文章摘要
梁锐明,殷鹏,王黎君,李镒冲,刘江美,刘韫宁,由金玲,齐金蕾,周脉耕.中国7个城市大气PM2.5对人群心血管疾病死亡的急性效应研究[J].中华流行病学杂志,2017,38(3):283-289
中国7个城市大气PM2.5对人群心血管疾病死亡的急性效应研究
Acute effect of fine particulate matters on daily cardiovascular disease mortality in seven cities of China
收稿日期:2016-10-11  出版日期:2017-03-18
DOI:10.3760/cma.j.issn.0254-6450.2017.03.003
中文关键词: 细颗粒物;心血管疾病;死亡;时间序列研究
英文关键词: Fine particulates;Cardiovascular disease;Mortality;Time-series
基金项目:环保部环保公益性行业科研专项(201509062);国家卫生和计划生育委员会公益性行业科研专项(201502003)
作者单位E-mail
梁锐明 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室  
殷鹏 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室  
王黎君 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室  
李镒冲 100050 北京, 中国疾病预防控制中心综合防控与评价室  
刘江美 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室  
刘韫宁 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室  
由金玲 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室  
齐金蕾 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心生命登记与死因监测室  
周脉耕 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心 maigengzhou@126.com 
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中文摘要:
      目的 探讨中国7个城市大气中粒径≤2.5 μm的颗粒物(PM2.5)对人群心血管疾病死亡的急性效应。方法 收集石家庄、哈尔滨、上海、武汉、广州、成都和西安7个城市2013年1月1日至2015年12月31日的PM2.5日均浓度数据、同期每日心血管疾病死亡人数和气象监测数据。采用广义相加模型和半泊松分布连接的方法,控制长期和季节趋势、气象因素及“星期几效应”的影响,在分城市水平和多城市水平分析中国7个城市大气PM2.5日均浓度和每日心血管疾病死亡的相关性。结果 单污染物模型结果显示,大气PM2.5和心血管疾病日死亡率的关联强度在不同城市间差异较大,广州市效应最强。在7个城市平均水平上,PM2.5浓度每升高10 μg/m3能引起居民心血管疾病死亡率增加0.315%(95% CI:0.133%~0.497%)。PM2.5的效应从lag0到lag2递减,lag01时最强。在双污染物模型中,调整SO2或NO2之后,各城市PM2.5对心血管疾病死亡率的影响均有所降低,且合并效应无统计学意义,提示PM2.5可能不具有独立的健康效应。分层分析结果显示,PM2.5对男性每日心血管疾病死亡率影响的效应值高于女性,其浓度每升高10 μg/m3对应的心血管疾病死亡率增加百分比分别为0.371%(95% CI:0.141%~0.600%)、0.199%(95% CI:0.077%~0.321%)。随着年龄的增长,PM2.5对心血管疾病死亡的影响逐渐增强。PM2.5对文化程度较低居民影响高于文化程度较高者。不同性别、年龄、文化程度、死亡地点的健康效应差异无统计学意义。PM2.5与心血管疾病死亡关系的暴露-反应关系非线性无阈值,高污染物浓度相对于低污染浓度时曲线更为平坦。结论 大气PM2.5浓度升高可导致人群每日心血管疾病死亡率增加。
英文摘要:
      Objective To explore the effect of fine particulate matters with an aerodynamic diameter less than 2.5 μm (PM2.5) on daily cardiovascular disease mortality in seven cities of China. Methods Daily average concentrations of PM2.5, cardiovascular disease mortality data and environmental data were collected from January 1, 2013 to December 31, 2015 in seven cities of China, including Shijiazhuang, Haerbin, Shanghai, Wuhan, Guangzhou, Chengdu and Xi'an. We linked generalized additive model with Quasi-Poisson distribution to evaluate the association between daily concentrations of PM2.5 and cardiovascular disease mortality at single-city level and multi-city level, after adjusting for the long-term and seasonal trend, as well as meteorological factors and the effect of "days of week". Results The single-pollutant model indicated that there were marked differences in association strength in these cities, among which the effect in Guangzhou was strongest. At multi-city level, a 10 μg/m3 increase of PM2.5 was associated with an increase of 0.315% (95%CI:0.133%-0.497%) of daily cardiovascular disease mortality. From lag0 to lag2, the effect of PM2.5 on cardiovascular disease mortality decreased, while it was strongest on lag01. In the two-pollutant model, the estimated effect decreased in all the cities with the adjustments of SO2 or NO2. The insignificant combined results suggested that PM2.5 might have combined effect with other pollutants. Each 10 μg/m3 increase of PM2.5 was associated with increases of 0.371% (95%CI:0.141%-0.600%) and 0.199% (95%CI:0.077%-0.321%) of cardiovascular disease mortality in males and females, respectively. The effect of PM2.5 on cardiovascular disease mortality increased with age and decreased with educational level, although the differences between different subgroups were insignificant. The dose-response relationship between PM2.5 and cardiovascular disease mortality was non-linear and non-threshold, with a steeper curve at lower concentrations. Conclusion The increases of PM2.5 concentration can result in the increase of daily cardiovascular mortality.
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