每小时环境空气污染物暴露与哮喘急诊就诊风险:一项多中心时间分层病例交叉分析
2024/02/23
摘要
背景：暴露于每日的环境空气污染物与哮喘发病率和死亡率的风险增加相关。然而，每小时水平的空气污染暴露与哮喘急诊就诊风险之间的关联仍不清楚。
方法：我们进行了时间分层的病例交叉设计，纳入了2016年1月1日至2021年9月30日期间来自中国浙江省3个城市11家医院的共计121,112例哮喘急诊科就诊患者。采用条件logistic回归结合分布滞后线性模型，在调整了气象因素和公共假期后，评估每小时细颗粒物(PM2.5)、可吸入颗粒物(PM10)、二氧化氮(NO2)、二氧化硫(SO2)、臭氧(O3)和一氧化碳(CO)暴露与哮喘急诊科就诊的关联。
结果：PM2.5、PM10、NO2、SO2和CO的每小时暴露与哮喘急诊就诊风险增加相关。这一关联在暴露的同时小时(滞后0小时)最为明显，在3-12小时期间迅速减弱，之后减弱。在0-72 h内，空气污染物的四分位间距每增加一个，哮喘急诊就诊的风险增加7.0%(95% CI: 5.4%， 8.6%)，M10为6.7% (95% CI: 5.1%，8.2%)，NO2为18.1%(95% CI: 15.4%，21.0%)，SO2为6.5%(95% CI: 4.8%，8.2%)，CO为7.4%(95% CI: 5.6%，9.1%)。
结论：我们的研究结果提示，PM2.5、PM10、NO2、SO2和CO每小时暴露与暴露后不久因哮喘到急诊就诊的风险增加相关，但与O3无关。
Exposure to hourly ambient air pollutants and risk of emergency department visits for asthma: A multicenter time-stratified case-crossover analysis
K. Yuan, Y. C. Zhang, X. Lv, W. N. Cao, Z. Y. Zhang, L. Z. Wu, et al.
Abstract
BACKGROUND:Exposure to daily ambient air pollutants has been linked with increased risk of asthma morbidity and mortality. However, the association between exposure to air pollution and risk of emergency department (ED) visits for asthma on an hourly level remains unclear.
METHODS:We conducted a time-stratified case-crossover design and included a total of 121,112 asthma ED visits from 11 hospitals in three cities located in Zhejiang province, China, between January 1, 2016 and September 30, 2021. We used conditional logistic regressions combined with a distributed lag linear model to estimate the association between risk of asthma ED visits and hourly exposure to fine particulate matter (PM2.5), respirable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) after adjusted for meteorological factors and public holiday.
RESULTS:Hourly exposure to PM2.5, PM10, NO2, SO2, and CO was associated with an increased risk of asthma ED visits. This association was most pronounced in the concurrent hour of exposure (lag 0 h), rapidly attenuated over a period of 3-12 h, and diminished thereafter. Each interquartile range increase in air pollutant over 0-72 h was associated with increased risk of asthma ED visits by 7.0% (95% confidence interval [CI]: 5.4%, 8.6%) for PM2.5, 6.7% (95% CI: 5.1%, 8.2%) for PM10, 18.1% (95% CI: 15.4%, 21.0%) for NO2, 6.5% (95% CI: 4.8%, 8.2%) for SO2, and 7.4% (95% CI: 5.6%, 9.1%) for CO.
CONCLUSION:Our findings suggest that hourly exposure to PM2.5, PM10, NO2, SO2, and CO, but not O3, is associated with increased risk of ED visits for asthma shortly after exposure.
背景：暴露于每日的环境空气污染物与哮喘发病率和死亡率的风险增加相关。然而，每小时水平的空气污染暴露与哮喘急诊就诊风险之间的关联仍不清楚。
方法：我们进行了时间分层的病例交叉设计，纳入了2016年1月1日至2021年9月30日期间来自中国浙江省3个城市11家医院的共计121,112例哮喘急诊科就诊患者。采用条件logistic回归结合分布滞后线性模型，在调整了气象因素和公共假期后，评估每小时细颗粒物(PM2.5)、可吸入颗粒物(PM10)、二氧化氮(NO2)、二氧化硫(SO2)、臭氧(O3)和一氧化碳(CO)暴露与哮喘急诊科就诊的关联。
结果：PM2.5、PM10、NO2、SO2和CO的每小时暴露与哮喘急诊就诊风险增加相关。这一关联在暴露的同时小时(滞后0小时)最为明显，在3-12小时期间迅速减弱，之后减弱。在0-72 h内，空气污染物的四分位间距每增加一个，哮喘急诊就诊的风险增加7.0%(95% CI: 5.4%， 8.6%)，M10为6.7% (95% CI: 5.1%，8.2%)，NO2为18.1%(95% CI: 15.4%，21.0%)，SO2为6.5%(95% CI: 4.8%，8.2%)，CO为7.4%(95% CI: 5.6%，9.1%)。
结论：我们的研究结果提示，PM2.5、PM10、NO2、SO2和CO每小时暴露与暴露后不久因哮喘到急诊就诊的风险增加相关，但与O3无关。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（Atmospheric Environment 2024 Vol. 319 DOI: ARTN 12030710.1016/j.atmosenv.2023.120307）
（Atmospheric Environment 2024 Vol. 319 DOI: ARTN 12030710.1016/j.atmosenv.2023.120307）
Exposure to hourly ambient air pollutants and risk of emergency department visits for asthma: A multicenter time-stratified case-crossover analysis
K. Yuan, Y. C. Zhang, X. Lv, W. N. Cao, Z. Y. Zhang, L. Z. Wu, et al.
Abstract
BACKGROUND:Exposure to daily ambient air pollutants has been linked with increased risk of asthma morbidity and mortality. However, the association between exposure to air pollution and risk of emergency department (ED) visits for asthma on an hourly level remains unclear.
METHODS:We conducted a time-stratified case-crossover design and included a total of 121,112 asthma ED visits from 11 hospitals in three cities located in Zhejiang province, China, between January 1, 2016 and September 30, 2021. We used conditional logistic regressions combined with a distributed lag linear model to estimate the association between risk of asthma ED visits and hourly exposure to fine particulate matter (PM2.5), respirable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) after adjusted for meteorological factors and public holiday.
RESULTS:Hourly exposure to PM2.5, PM10, NO2, SO2, and CO was associated with an increased risk of asthma ED visits. This association was most pronounced in the concurrent hour of exposure (lag 0 h), rapidly attenuated over a period of 3-12 h, and diminished thereafter. Each interquartile range increase in air pollutant over 0-72 h was associated with increased risk of asthma ED visits by 7.0% (95% confidence interval [CI]: 5.4%, 8.6%) for PM2.5, 6.7% (95% CI: 5.1%, 8.2%) for PM10, 18.1% (95% CI: 15.4%, 21.0%) for NO2, 6.5% (95% CI: 4.8%, 8.2%) for SO2, and 7.4% (95% CI: 5.6%, 9.1%) for CO.
CONCLUSION:Our findings suggest that hourly exposure to PM2.5, PM10, NO2, SO2, and CO, but not O3, is associated with increased risk of ED visits for asthma shortly after exposure.
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衰弱与慢性阻塞性肺病或哮喘之间的因果关系：双向孟德尔随机抽样研究
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母亲罹患哮喘的婴幼儿的呼出气一氧化氮与空气污染物之间相关性分析
