美国空气污染混合物年度暴露与哮喘住院率的关联性
2025/10/11
摘要
背景：空气污染物对所有年龄段人群的哮喘急性发作均存在不良影响。然而，目前较少研究关注长期暴露于颗粒物成分与二氧化氮（NO2）和臭氧（O3）混合物的综合效应。本研究采用加权分位数和回归方法，评估了15种颗粒物成分（包括有机化合物和金属物质）与NO₂、O₃的混合暴露对0-18岁儿童及19-64岁成人哮喘住院人数的累积效应。
方法：我们针对两个年龄组分别建立加权分位数和回归模型，权重约束在0至1之间且总和为1，设置十分位数q=10，并进行100次 Bootstrap 抽样。
结果：哮喘住院数据收集自2002年至2016年间美国11个州的住院数据库，同时纳入气温变量和美国人口普查的社会经济指标。所有变量均聚合至年度邮政编码层级。研究发现：污染物混合物浓度每增加一个十分位数，0-18岁儿童群体的哮喘年住院人数增加10.6%（95%置信区间10.0-11.2%），19-64岁成人群体增加8.0%（95%置信区间7.7-8.4%）。其中镍、钒、硫酸盐、硝酸盐、溴和铵盐对该关联性的权重贡献最大。
结论：长期暴露于污染物混合物会显著增加儿童和成人的哮喘住院风险，未来需通过每日颗粒物成分监测数据来评估短期暴露效应。
Association of Annual Exposure to Air Pollution Mixture on Asthma Hospitalizations in the United States
Vu BN, Amini H, Qiu X, Feng Y, Wei Y, Schwartz J
Abstract
BACKGROUND:Air pollutants have adverse effects on asthma exacerbation in people of all ages. However, fewer studies have examined long-term exposure to particle components in conjunction with nitrogen dioxide (NO2) and ozone (O3) to assess their mixture effects. We used weighted quantile sum regression to assess the cumulative effects of 15 particle components, including organic compounds and metals, together with NO2 and O3, on counts of inpatient asthma hospitalizations for children 0-18 years of age and adults 19-64 years of age.
METHODS:We conducted two separate weighted quantile sum models for each age group, with weights constrained between 0 and 1 while summing up to 1, q = 10 deciles, and 100 bootstrap samples.
RESULTS:Inpatient records for asthma hospitalizations from 2002 to 2016 were collected from 11 U.S. state inpatient databases. We also included temperature and variables from the U.S. census to control for socioeconomic status. All variables were aggregated to the annual ZIP code level. We observed an increase of 10.6% (95% confidence interval, 10.0%～11.2%) and 8.0% (95% confidence interval, 7.7%～8.4%) in the number of asthma inpatient hospitalizations each year for each decile increase of the pollutant mixture in children 0-18 years of age and adults 19-64 years of age, respectively. Nickel, vanadium, sulfate, nitrate, bromine, and ammonium contributed the most weight to the association found.
CONCLUSION:Our results indicate that long-term exposure to pollutant mixtures is associated with increased risk of asthma hospitalization in both children and adults, and daily measurements of particle components data are needed to assess short-term exposure.
背景：空气污染物对所有年龄段人群的哮喘急性发作均存在不良影响。然而，目前较少研究关注长期暴露于颗粒物成分与二氧化氮（NO2）和臭氧（O3）混合物的综合效应。本研究采用加权分位数和回归方法，评估了15种颗粒物成分（包括有机化合物和金属物质）与NO₂、O₃的混合暴露对0-18岁儿童及19-64岁成人哮喘住院人数的累积效应。
方法：我们针对两个年龄组分别建立加权分位数和回归模型，权重约束在0至1之间且总和为1，设置十分位数q=10，并进行100次 Bootstrap 抽样。
结果：哮喘住院数据收集自2002年至2016年间美国11个州的住院数据库，同时纳入气温变量和美国人口普查的社会经济指标。所有变量均聚合至年度邮政编码层级。研究发现：污染物混合物浓度每增加一个十分位数，0-18岁儿童群体的哮喘年住院人数增加10.6%（95%置信区间10.0-11.2%），19-64岁成人群体增加8.0%（95%置信区间7.7-8.4%）。其中镍、钒、硫酸盐、硝酸盐、溴和铵盐对该关联性的权重贡献最大。
结论：长期暴露于污染物混合物会显著增加儿童和成人的哮喘住院风险，未来需通过每日颗粒物成分监测数据来评估短期暴露效应。
（中日友好医院呼吸与危重症医学科 沈焜路 摘译林江涛 审校）
（Am J Respir Crit Care Med. 2025 Sep; DOI: 10.1164/rccm.202409-1853OC）
Association of Annual Exposure to Air Pollution Mixture on Asthma Hospitalizations in the United States
Vu BN, Amini H, Qiu X, Feng Y, Wei Y, Schwartz J
Abstract
BACKGROUND:Air pollutants have adverse effects on asthma exacerbation in people of all ages. However, fewer studies have examined long-term exposure to particle components in conjunction with nitrogen dioxide (NO2) and ozone (O3) to assess their mixture effects. We used weighted quantile sum regression to assess the cumulative effects of 15 particle components, including organic compounds and metals, together with NO2 and O3, on counts of inpatient asthma hospitalizations for children 0-18 years of age and adults 19-64 years of age.
METHODS:We conducted two separate weighted quantile sum models for each age group, with weights constrained between 0 and 1 while summing up to 1, q = 10 deciles, and 100 bootstrap samples.
RESULTS:Inpatient records for asthma hospitalizations from 2002 to 2016 were collected from 11 U.S. state inpatient databases. We also included temperature and variables from the U.S. census to control for socioeconomic status. All variables were aggregated to the annual ZIP code level. We observed an increase of 10.6% (95% confidence interval, 10.0%～11.2%) and 8.0% (95% confidence interval, 7.7%～8.4%) in the number of asthma inpatient hospitalizations each year for each decile increase of the pollutant mixture in children 0-18 years of age and adults 19-64 years of age, respectively. Nickel, vanadium, sulfate, nitrate, bromine, and ammonium contributed the most weight to the association found.
CONCLUSION:Our results indicate that long-term exposure to pollutant mixtures is associated with increased risk of asthma hospitalization in both children and adults, and daily measurements of particle components data are needed to assess short-term exposure.
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