Influences of socioeconomic vulnerability and intra-urban air pollution exposure on short-term mortality during extreme dust events

Highlights: • PM_10-2.5 contributes to short-term mortality risk of extreme dust events. • Socioeconomically vulnerable population have higher mortality risk on dusty days. • Identified vulnerable population are unemployed or senior or unmarried population. • Areas with higher air pollution have higher mortality risk on general population. • Areas with higher air pollution have higher mortality risk on vulnerable population. Air pollution has been shown to be significantly associated with morbidity and mortality in urban areas, but there is lack of studies focused on extreme pollution events such as extreme dust episodes in high-density Asian cities. However, such cities have had extreme climate episodes that could have adverse health implications for downwind areas. More importantly, few studies have comprehensively investigated the mortality risks of extreme dust events for socioeconomically vulnerable populations. This paper examined the association between air pollutants and mortality risk in Hong Kong from 2006 to 2010, with a case-crossover analysis, to determine the elevated risk after an extreme dust event in a high-density city. The results indicate that PM_10-2.5 dominated the all-cause mortality effect at the lag 0 day (OR: 1.074 [1.051, 1.098]). This study also found that people who were aged ≥ 65, economically inactive, or non-married had higher risks of all-cause mortality and cardiorespiratory mortality during days with extreme dust events. In addition, people who were in areas with higher air pollution had significantly higher risks of all-cause mortality and cardiorespiratory mortality. In conclusion, the results of this study can be used to target the vulnerable among a population or an area and the day(s) at risk to assist in health protocol development and emergency planning, as well as to develop early warnings for the general public in order to mitigate potential mortality risk for vulnerable population groups caused by extreme dust events.