OBJECTIVETo explore the short-term impact of ambient PM(10) on daily non-accidental death, cardiovascular and respiratory death of residents in Beijing.

METHODSMortality data of residents in Beijing during 2006 to 2009 were obtained from public health surveillance and information service center of Chinese Center for Disease Control and Prevention, contemporaneous data of average daily air concentration of PM(10), SO(2), NO(2) were obtained from Beijing Environment Protection Bureau (year 2005 - 2006) and public website of Beijing environmental protection (year 2007 - 2009), respectively, contemporaneous meteorological data were obtained from china meteorological data sharing service system. Generalized addictive model (GAM) of time serial analysis was applied. In additional to the control of confounding factors such as long-term trend, day of the week effect, meteorological factors, lag effect and the effects of other atmospheric pollutants were also analyzed.

RESULTSDuring year 2006 to 2009, the number of average daily non-accidental death, respiratory disease caused death, cardiovascular and cerebrovascular diseases caused death among Beijing residents were 140.1, 15.0, 65.8, respectively;contemporaneous medians of average daily air concentration of PM(10), SO(2), NO(2) were 123.0, 26.0, 58.0 µg/m(3), respectively;contemporaneous average atmosphere pressure, temperature and relative humidity were 10.1 kPa, 13.5°C and 51.9%, respectively. An exposure-response relationship between exposure to ambient PM(10) and increased daily death number was found as every 10 µg/m(3) increase in daily average concentration of PM(10), there was a 0.1267% (95%CI: 0.0824% - 0.1710%) increase in daily non-accidental death of residents, 0.1365% (95%CI: 0.0010% - 0.2720%) increase in respiratory death and 0.1239% (95%CI: 0.0589% - 0.1889%) increase in cardiovascular death. Ambient PM(10) had greatest influence on daily non-accidental and cardiovascular death of the same day, while its greatest influence on respiratory death occurred 5 days later.

CONCLUSIONThe ambient PM(10) pollution increased daily non-accidental, respiratory disease caused, cardiovascular and cerebrovascular diseases caused deaths among residents in Beijing, and lag effect existed as for the effect of ambient PM(10) pollution on respiratory disease caused death.

Air Pollutants ; analysis ; Air Pollution ; analysis ; Cardiovascular Diseases ; mortality ; China ; epidemiology ; Environmental Exposure ; analysis ; Humans ; Mortality ; Particle Size ; Particulate Matter ; analysis ; Respiratory Tract Diseases ; mortality ; Time Factors

OBJECTIVETo study the characteristics of the effect of different temperatures on mortality of different cities through analyzing the relationship between mortality and meteorology of five Chinese cities.

METHODSWe get the demography and climate data of Beijing, Tianjin, Shanghai, Nanjing and Changsha cities from National Center of Disease Control and Prevention and Climate net respectively. Then we applied the R software and Distributed Lag Non-linear Models (DLNM) package to analyze our data and find the nonlinear and lag effects on mortality using DLNM.

RESULTSThe city of Beijing and Tianjin are located in the temperate zone. And the climate of Shanghai, Nanjing, Changsha belong to subtropical monsoon climate. When the daily mean temperature arrived 30°C and on lag 0 day, the values of relative risk of effect of high mean temperature on mortality in Nanjing (1.31, 95%CI: 1.21 - 1.41) and Changsha (1.25, 95%CI: 1.13 - 1.39) are larger than that in Beijing (1.18, 95%CI: 1.12 - 1.25), Tianjin (1.18, 95%CI: 1.10 - 1.26) and Shanghai(1.15, 95%CI: 1.06 - 1.24). While the relative risk of effect of low mean temperature on mortality is lower and lasts for a longer lag time. During the whole lag time, the relative risk of effect of the lowest daily mean temperature of each city on mortality in Tianjin, Changsha, Beijing, Nanjing, and Shanghai is 3.41, 95%CI: 1.60 - 7.27, 2.15, 95%CI: 1.11 - 4.15, 2.24, 95%CI: 1.12 - 4.48, 2.80, 95%CI: 1.75 - 4.48, 1.53, 95%CI: 1.12 - 2.03, respectively. The cumulative effect of mean temperature on mortality appears like a U-shape. When on lag 0-1 day, the value of relative risk of effect of extremely high temperature and the highest mean temperature on mortality is larger than 1. While the effect of low temperature on mortality becomes obvious after lag 2 days.

