中国颗粒物污染与哮喘死亡率：2015-2020年间全国时间分层病例交叉研究
2022/11/22
摘要
背景：短期暴露于亚微米颗粒物(PM1)污染与哮喘死亡率之间的关系缺乏全国性和综合性的评估。
方法：收集2015年至2020年中国全国死亡监测系统中29,553例哮喘死亡病例的资料。我们使用双线性插值法，根据每个参与者的地理编码居住地址、来自中国高空气污染物的10公里×10公里网格和欧洲第五代再分析-土地再分析数据集，估计了每个参与者每天的环境颗粒物污染和气象变量暴露。使用时间分层病例交叉设计和条件Logistic回归分析来评估这些相关性。
结果：我们的结果显示，短期暴露于各种颗粒物与哮喘死亡率之间存在显著的相关性。颗粒物暴露的5日移动平均值产生了最明显的影响。与细颗粒物(PM2.5)和可吸入颗粒物(PM10)相比，PM1污染对哮喘死亡率的影响明显更大。与PM1 (IQR: 19.2 μg/m3)暴露量增加相关的哮喘死亡率ERs%为5.59% (95% CI: 2.11-9.19)，分别比PM2.5 (IQR: 32.0 μg/m3, 4.82% (95% CI: 1.84-7.90)和PM10 (IQR: 52.2 μg/m3, 4.37% (95% CI: 1.16-7.69)高14%和22%。在各种敏感性分析中，估计值保持一致。
结论：我们的研究提供了全国性的证据，即急性暴露于各种环境颗粒物污染可以增加中国因哮喘而导致的死亡率，强调了其与环境PM1比PM2.5和PM10具有更强的相关性。中国迫切需要调整现行环境空气质量标准，更加重视PM1对健康的不利影响。
Particulate matter pollution and asthma mortality in China: A nationwide time-stratified case-crossover study from 2015 to 2020
Liu W, Wei J, Cai M, Qian Z,
Abstrast
Background: A national and comprehensive evaluation is lacking on the relationship between short-term exposure to submicron particulate matter (PM1) pollution and asthma mortality.
Methods: Data was obtained from 29,553 asthma deaths from the China National Mortality Surveillance System from 2015 to 2020. We used a bilinear interpolation approach to estimate each participant's daily ambient particulate matter pollution and meteorological variables exposure based on their geocoded residential address and a 10 km × 10 km grid from China High Air Pollutants and the fifth generation of European ReAnalysis-Land reanalysis data set. The associations were estimated using a time-stratified case-crossover design and conditional logistic regressions.
Results: Our results revealed significant associations between short-term exposure to various particulate matter and asthma mortality. The 5-day moving average of particulate matter exposure produced the most pronounced effect. Compared to fine particulate matter (PM2.5) and inhalable particulate matter (PM10), significantly stronger effects on asthma mortality related to PM1 pollution were noted. The ERs% for asthma mortality associated with each interquartile range (IQR) increase of exposures to PM1 (IQR: 19.2 μg/m3) was 5.59% (95% CI: 2.11-9.19), which is 14% and 22% higher than that for PM2.5 (IQR: 32.0 μg/m3, 4.82% (95% CI: 1.84-7.90)) and PM10 (IQR: 52.2 μg/m3, 4.37% (95% CI: 1.16-7.69)), respectively. The estimates remained consistent in various sensitivity analyses.
Conclusions: Our study provided national evidence that acute exposures to various ambient particulate matter pollution can increase mortality due to asthma in China, highlighting stronger associations with ambient PM1 than PM2.5 and PM10. China needs to adjust the current ambient air quality standards urgently and pay greater attention to the adverse health effects of PM1.
背景：短期暴露于亚微米颗粒物(PM1)污染与哮喘死亡率之间的关系缺乏全国性和综合性的评估。
方法：收集2015年至2020年中国全国死亡监测系统中29,553例哮喘死亡病例的资料。我们使用双线性插值法，根据每个参与者的地理编码居住地址、来自中国高空气污染物的10公里×10公里网格和欧洲第五代再分析-土地再分析数据集，估计了每个参与者每天的环境颗粒物污染和气象变量暴露。使用时间分层病例交叉设计和条件Logistic回归分析来评估这些相关性。
结果：我们的结果显示，短期暴露于各种颗粒物与哮喘死亡率之间存在显著的相关性。颗粒物暴露的5日移动平均值产生了最明显的影响。与细颗粒物(PM2.5)和可吸入颗粒物(PM10)相比，PM1污染对哮喘死亡率的影响明显更大。与PM1 (IQR: 19.2 μg/m3)暴露量增加相关的哮喘死亡率ERs%为5.59% (95% CI: 2.11-9.19)，分别比PM2.5 (IQR: 32.0 μg/m3, 4.82% (95% CI: 1.84-7.90)和PM10 (IQR: 52.2 μg/m3, 4.37% (95% CI: 1.16-7.69)高14%和22%。在各种敏感性分析中，估计值保持一致。
结论：我们的研究提供了全国性的证据，即急性暴露于各种环境颗粒物污染可以增加中国因哮喘而导致的死亡率，强调了其与环境PM1比PM2.5和PM10具有更强的相关性。中国迫切需要调整现行环境空气质量标准，更加重视PM1对健康的不利影响。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(Chemosphere. 2022 Dec;308(Pt 2):136316.doi: 10.1016/j.chemosphere.2022.136316. Epub 2022 Sep 6.IF: 5.778)
(Chemosphere. 2022 Dec;308(Pt 2):136316.doi: 10.1016/j.chemosphere.2022.136316. Epub 2022 Sep 6.IF: 5.778)
Particulate matter pollution and asthma mortality in China: A nationwide time-stratified case-crossover study from 2015 to 2020
Liu W, Wei J, Cai M, Qian Z,
Abstrast
Background: A national and comprehensive evaluation is lacking on the relationship between short-term exposure to submicron particulate matter (PM1) pollution and asthma mortality.
Methods: Data was obtained from 29,553 asthma deaths from the China National Mortality Surveillance System from 2015 to 2020. We used a bilinear interpolation approach to estimate each participant's daily ambient particulate matter pollution and meteorological variables exposure based on their geocoded residential address and a 10 km × 10 km grid from China High Air Pollutants and the fifth generation of European ReAnalysis-Land reanalysis data set. The associations were estimated using a time-stratified case-crossover design and conditional logistic regressions.
Results: Our results revealed significant associations between short-term exposure to various particulate matter and asthma mortality. The 5-day moving average of particulate matter exposure produced the most pronounced effect. Compared to fine particulate matter (PM2.5) and inhalable particulate matter (PM10), significantly stronger effects on asthma mortality related to PM1 pollution were noted. The ERs% for asthma mortality associated with each interquartile range (IQR) increase of exposures to PM1 (IQR: 19.2 μg/m3) was 5.59% (95% CI: 2.11-9.19), which is 14% and 22% higher than that for PM2.5 (IQR: 32.0 μg/m3, 4.82% (95% CI: 1.84-7.90)) and PM10 (IQR: 52.2 μg/m3, 4.37% (95% CI: 1.16-7.69)), respectively. The estimates remained consistent in various sensitivity analyses.
Conclusions: Our study provided national evidence that acute exposures to various ambient particulate matter pollution can increase mortality due to asthma in China, highlighting stronger associations with ambient PM1 than PM2.5 and PM10. China needs to adjust the current ambient air quality standards urgently and pay greater attention to the adverse health effects of PM1.
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极端温度引发的哮喘:从流行病学证据到生物学合理性
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儿童血液嗜酸性粒细胞与过敏性疾病症状:中国南方的一项横断面研究
