Investigation of association between smoke haze and under-five mortality in Malaysia, accounting for time lag, duration and intensity
Investigation of association between smoke haze and under-five mortality in Malaysia, accounting for time lag, duration and intensity
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调查马来西亚烟霾与五岁以下儿童死亡率之间的关联，考虑时间滞后、持续时间和强度
DOI：
10.1093/ije/dyab100
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发表时间：
2021
影响因子：
7.7
通讯作者：
Takano Hirohisa
中科院分区：
文献类型：
--
作者：
Phung Vera Ling Hui;Ueda Kayo;Sahani Mazrura;Seposo Xerxes Tesoro;Wan Mahiyuddin Wan Rozita;Honda Akiko;Takano Hirohisa
背景近年来，由于极端天气条件和植被火灾的增加，关于烟雾和有害健康影响之间关系的研究有所增加。5岁以下儿童(U5岁以下儿童)可能受到的健康不良影响尤其令人担忧，因为他们的状况很脆弱。尽管东南亚不断发生严重雾霾事件，但该区域的流行病学研究仍然很少。此外，还没有研究同时考察三个重要方面(时间滞后、持续时间和强度)的相关性。目的本研究旨在检验马来西亚雾霾与U5Y死亡率之间的关联，考虑暴露的时滞、持续时间和强度。方法我们使用广义相加模型进行时间分层病例交叉研究，以检验马来西亚12个地区2014至2016年与雾霾相关的U5Y死亡率。雾霾日的特征是强度[基于颗粒物(PM)的浓度]和持续时间(雾霾发生的连续性，最长可达3 天)。结果我们观察到强度为3的滞后4的U5Y死亡率的优势比(OR)最高，但不显著。滞后模式揭示了雾霾持续和加强时敏锐度更高的可能性。根据PM分布的第95个百分位数对这些地区进行分层，在强度-2持续时间-3[OR：1.210(95%可信区间：1.000，1.464)]中，“低”类别显示边缘正相关。结论我们发现雾霾与U5Y死亡率之间没有关联。在不同的持续时间和强度上观察到的关联的不同滞后模式表明在未来的研究中考虑这些方面。
BackgroundStudies on the association between smoke haze (hereafter ‘haze’) and adverse health effects have increased in recent years due to extreme weather conditions and the increased occurrence of vegetation fires. The possible adverse health effects on under-five children (U5Y) is especially worrying due to their vulnerable condition. Despite continuous repetition of serious haze occurrence in Southeast Asia, epidemiological studies in this region remained scarce. Furthermore, no study had examined the association accounting for three important aspects (time lag, duration and intensity) concurrently.ObjectiveThis study aimed to examine the association between haze and U5Y mortality in Malaysia, considering time lag, duration and intensity of exposure.MethodsWe performed a time-stratified case-crossover study using a generalized additive model to examine the U5Y mortality related to haze in 12 districts in Malaysia, spanning from 2014 to 2016. A ‘haze day’ was characterized by intensity [based on concentrations of particulate matter (PM)] and duration (continuity of haze occurrence, up to 3 days).ResultsWe observed the highest but non-significant odds ratios (ORs) of U5Y mortality at lag 4 of Intensity-3. Lag patterns revealed the possibility of higher acuteness at prolonged and intensified haze. Stratifying the districts by the 95th-percentile of PM distribution, the ‘low’ category demonstrated marginal positive association at Intensity-2 Duration-3 [OR: 1.210 (95% confidence interval: 1.000, 1.464)].ConclusionsWe found a null association between haze and U5Y mortality. The different lag patterns of the association observed over different duration and intensity suggest consideration of these aspects in future studies.