CONCLUSIONDepending on this research, extremely low temperature and the lowest mean temperature has a more obvious impact on mortality in the northern area than in the south. Extremely high temperature and the highest daily mean temperature is on the contrary. Meanwhile, different temperatures have different impacts on mortality in the same city: high temperature has an acute impact while there is a longer lag time in low temperature.

China ; Climate ; Humans ; Mortality ; Nonlinear Dynamics ; Temperature ; Urban Population

OBJECTIVETo compare the characteristics of suicides in the four main demographic groups: urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China.

METHODSA detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country.

RESULTSPesticide ingestion accounted for 58% (519) of all suicides and 61% (318/519) of deaths were due to unsuccessful medical resuscitation. A substantial proportion (37%) of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% (76/563) received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion (79%), the lowest prevalence of mental illness (39%), and the highest acute stress from precipitating life events just prior to the suicide.

CONCLUSIONMany suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Mental Disorders ; epidemiology ; psychology ; Middle Aged ; Rural Population ; Suicide ; psychology ; statistics & numerical data ; trends ; Urban Population

OBJECTIVETo understand the current status and trends of tuberculosis mortality rates in China.

METHODSIn 2010, 161 National Disease Surveillance Points representing all 31 mainland provinces, municipalities, and autonomous regions of China collected tuberculosis mortality surveillance data, including age, sex, region, and type of tuberculosis (all, pulmonary, and extra-pulmonary). The mortality rates of the three types of tuberculosis were compared between 2004 and 2010.

RESULTSIn 2010, the mortality rates due to all tuberculosis, pulmonary tuberculosis, and extra-pulmonary tuberculosis were 4.69 (95% CI 4.54-4.84), 4.38 (4.23-4.52), and 0.31 (0.27-0.35) per 100 000 population, respectively. Mortality rates due to all tuberculosis and pulmonary tuberculosis were higher in males, the elderly, and those living in western and rural areas. From 2004 to 2010, the mortality rates due to all tuberculosis and pulmonary tuberculosis decreased by 36.02% and 37.70%, respectively, with an average annual rate of decline of 7.20% and 7.61%, respectively.

CONCLUSIONMortality rates due to tuberculosis have declined rapidly in China. The target of reducing the 1990 mortality rate by 50% by 2015 has already been achieved. However, the tuberculosis control program should pay more attention to high-risk groups, including the elderly and those living in underdeveloped areas.

China ; epidemiology ; Female ; Humans ; Male ; Tuberculosis ; epidemiology ; mortality

Pedestrian safety in China is an important but largely neglected issue, in part due to the substantial under-reporting within police data. In this study we aimed to examine changes in pedestrian fatality between 2006 and 2010 in China using non-police reported data. A multi-year study was conducted based on the mortality data during 2006-2010 from the Disease Surveillance Points (DSP) data in China. Between 2006 and 2010, the crude pedestrian mortality increased from 7.0 to 10.5 per 100 000 populations. Annual pedestrian mortality from DSP data was 13 times in 2006 and 55 times in 2010 mortality for pedestrians and passengers from police-reported data in the corresponding years. After controlling for sex, age, and urban/rural, the mortality increased by 44% from 2006 to 2010 (adjusted mortality rate ratio (MRR)=1.11, 95% CI 1.10-1.12). The problem of pedestrian deaths is much more serious in China than that officially reported by the police. Significant and urgent efforts are needed to save lives of pedestrian in China.
Accidents, Traffic ; China ; epidemiology ; Humans ; Pedestrians ; Police ; Rural Population ; Wounds and Injuries

OBJECTIVETo describe the status and characteristics of under-reporting of death cases within national disease surveillance system (DSPs).

