PARTICULATE AIR-POLLUTION AS A PREDICTOR OF MORTALITY IN A PROSPECTIVE-STUDY OF US ADULTS
PARTICULATE AIR-POLLUTION AS A PREDICTOR OF MORTALITY IN A PROSPECTIVE-STUDY OF US ADULTS
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DOI：
10.1164/ajrccm/151.3_pt_1.669
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发表时间：
1995-03-01
影响因子：
24.7
通讯作者：
HEATH, CW
中科院分区：
文献类型：
--
作者：
POPE, CA;THUN, MJ;HEATH, CW
时间序列、横断面和前瞻性队列研究已经观察到死亡率和颗粒物空气污染之间的关联，但受到生态设计或少数受试者或研究区域的限制。本研究使用来自许多研究地区的大量队列数据来评估颗粒物空气污染对死亡率的影响。我们将1980年美国151个大都会地区的环境空气污染数据与1982年参加一项前瞻性研究时居住在这些地区的552,138名成年人的个人风险因素联系起来。死亡人数已确定至1989年12月。根据国家数据库估算了主要来自化石燃料燃烧的硫酸盐和细颗粒物空气污染。通过控制吸烟、教育程度和其他危险因素的多变量分析，研究了空气污染与各种原因、肺癌和心肺死亡率的关系。虽然与吸烟相比，死亡率较小，但观察到了死亡率和颗粒物空气污染之间的联系。在使用硫酸盐和细颗粒物措施时，污染最严重的地区与污染最轻的地区相比，调整后的全因死亡的相对风险比(95%可信区间)分别为1.15(1.09至1.22)和1.17(1.09至1.26)。颗粒物空气污染与心肺和肺癌死亡率有关，但与其他原因的死亡率无关。死亡率的增加与硫酸盐和细颗粒物空气污染有关，这种污染在美国城市中很常见。风险的增加不能归因于吸烟，尽管不能肯定地排除其他未经测量的污染相关性。
Time-series, cross-sectional, and prospective cohort studies have observed associations between mortality and particulate air pollution but have been limited by ecologic design or small number of subjects or study areas. The present study evaluates effects of particulate air pollution on mortality using data from a large cohort drawn from many study areas. We linked ambient air pollution data from 151 U.S. metropolitan areas in 1980 with individual risk factor on 552,138 adults who resided in these areas when enrolled in a prospective study in 1982. Deaths were ascertained through December, 1989. Exposure to sulfate and fine particulate air pollution, which is primarily from fossil fuel combustion, was estimated from national data bases. The relationships of air pollution to all-cause, lung cancer, and cardiopulmonary mortality was examined using multivariate analysis which controlled for smoking, education, and other risk factors. Although small compared with cigarette smoking, an association between mortality and particulate air pollution was observed. Adjusted relative risk ratios (and 95% confidence intervals) of all-cause mortality for the most polluted areas compared with the least polluted equaled 1.15 (1.09 to 1.22) and 1.17 (1.09 to 1.26) when using sulfate and fine particulate measures respectively. Particulate air pollution was associated with cardiopulmonary and lung cancer mortality but not with mortality due to other causes. Increased mortality is associated with sulfate and fine particulate air pollution at levels commonly found in U.S. cities. The increase in risk is not attributable to tobacco smoking, although other unmeasured correlates of pollution cannot be excluded with certainty.