Long-Term PM2.5 Exposure and Respiratory, Cancer, and Cardiovascular Mortality in Older US Adults
Long-Term PM2.5 Exposure and Respiratory, Cancer, and Cardiovascular Mortality in Older US Adults
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DOI：
10.1093/aje/kwx166
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发表时间：
2017-10-15
影响因子：
5
通讯作者：
Suh, Helen H.
中科院分区：
文献类型：
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作者：
Pun, Vivian C.;Kazemiparkouhi, Fatemeh;Suh, Helen H.
长期接触细颗粒物（空气动力学直径小于或等于2.5 μ m的颗粒物（PM2.5））对呼吸系统疾病和肺癌死亡率的影响知之甚少。在2000年至2008年期间居住在美国本土的1890万名医疗保险受益人（420万人死亡）中，我们研究了慢性PM2.5暴露与特定原因死亡率之间的关联。我们通过调整邻里行为协变量和分解PM2.5到2个时空尺度评估混杂。我们发现12个月移动平均PM2.5暴露（每增加10 μ g/m3）与呼吸系统疾病、慢性阻塞性肺病和肺炎死亡率显著正相关，风险比范围为1.10至1.24。我们还发现，PM2.5显著增加了心血管和肺癌死亡率的风险。风险比率通常随着移动平均线的延长而增加;例如，60个月移动平均PM（2.）5次暴露与肺癌死亡风险的1.33倍（95%置信区间：1.24，1.40）相关，而12个月移动平均暴露与肺癌死亡风险的1.13倍（95%置信区间：1.11，1.15）相关。在多变量模型中观察到的相关性是稳健的，尽管仍存在未测量的混杂证据。在这个大型的美国老年人队列中，我们提供了重要的新证据，表明长期PM2.5暴露与呼吸系统疾病、肺癌和心血管疾病的死亡率增加显著相关。
The impact of chronic exposure to fine particulate matter (particulate matter with an aerodynamic diameter less than or equal to 2.5 mu m (PM2.5)) on respiratory disease and lung cancer mortality is poorly understood. In a cohort of 18.9 million Medicare beneficiaries (4.2 million deaths) living across the conterminous United States between 2000 and 2008, we examined the association between chronic PM2.5 exposure and cause-specific mortality. We evaluated confounding through adjustment for neighborhood behavioral covariates and decomposition of PM2.5 into 2 spatiotemporal scales. We found significantly positive associations of 12-month moving average PM2.5 exposures (per 10-mu g/m(3) increase) with respiratory, chronic obstructive pulmonary disease, and pneumonia mortality, with risk ratios ranging from 1.10 to 1.24. We also found significant PM2.5-associated elevated risks for cardiovascular and lung cancer mortality. Risk ratios generally increased with longer moving averages; for example, an elevation in 60-month moving average PM(2.)5 exposures was linked to 1.33 times the lung cancer mortality risk (95% confidence interval: 1.24, 1.40), as compared with 1.13 (95% confidence interval: 1.11, 1.15) for 12-month moving average exposures. Observed associations were robust in multivariable models, although evidence of unmeasured confounding remained. In this large cohort of US elderly, we provide important new evidence that long-term PM2.5 exposure is significantly related to increased mortality from respiratory disease, lung cancer, and cardiovascular disease.