METHODSSix villages (communities) were selected in each of the 161 counties of DSPs by multi-stage random cluster sampling methods, the information of resident from 2006 to 2008 was collected, and a survey of the under-reporting deaths cases was carried out which covered 6 422 667 people in all. The under-reporting rate was estimated by ages, genders and regions. The mortality was compared before and after the adjustment of the under-reporting rate.

RESULTSThe total crude rate of under-reporting of whole nation was 16.68% (6271/37 603), and after the adjustment by weight the rate was 17.44%; the under-reporting rate of urban areas was a bit lower than rural areas, which were 16.08% and 18.14% respectively (P < 0.01); the under-reporting rate of middle and west regions were higher than the east, which were 19.27%, 18.15% and 15.46% respectively (P < 0.01). The under-reporting rate of children of under-five years old was much higher than that of people of five and above-five years old, which were 34.95% and 16.90% respectively (P < 0.01). The gender difference was especially obvious in age group 0-4, for women 39.36% while 31.93% for men. After adjusted by under-reporting rate, the mortality rate of male raised from 6.38‰ to 7.74‰ and for female raised from 4.66‰ to 5.64‰. In the middle region, the mortality rate of male raised from 6.49‰ to 8.00‰ and for female raised from 4.59‰ to 5.73‰ after the adjustment. And the mortality rate of male in age group 0-4 raised from 2.48‰ to 3.64‰ and for female raised from 1.98‰ to 3.27‰. Of which in urban area, the mortality rate of male was much higher than female before the adjustment, which were 1.76‰ and 1.39‰ respectively; however, the mortality rate of male was a bit lower than female after the adjustment, which were 2.26‰ and 2.41‰ respectively. The mortality in male of five and above-five raised from 6.60‰ to 7.69‰ after the adjustment while in female raised from 4.80‰ to 5.77‰.

CONCLUSIONThere are regional and age-group differences of the under-reporting rate of the National Disease Surveillance System. The gender differences mainly shows in age 0-4.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Disease Notification ; statistics & numerical data ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Mortality ; Population Surveillance ; Young Adult

OBJECTIVEThe mortality and trend of injury in 1991 - 2000, the distribution of causes of injuries by areas as well as disease burden in Chinese population were discussed.

METHODSData on mortality level and causes of injuries provided by National Disease Surveillance Program in 1991 - 2000, adjusted by under-reporting rate together with years of potential life lost (YPLL) and WPYLL of injuries and proportion of YPLL and WPYLL of total death, were calculated.

RESULTSThe mortality of injury was kept at a stable level from 1991 to 2000. The adjusted average death rates were 66.56/100,000 with 81.41/100,000 in males, 51.17/100,000 in females, and 38.68/100,000, 74.63/100,000 in urban and rural populations respectively. Death rates of injury in the east, central and west rural areas were 1:1.14:1.21 respectively. Injury was the main cause of death among children and youths. Traffic accident, suicide, drowning, poisoning and fall were main causes of injury accounting for 70 percent of all the injury mortality. Since 1990's, the death rate of traffic accident had been obviously increasing, YPLL and WPYLL in injury 2132 years/10,000 and 1587 years/10,000, respectively. The YPLL and WPYLL were 24.56% and 26.51% of total deaths.

CONCLUSIONThe disease burden of injury was heavy and the death of injury caused more social and economic losses owing to premature death. The increasing death rate of traffic accident called for more attention. Different effective control strategies should be formulated based on different death causes of injury and different target populations.

Age Factors ; China ; epidemiology ; Female ; Humans ; Male ; Retrospective Studies ; Sex Factors ; Suburban Population ; statistics & numerical data ; Survival Rate ; Urban Population ; statistics & numerical data ; Wounds and Injuries ; epidemiology ; mortality

OBJECTIVETo analyze the status and trend of injury deaths in Chinese people, and provide basic evidence for injury interventions.

