| 张奕,陈力,蒋家诺,马涛,刘婕妤,袁雯,郭桐君,陈曼曼,王若琳,董彦会,宋逸,马军.大气污染物PM2.5及其组分暴露与中国9~18岁儿童青少年心理困扰的关联研究[J].中华流行病学杂志,2023,44(10):1575-1582 |
| 大气污染物PM2.5及其组分暴露与中国9~18岁儿童青少年心理困扰的关联研究 |
| Research on the association between ambient PM2.5 and its components and psychological distress among Chinese children and adolescents aged 9-18 years |
| 收稿日期:2023-05-04 出版日期:2023-10-12 |
| DOI：10.3760/cma.j.cn112338-20230504-00276 |
| 中文关键词: 空气污染 细颗粒物 心理困扰 儿童 青少年 |
| 英文关键词: Air pollution Particular matters Psychological distress Children Adolescents |
| 基金项目:全国学生体质与健康调研 |
| 作者 | 单位 | E-mail | | 张奕 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 陈力 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 蒋家诺 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 马涛 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 刘婕妤 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 袁雯 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 郭桐君 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 陈曼曼 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 王若琳 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 董彦会 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 宋逸 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | | | 马军 | 北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191 | majunt@bjmu.edu.cn |
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| 中文摘要: |
| 目的 分析中国9~18岁在校儿童青少年暴露于大气污染物PM2.5及其组分［硫酸盐（SO42-）、硝酸盐（NO3-）、铵盐（NH4+）、有机物（OM）、黑碳（BC）］与心理困扰的关联。方法 基于2019年全国学生体质与健康调研数据，纳入130 808名9~18岁儿童青少年，根据凯斯勒心理困扰量表（K10）进行评分和判定高心理困扰，根据调查地点和时间匹配污染物年均暴露数据，采用基于logistic回归的限制性立方样条方法对PM2.5、SO42-、NO3-、NH4+、OM及BC组分浓度和心理困扰关联进行拟合；采用多因素logistic回归模型对不同年龄、性别、BMI和身体活动亚组进行分析，估计不同亚组暴露于高污染浓度污染物和高心理困扰的关联。结果 我国儿童青少年高心理困扰率为30.4%，女生高心理困扰率高于男生，分别为31.6%和29.1%，差异有统计学意义（P<0.05）。暴露于PM2.5、SO42-、NO3-、OM和中国9~18岁儿童青少年高心理困扰存在非线性正向关联，当PM2.5、NO3-、NH4+、OM和BC浓度较高时，随着浓度继续上升，高心理困扰发生风险的增加有所减缓甚至达到平台期；而SO42-则表现为较低浓度时，心理困扰风险变化不大，但浓度较高时，风险持续上升。PM2.5及其组分暴露和体力活动不足组心理困扰有统计学关联，和体力活动充足组无统计学关联；与13~15岁、16~18岁学生相比，9~12岁学生中，高浓度污染物和高心理困扰关联更强。结论 大气污染物PM2.5及其组分与我国9~18岁儿童青少年心理困扰相关，在体力活动不足的儿童青少年中，高污染物暴露是高心理困扰的危险因素，且PM2.5及其组分和心理困扰的关联存在年龄差异。 |
| 英文摘要: |
| Objective To analyze the association between exposure to ambient PM2.5 and its components [sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), organic matter (OM), and black carbon (BC)] and psychological distress among school children and adolescents aged 9 to 18 years in China. Methods Based on data from the 2019 Chinese National Survey on Students' Constitution and Health, 130 808 children and adolescents aged 9 to 18 years were included. Scoring and determination of higher psychological distress were based on the Kessler Psychological Distress Scale (K10), and annual average exposure data for air pollution were matched by survey location and time. We used a restricted cubic spline approach based on logistic regression to fit the associations between PM2.5, SO42-, NO3-, NH4+, organic matter, black carbon concentrations, and psychological distress. Logistic regression models were used to analyse different age, gender, BMI and physical activity subgroups to estimate the association between exposure to high levels of pollution and high levels of psychological distress in different subgroups. Results The proportion of children and adolescents with high levels of psychological distress in China was 30.4%, with girls being higher than boys at 31.6% and 29.1%, respectively (P<0.05). A non-linear positive association existed between exposure to PM2.5, SO42-, NO3- and organic matter concentrations and higher psychological distress. As PM2.5, NO3-, NH4+, organic matter, and black carbon concentrations continued to rise, the increase in the risk of higher psychological distress slowed, while SO42- showed little change in the OR of psychological distress at lower concentrations but continued to rise at higher concentrations. PM2.5 and its components were statistically associated with psychological distress in the physically inactive group but not in the physically active group. The association between high levels of pollutants and high psychological distress was stronger among students aged 9 to 12 years compared with students aged 13 to 15 years and 16 to 18 years. Conclusions The ambient pollutant PM2.5 and its components are associated with psychological distress in children and adolescents aged 9 to 18 years in China. High pollutant exposure is a risk factor for high psychological distress among physically inactive children and adolescents, and there are age differences in the association between PM2.5 and components and psychological distress. |
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