Years of life lost from ischaemic and haemorrhagic stroke related to ambient nitrogen dioxide exposure: A multicity study in China.
Years of life lost from ischaemic and haemorrhagic stroke related to ambient nitrogen dioxide exposure: A multicity study in China.
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DOI：
10.1016/j.ecoenv.2020.111018
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发表时间：
2020-10-15
影响因子：
6.8
通讯作者：
Li G
中科院分区：
文献类型：
--
作者：
Li J;Huang J;Wang Y;Yin P;Wang L;Liu Y;Pan X;Zhou M;Li G
在发展中国家进行的几项多城市研究，以区分环境二氧化氮（NO2）对不同亚型中风的寿命损失年数（YLL）的急性影响。我们的目的是区分NO2暴露与YLL与中国中风主要病理类型之间的关联，并估计相关的经济损失。在中国48个城市进行了一项时间序列研究，以探讨2013年至2017年短期NO2暴露与缺血性和出血性卒中YLL之间的关系。每个城市的每日NO2数据和脑卒中死亡人数分别来自国家城市空气质量实时发布平台和中国疾病预防控制中心。应用广义加性模型估计每个城市NO2的累积效应，并使用荟萃分析将城市特定估计值进行联合收割机合并。相关经济损失采用每统计生命年价值（VSLY）法估算。当天和前一天（滞后0-1）环境NO2浓度增加10 μg/m3，缺血性脑卒中的YLL变化百分比（0.82%，95%CI：0.46%，1.19%）的增量相对高于出血性脑卒中（0.46%，95%CI：0.09%，0.84%）。与高学历人群相比，低学历人群与缺血性卒中的相关性显著更强。此外，中国南方与两种卒中亚型的相关性显著高于中国北方。与NO2暴露相关的缺血性卒中因YLL过多而造成的经济损失高于出血性卒中。我们的研究表明，在中国，与NO2暴露相关的缺血性卒中的相关性和经济损失高于出血性卒中，这为与NO2污染和弱势人群保护相关的特定类型卒中预防策略的优先事项提供了信息。
Few multicity studies have been conducted in developing countries to distinguish the acute effects of ambient nitrogen dioxide (NO2) on the years of life lost (YLL) from different subtypes of stroke. We aimed to differentiate the associations between NO2 exposure and YLL from major pathological types of stroke in China, and estimate the relevant economic loss. A time-series study was conducted to explore the associations between short-term NO2 exposure and YLL from ischaemic and haemorrhagic stroke from 2013 to 2017 in 48 Chinese cities. Daily NO2 data and stroke mortality counts for each city were obtained from the National Urban Air Quality Real-time Publishing Platform and Chinese Center for Disease Control and Prevention, respectively. Generalized additive models were applied to estimate the cumulative effects of NO2 in each city, and meta-analysis was used to combine the city-specific estimates. The relevant economic loss was estimated using the method of the value per statistical life year (VSLY). A 10 μg/m3 increase in ambient NO2 concentration on the present day and previous day (lag 0–1) would lead to relatively higher increments in percentage change of YLL from ischaemic stroke (0.82%, 95% CI: 0.46%, 1.19%) than haemorrhagic stroke (0.46%, 95% CI: 0.09%, 0.84%). The association was significantly stronger in the low-education population than high-education population for ischaemic stroke. Furthermore, significantly higher association was found in South China than those in North China for both subtypes of stroke. Economic loss due to excess YLL from ischaemic stroke related to NO2 exposure was higher than that for haemorrhagic stroke. Our study indicated higher association and economic loss of ischaemic than haemorrhagic stroke related to NO2 exposure in China, which informed priorities for type-specific stroke prevention strategies related to NO2 pollution and vulnerable population protection.
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DOI：
10.1136/bmj.f7139
发表时间：
2013-12-09
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Guo Y;Li S;Tian Z;Pan X;Zhang J;Williams G
通讯作者：
Williams G
影响因子：
2
作者：
Gasparrini, A.;Armstrong, B.;Kenward, M. G.
通讯作者：
Kenward, M. G.
中国空气污染防治行动计划对健康的影响：全国空气质量监测和死亡率数据分析。
影响因子：
25.7
作者：
Huang, Jing;Pan, Xiaochuan;Li, Guoxing
通讯作者：
Li, Guoxing
影响因子：
8.3
作者：
Hong, YC;Lee, JT;Kwon, HJ
通讯作者：
Kwon, HJ
影响因子：
8.3
作者：
Huang, Jing;Li, Guoxing;Guo, Xinbiao
通讯作者：
Guo, Xinbiao