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Dietary habits and the short-term effects of air pollution on mortality in the Chinese population in Hong Kong
  1. Chun-Quan Ou1,2,
  2. Chit-Ming Wong2,
  3. Sai-Yin Ho2,
  4. Mary Schooling2,
  5. Lin Yang2,
  6. Anthony J Hedley2,
  7. Tai-Hing Lam2
  1. 1Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China
  2. 2Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong
  1. Correspondence to Dr Chit-Ming Wong, Department of Community Medicine, The University of Hong Kong, 5th Floor, Li Ka Shing Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong, China; hrmrwcm{at}


Background Both diet and air pollution are associated with mortality risks. However, no epidemiological study has examined the potential interaction between diet and air pollution on mortality. We assessed their interaction on an additive scale.

Methods We analysed the data on daily concentrations of ambient air pollutants (PM10, NO2, SO2 and O3) and a total of 23 484 deaths in 1998 in Hong Kong. A standardised questionnaire was used in all four death registries to collect food frequency data from proxy respondents while waiting for the registration to be completed. We fitted a linear odds ratio model and estimated excess relative risk due to the interaction (ERRI) between air pollution and regular consumption (at least once per week) of each food item to measure departure from additivity of effects on mortality.

Results We observed consistently negative ERRI between all of the four pollutants and regular consumption of vegetables, fruits and soy. The effects of PM10, NO2 and O3 were significant smaller in the subjects who regularly consumed fruits than those who never or seldom consumed such food. The effect modification of soy consumption on PM10, NO2 and SO2 associated mortality was also found statistically significant. However, regular consumption of dairy products was associated with significant increased effects of PM10 and NO2.

Conclusions This study provides insight into dietary habit as one of the modifiers of health effects of air pollution. Our findings merit further studies to characterise the influence of diet on air pollution-related health and elucidate the underlying mechanisms.

  • Air pollution
  • Chinese
  • dietary habits
  • mortality
  • health impact assessment
  • diet RB

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  • Funding This study is financially supported by the Hong Kong Health Care & Promotion Fund (#215032).

  • Competing interests None.

  • Ethics approval The study proposal has been approved by the Ethics Committee of the Faculty of Medicine, The University of Hong Kong, Hong Kong (EC 1377-00).

  • Provenance and peer review Not commissioned; externally peer reviewed.