Ozone and short-term mortality in 95 US urban communities, 1987-2000
Ozone and short-term mortality in 95 US urban communities, 1987-2000
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DOI：
10.1001/jama.292.19.2372
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发表时间：
2004-11-17
影响因子：
120.7
通讯作者：
Dominici, F
中科院分区：
文献类型：
--
作者：
Bell, ML;McDermott, A;Dominici, F
背景臭氧与各种不良健康影响有关，包括住院率增加和呼吸道疾病加重。虽然大量的时间序列研究已经估计了臭氧水平每天的变化和死亡计数之间的关系，但结果还没有确定。目的调查短期(每日和每周)暴露在环境臭氧中是否与美国的死亡率相关。设计和设置使用为国家发病率、死亡率和空气污染研究开发的分析方法和数据库，我们估计了1987-2000年间美国95个大型城市社区与短期暴露于环境臭氧有关的全国平均相对死亡率。我们使用分布式滞后模型来估计经时变混杂因素(颗粒物、天气、季节性和长期趋势)调整后的社区特定相对死亡率，并使用分层模型合并社区间的相对死亡率来估计全国平均相对死亡率，同时考虑到空间异质性。主要结果衡量在14年期间美国95个大型社区的总非伤害相关死亡率以及心血管和呼吸系统死亡率的每日计数。结果前一周臭氧浓度增加10 ppb与每日死亡率增加0.52%(95%后间隔[PI]，心血管和呼吸系统死亡率增加0.64%(95%PI，0.31%-0.98%)。对前一周臭氧总量的影响估计比只考虑一天暴露的模型要大。这些结果对颗粒物、天气、季节性和长期趋势的调整是稳健的。结论这些结果表明，美国95个大型城市社区的臭氧短期变化与平均死亡率之间存在统计上的显著关联，这些社区约占美国总人口的40%。研究结果表明，这种广泛存在的污染物对公众健康造成了不利影响。
Context Ozone has been associated with various adverse health effects, including increased rates of hospital admissions and exacerbation of respiratory illnesses. Although numerous time-series studies have estimated associations between day-today variation in ozone levels and mortality counts, results have been inconclusive.Objective To investigate whether short-term (daily and weekly) exposure to ambient ozone is associated with mortality in the United States.Design and Setting Using analytical methods and databases developed for the National Morbidity, Mortality, and Air Pollution Study, we estimated a national average relative rate of mortality associated with short-term exposure to ambient ozone for 95 large US urban communities from 1987-2000. We used distributed-lag models for estimating community-specific relative rates of mortality adjusted for time-varying confounders (particulate matter, weather, seasonality, and long-term trends) and hierarchical models for combining relative rates across communities to estimate a national average relative rate, taking into account spatial heterogeneity.Main Outcome Measure Daily counts of total non-injury-related mortality and cardiovascular and respiratory mortality in 95 large US communities during a 14-year period.Results A 10-ppb increase in the previous week's ozone was associated with a 0.52% increase in daily mortality (95% posterior interval [PI], 0.27%-0.77%) and a 0.64% increase in cardiovascular and respiratory mortality (95% PI, 0.31%-0.98%). Effect estimates for aggregate ozone during the previous week were larger than for models considering only a single day's exposure. Results were robust to adjustment for particulate matter, weather, seasonality, and long-term trends.Conclusions These results indicate a statistically significant association between short-term changes in ozone and mortality on average for 95 large US urban communities, which include about 40% of the total US population. The findings indicate that this widespread pollutant adversely affects public health.