| 李曼,吴瑶,田耀华,曹桂莹,姚珊珊,艾萍,黄哲,黄超,王小文,曹亚英,项骁,隽娟,胡永华.PM2.5短期暴露对我国死亡和急诊量影响的Meta分析[J].中华流行病学杂志,2018,39(10):1394-1401 |
| PM2.5短期暴露对我国死亡和急诊量影响的Meta分析 |
| A Meta-analysis on the relations between short-term exposure to PM2.5 and both mortality and related emergency visits in China |
| 收稿日期:2018-05-25 出版日期:2018-10-23 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.10.019 |
| 中文关键词: 空气污染 全因死亡 全因急诊量 短期效应 |
| 英文关键词: Air pollution All-cause mortality All-cause emergency room visits Short-term effects |
| 基金项目:国家自然科学基金重点项目（81230066）；国家自然科学基金（81473043） |
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| 中文摘要: |
| 目的 利用Meta分析定量评价空气中粒径≤ 2.5 μm的颗粒物（PM2.5）短期暴露与我国居民全因死亡和急诊之间的关系。方法 于2018年3月系统检索中国知网、万方数据知识服务平台、PubMed和EMBASE收集相关文献，提取相对危险度（RR）、超额危险度（ER）及其95% CI，根据异质性检验结果，采用固定或随机效应模型对数据进行合并，并对其进行亚组分析、Meta回归和检验发表偏倚。结果 共纳入33篇原始文献，分别利用39组死亡数据和4组急诊量数据进行Meta分析，结果显示，在47.7~176.7 μg/m3的浓度范围内，PM2.5每上升10 μg/m3，居民每日全因死亡增加0.49%（95% CI：0.39%~0.59%），全因急诊量增加0.30%（95% CI：0.10%~0.51%）。对死亡数据的亚组分析显示北方地区（ER=0.42%，95% CI：0.30%~0.54%）合并效应值低于南方地区（ER=0.63%，95% CI：0.44%~0.82%），研究期间PM2.5浓度<75 μg/m3地区的合并效应值（ER=0.50%，95% CI：0.37%~0.62%）高于PM2.5浓度≥ 75 μg/m3的地区（ER=0.39%，95% CI：0.26%~0.52%）。结论 在47.7~176.7 μg/m3的浓度范围内，PM2.5短期暴露可能与全因死亡和急诊量增加有关。 |
| 英文摘要: |
| Objective To carry out a quantitative estimate that related to the effects of short-term exposure to PM2.5 on all-cause mortality and emergency visits in China by using the systematic review and Meta-analysis. Methods We selected all the studies published before March 2018 from China National Knowledge Infrastructure, Wanfang database, PubMed and EMBASE and data on relative risk (RR), excess risk (ER) and their 95% CIs:appeared in these papers were extracted. According to the differences in the size or direction (heterogeneity) of the results, we computed summary estimates of the effect values using a random-effect or fixed effect model. We also conducted the subgroup analysis and Meta-analysis to have assessed the selected studies for the evidence of study bias. Results A total of 33 original studies, indexed in databases, were identified. Among those studies, 39 sets of data on mortality and 4 sets of data on emergency were valid to show that within the daily concentration range from 47.7 to 176.7 μg/m3, for 10 μg/m3 increases in PM2.5 concentrations, it would increase the daily numbers of deaths by 0.49% (95% CI:0.39%-0.59%) and 0.30% (95% CI:0.10%-0.51%) for all-cause deaths and all-cause emergency-room visits, respectively. For subgroup analysis, the combined effect of PM2.5 in causing short-term all-cause deaths in the northern areas (ER=0.42%, 95% CI:0.30%-0.54%) seemed lower than that in the southern areas (ER=0.63%, 95% CI:0.44%-0.82%). The combined effect of PM2.5 concentration below 75 μg/m3 (ER=0.50%, 95% CI:0.37%-0.62%) was higher than that of PM2.5 concentration ≥ 75 μg/m3 (ER=0.39%, 95% CI:0.26%-0.52%). Conclusion Within the concentration range from 47.7 to 176.7 μg/m3, short-term exposure to current level of PM2.5 might increase both the all-cause daily mortality and daily emergency visits in China. |
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