Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project
Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project
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DOI：
10.1016/s0140-6736(13)62158-3
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发表时间：
2014-03-01
期刊：
影响因子：
168.9
通讯作者：
Hoek, Gerard
中科院分区：
文献类型：
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作者：
Beelen, Rob;Raaschou-Nielsen, Ole;Hoek, Gerard
欧洲关于长期暴露于空气污染和死亡率的研究很少。在多中心的欧洲队列研究空气污染的影响（ESCAPE），我们的目的是调查自然原因的死亡率和长期暴露于几种空气pollutants.Methods之间的关联，我们使用的数据从22个欧洲队列研究，创造了一个总的研究人口367 251名参与者。所有队列均为一般人群样本，尽管有些队列仅限于一种性别。根据严格标准化的协议，我们评估了住宅对空气污染物的暴露，即直径小于2.5 μ m的颗粒物（PM）的年平均浓度PM2.5以下、PM10以下、10 - 2.5 μ m（PMcoarse）、PM2.5吸光度和氮氧化物（NO2和NOx）的年平均浓度，以及土地利用回归模型。我们还调查了两个交通强度变量最近的道路上的交通强度（车辆每天）和总的交通负荷在100米缓冲区内的所有主要道路。我们使用混杂因素模型（增加对混杂因素变量的调整）和考克斯比例风险模型（采用共同方案）进行队列特异性统计分析。我们获得了汇总效果估计通过随机效应荟萃analysis.Findings-总研究人群包括367 251名参与者谁贡献了5 118 039人年的风险（平均随访13.9年），其中29 076人死于自然原因在随访期间。记录到PM2.5的风险比（HR）显著增加，为1.07（95%CI 1.02-1.13）/5 μ g/m3。个体队列效应估计值之间未观察到异质性（I-2 p值=0.95）。即使我们只包括暴露于低于欧洲年平均限值25 μ g/m的污染物浓度的参与者，PM2.5的HR仍然显着升高（3）（风险比1.06，95%置信区间1.00-1.12）或低于20微克/立方米（3）（1.07，1.01-1.13）.解释长期暴露于细颗粒空气污染与自然原因死亡率有关，即使在远低于目前欧洲年平均限值的浓度范围内。
Background Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants.Methods We used data from 22 European cohort studies, which created a total study population of 367 251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2.5 mu m (PM2.5), less than 10 mu m (PM10), and between 10 mu m and 2.5 mu m (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOx), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buff er. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta-analysis.Findings The total study population consisted of 367 251 participants who contributed 5 118 039 person-years at risk (average follow-up 13.9 years), of whom 29 076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2.5 of 1.07 (95% CI 1.02-1.13) per 5 mu g/m(3) was recorded. No heterogeneity was noted between individual cohort effect estimates (I-2 p value=0.95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 mu g/m(3) (HR 1.06, 95% CI 1.00-1.12) or below 20 mu g/m(3) (1.07, 1.01-1.13).Interpretation Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value.