挥发性有机化合物与人群卒中死亡风险的关联研究

杨斯茹; 黄琳; 董航; 刘迪; 杨周; 陈素娟; 林国桢; 王伯光; 杨军

Abstract

杨斯茹,黄琳,董航,刘迪,杨周,陈素娟,林国桢,王伯光,杨军.挥发性有机化合物与人群卒中死亡风险的关联研究[J].Chinese journal of Epidemiology,2023,44(8):1216-1223

挥发性有机化合物与人群卒中死亡风险的关联研究

Association between volatile organic compounds and mortality risk of stroke

Received:October 31, 2022

DOI：10.3760/cma.j.cn112338-20221031-00930

KeyWord: 挥发性有机化合物卒中死亡敏感人群季节效应时间序列

English Key Word: Volatile organic compounds Stroke Mortality Vulnerable population Seasonal effect Time-series

FundProject:国家自然科学基金青年基金（82003552）；广东省基础与应用基础研究基金（2020A1515011161）

Author Name	Affiliation	E-mail
Yang Siru	School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
Huang Lin	Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
Dong Hang	Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Liu Di	School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
Yang Zhou	School of Public Health, Southern Medical University, Guangzhou 510515, China
Chen Sujuan	Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
Lin Guozhen	Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Wang Boguang	Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China	tbongue@jnu.edu.cn
Yang Jun	School of Public Health, Guangzhou Medical University, Guangzhou 511436, China	yangjun@gzhmu.edu.cn

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Abstract:

目的探讨广州市大气中挥发性有机化合物(VOCs)暴露对卒中逐日死亡风险的影响。方法通过收集广州市2020-2021年12种大气中VOCs逐日平均浓度、气象因素,卒中及其亚型(包括缺血性卒中和出血性卒中)死亡数据,采用时间序列的Poisson回归广义相加模型分析不同滞后天数空气中VOCs日平均浓度与卒中逐日死亡之间的关系,并对季节、卒中死亡人群的性别及年龄进行亚组分析。结果甲苯和正戊烷对卒中及其亚型的死亡风险更高:在累积滞后0~1 d,滑动平均浓度甲苯每增加1个四分位距(IQR),发生卒中及出血性卒中死亡的RR值分别为1.060(95%CI:1.036~1.085)、1.071(95%CI:1.030~1.113);正戊烷每增加1个IQR的浓度,发生缺血性卒中死亡的RR值为1.064(95%CI:1.030~1.099)。冷季、女性和 ≥ 75岁的人群可能更易受VOCs的影响,滑动平均浓度甲苯每增加1个IQR的浓度,冷季和女性卒中死亡风险RR值分别为1.099(95%CI:1.056~1.143)、1.085(95%CI:1.050~1.120);正戊烷每增加1个IQR的浓度, ≥ 75岁的人群发生卒中死亡风险RR值为1.072(95%CI:1.036~1.109)。敏感性分析结果显示,当大气细颗粒物和臭氧进行双污染物模型分析以及改变自由度后,结果波动较小。结论 VOCs可能为卒中人群逐日死亡人数的独立危险因素,而甲苯对健康影响最大。

English Abstract:

Objective To investigate the effect of volatile organic compounds (VOCs) exposure in the atmosphere on the risk of daily death from stroke in Guangzhou. Methods Daily average concentrations of twelve atmospheric VOCs, meteorological factors, and daily deaths for stroke and its subtypes (including ischemic and hemorrhagic stroke) in Guangzhou from 2020 to 2021 were collected. The time-series Poisson generalized additive model was established to analyze the relationship between daily average concentrations of atmospheric VOCs and daily mortality from a stroke on different lag days. The season, gender, and age group further performed stratification analysis. Results Toluene and n-pentane were associated with a higher mortality risk from stroke and its subtypes. For each interquartile range (IQR) increment in toluene concentration at lag0-1 days, the RRs for mortality from stroke and hemorrhagic stroke were 1.060 (95%CI:1.036-1.085) and 1.071 (95%CI:1.030-1.113), respectively. For each IQR increment in n-pentane concentration, the RR for mortality from ischemic stroke was 1.064 (95%CI:1.030-1.099). The effect estimates of VOCs may be higher during the cold season and among women and people aged ≥ 75 years. For each IQR increment in toluene concentration, the RRs for mortality risk of stroke in the cold season and women were 1.099 (95%CI:1.056-1.143) and 1.085 (95%CI:1.050-1.120), respectively. For n-pentane, the RR for death risk of stroke in people aged ≥ 75 years old was 1.072 (95%CI:1.036-1.109). Results of sensitivity analysis showed that the effect estimates fluctuated less when PM_2.5 and O₃ were separately introduced for the two-pollutant model, as well as changing the degrees of freedom for covariates. Conclusions This study suggests that VOCs may be an independent risk factor for daily mortality from stroke. Moreover, Toluene presented the most significant health impact.

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