METHODSData came from 2004-2005 the 3rd national retrospective sampling survey of death cause and covered 31 province-level regions and 160 surveillance spots in the interior of China, Total 142 660 482 person years were investigated. To describe the status of injury deaths, the crude death rate, years of potential life lost (YPLL), working years of potential life lost (WYPLL) and the standardized death rate were calculated. The population used for standardization was from census in 2000 and each five-year was counted as an age group; To analyze the trend of injury deaths, the constitution of the death causes were calculated based on the data of 1991-2000 national disease surveillance system which covered more than 10 000 000 population and 145 surveillance spots.

RESULTSThe total number of residents in survey districts died of injury between 2004 and 2005 was 87 753 (male 59 664, female 28 089, urban 23 308, rural 64 445); the crude death rate of injury in China 2004-2005 was 61.51/100 000 and accounting for 10.10% of all deaths; the standardized death rate was 58.45/100 000, ranking the fourth among the main cause of death for Chinese people. The YPLL of injury was 1579.61 person years per 100 000 and the WYPLL was 1721.41 person years per 100 000. The crude death rate of injury was 81.76/100 000 in male and 40.31/100 000 in female; the standardized death rates were 79.96/100 000 and 36.25/100 000, respectively. Injury mortality in male was two times higher than that in female. The crude death rates of injury were 48.66/100 000 in urban area and 68.01/100 000 in rural area; the standardized death rate were 44.08/100 000 and 66.25/100 000, respectively; the mortality in rural area was 1.4 times higher than that in urban area. The mortality for the aged 15 - 44 was 48.94/100 000(35 497/72 531 671) and accounting for 40% of all deaths, injury was the first cause of death for the aged 15 - 44. During 2004-2005, the top five causes of death related to injury were traffic accidents, suicide, falls, drowning and poisoning; the cases were 29 669, 18 678, 10 901, 7752, 4857 respectively in survey districts; the crude death rate were 20.80/100 000, 13.09/100 000, 7.64/100 000, 5.43/100 000, 3.40/100 000 respectively. From 1991 to 2005, the proportion of all injury deaths due to traffic accident increased from 15.00% (1551/10 338) to 33.79% (14 792/43 774) which showed a rising trend, the proportion of all injury deaths due to suicide decreased from 26.66% (2756/10 338) to 20.46% (8599/43 774) and the proportion of all injury deaths due to fall increased from 5.15% (532/10 338) to 12.87% (5630/43 774).

CONCLUSIONInjury is the primary cause of death resulting in premature death among Chinese people, traffic accident is the first cause of injury death. Since 1990s, the pattern of injury mortality of Chinese people has changed.

Accidents ; mortality ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Cause of Death ; trends ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult

methods had some limitations. There was big difference between the results when using SEG and GGB, suggesting that we should try to combine GGB and SEG methods to get the better results.

OBJECTIVETo study the quality of reporting network system on death cases among county and above levels' medical institutions.

METHODSData on variables related to county reporting rate, unit reporting rate, timeliness of reporting, eligibility rate of reporting, auditing rate, timeliness of auditing, eligibility rate of auditing, percentage of reporting deaths of medical institutes to deaths among total population, percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths at these institutes were collected and distribution of common coding errors was applied to the assessment of reporting deaths.

RESULTSThe total reporting rates were: 82.58% at the county level, 42.79% at the units with auditing rate as 96.96%. The eligibility rate of reporting was 69.10% with eligibility rate of auditing as 73.58%. The percentage of reporting deaths from medical institutes to deaths among total population was 8.91%, and the percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths of these institutes was 30.76%. The percentage of obvious coding errors among deaths reported by county and above levels' medical institutes was as high as 22.87%.

CONCLUSIONNetwork reporting system of death cases among county and above levels' medical institutes had remarkably increased the timeliness of data reporting system. Network reporting of data on death was the best opportunity to expand the coverage and to improve the quality of data reporting. Based on network reporting of death cases among county and above levels' medical institutes as well as deaths accrued at the communities should also be reported via this network in the eligible areas. The quality of coding on death causes among medical institutes were commonly poor, indicating that the training on ascertainment and coding of underlying death causes were quite essential.

China ; epidemiology ; Death Certificates ; Forms and Records Control ; standards ; Health Facilities ; statistics & numerical data ; Humans ; Mortality ; Quality Control