523, 95%CI:1.171-1.979) and a 79.1% increased risk for CVD mortality (HR=1.791, 95%CI: 1.004-3.192). Conclusions: PM2.5 exposure increases the risks for all-cause mortality and CVD mortality in the elderly population in urban and rural areas in Beijing. Regular physical activity might partially offset the adverse health effects of PM2.5 exposure, but this protective effect is limited under extremely high pollution levels. It is suggested to encourage the elderly to maintain regular physical activity but have indoor physical activity in days when air PM2.5 concentrations are high.

doi.org/10.3760/cma.j.cn112338-20251204-00870PubMed 42907183Populations