短期暴露于周围空气污染和哮喘死亡率的影响
2019/07/11
摘要
理由：短期暴露于空气污染与哮喘的急性加重和哮喘引起的医疗保健使用增加有关，但其对哮喘死亡率的影响仍不清楚。
目的：定量评估短期暴露于空气污染与哮喘死亡率之间的关系。
方法：对2013年至2018年在中国湖北省生活并死于哮喘的4454名患者进行调查。采用病例交叉设计和条件逻辑回归模型进行数据分析。采用反距离加权平均值计算距离每个病例家庭50千米以内所有监测站点的PM2.5(空气动力学直径≤2.5微米)、PM10、二氧化硫（SO2）、二氧化氮（NO2）、一氧化碳（CO）和臭氧（O3）的暴露量。
测量和主要结果：PM2.5(lag 3; IQR:47.1 µg/m3)、NO2(lag 03; IQR: 26.3 µg/m3)、O3（lag 3; IQR: 52.9 µg/m3）的四分位间距（IQR）增加与哮喘的死亡率呈正相关，比值比（ORS）分别为1.07（95%置信区间：1.01-1.12）、1.11(95%置信区间：1.01-1.22)和1.09（95%置信区间：1.01-1.18）。没有证据表明这些关联偏离线性。对其他污染物的进一步校正并没有改变这种关联。我们并没有观察到PM10、SO2、CO暴露与哮喘死亡率之间的显著相关性。总的来说，各种敏感性分析的计算值保持一致。
结论：我们的研究结果提供了新的证据：短期暴露与PM2.5、NO2和O3可能增加哮喘的死亡风险。需要在其他人群中进一步证实我们的结果。
Short-Term Exposure to Ambient Air Pollution and Asthma Mortality.
Liu Y, Pan J, Zhang H, Shi C, Li G, Peng Z, Ma J, Zhou Y, Zhang L.
Abstract
Rationale:Short-term exposure to air pollution has been associated with asthma exacerbation and increased healthcare use caused by asthma, but its effect on asthma mortality remains largely unknown.
Objectives:To quantitatively assess the association between short-term exposure to air pollution and asthma mortality.
Methods:We investigated 4,454 individuals who lived in Hubei province, China, and died from asthma between 2013 and 2018. A case-crossover design and conditional logistic regression models were applied for data analyses. Exposures to particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5), particulate matter ≤10 μm in aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were estimated by inverse distance weighted averages of all monitoring stations within 50 km from each case's home address.
Measurements and Main Results:Each interquartile range (IQR) increase of PM2.5 (lag 3; IQR, 47.1 μg/m3), NO2 (lag 03; IQR, 26.3 μg/m3), and O3 (lag 3; IQR, 52.9 μg/m3) were positively associated with asthma mortality, with odds ratios of 1.07 (95% confidence interval, 1.01-1.12), 1.11 (95% confidence interval, 1.01-1.22), and 1.09 (95% confidence interval, 1.01-1.18), respectively. There was no evidence of departure from linearity for these associations. Further adjustment for other pollutants did not change the associations materially. We did not observe significant associations between PM10, SO2, and CO exposures and asthma mortality. Overall, the estimates remained consistent in various sensitivity analyses.
Conclusions:Our results provide new evidence that short-term exposures to PM2.5, NO2, and O3 may increase asthma mortality risk. Further studies are needed to confirm our findings in other populations.
理由：短期暴露于空气污染与哮喘的急性加重和哮喘引起的医疗保健使用增加有关，但其对哮喘死亡率的影响仍不清楚。
目的：定量评估短期暴露于空气污染与哮喘死亡率之间的关系。
方法：对2013年至2018年在中国湖北省生活并死于哮喘的4454名患者进行调查。采用病例交叉设计和条件逻辑回归模型进行数据分析。采用反距离加权平均值计算距离每个病例家庭50千米以内所有监测站点的PM2.5(空气动力学直径≤2.5微米)、PM10、二氧化硫（SO2）、二氧化氮（NO2）、一氧化碳（CO）和臭氧（O3）的暴露量。
测量和主要结果：PM2.5(lag 3; IQR:47.1 µg/m3)、NO2(lag 03; IQR: 26.3 µg/m3)、O3（lag 3; IQR: 52.9 µg/m3）的四分位间距（IQR）增加与哮喘的死亡率呈正相关，比值比（ORS）分别为1.07（95%置信区间：1.01-1.12）、1.11(95%置信区间：1.01-1.22)和1.09（95%置信区间：1.01-1.18）。没有证据表明这些关联偏离线性。对其他污染物的进一步校正并没有改变这种关联。我们并没有观察到PM10、SO2、CO暴露与哮喘死亡率之间的显著相关性。总的来说，各种敏感性分析的计算值保持一致。
结论：我们的研究结果提供了新的证据：短期暴露与PM2.5、NO2和O3可能增加哮喘的死亡风险。需要在其他人群中进一步证实我们的结果。
(中日友好医院呼吸与危重症医学科 张清 摘译 林江涛 审校)
(Am J Respir Crit Care Med. 2019 Jul 1;200(1):24-32.)
(Am J Respir Crit Care Med. 2019 Jul 1;200(1):24-32.)
Short-Term Exposure to Ambient Air Pollution and Asthma Mortality.
Liu Y, Pan J, Zhang H, Shi C, Li G, Peng Z, Ma J, Zhou Y, Zhang L.
Abstract
Rationale:Short-term exposure to air pollution has been associated with asthma exacerbation and increased healthcare use caused by asthma, but its effect on asthma mortality remains largely unknown.
Objectives:To quantitatively assess the association between short-term exposure to air pollution and asthma mortality.
Methods:We investigated 4,454 individuals who lived in Hubei province, China, and died from asthma between 2013 and 2018. A case-crossover design and conditional logistic regression models were applied for data analyses. Exposures to particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5), particulate matter ≤10 μm in aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were estimated by inverse distance weighted averages of all monitoring stations within 50 km from each case's home address.
Measurements and Main Results:Each interquartile range (IQR) increase of PM2.5 (lag 3; IQR, 47.1 μg/m3), NO2 (lag 03; IQR, 26.3 μg/m3), and O3 (lag 3; IQR, 52.9 μg/m3) were positively associated with asthma mortality, with odds ratios of 1.07 (95% confidence interval, 1.01-1.12), 1.11 (95% confidence interval, 1.01-1.22), and 1.09 (95% confidence interval, 1.01-1.18), respectively. There was no evidence of departure from linearity for these associations. Further adjustment for other pollutants did not change the associations materially. We did not observe significant associations between PM10, SO2, and CO exposures and asthma mortality. Overall, the estimates remained consistent in various sensitivity analyses.
Conclusions:Our results provide new evidence that short-term exposures to PM2.5, NO2, and O3 may increase asthma mortality risk. Further studies are needed to confirm our findings in other populations.
上一篇：
确诊为中度及重度哮喘前血清中IL-5，IL-6，IL-8，IL-13和IL-17A水平的变化
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哮喘缓解的病理生理学研究进展
