Does deprivation index modify the acute effect of black smoke on cardiorespiratory mortality?
Does deprivation index modify the acute effect of black smoke on cardiorespiratory mortality?
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DOI：
10.1136/oem.2008.044602
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发表时间：
2010-02-01
影响因子：
4.9
通讯作者：
Agius, R. M.
中科院分区：
文献类型：
--
作者：
Carder, M.;McNamee, R.;Agius, R. M.
目的探讨剥夺指数是否修正了黑烟对心肺疾病死亡率的急性效应。方法采用广义线性泊松回归模型，对1981年1月至2001年12月苏格兰两个最大城市(格拉斯哥和爱丁堡)的剥夺指数(以卡斯特拉斯剥夺指数衡量)是否修正了黑烟对死亡率的急性效应。结果剥夺指数显著地改变了黑烟对死亡率的影响，且随着剥夺程度的增加，黑烟对死亡率的影响也随之增加。假设黑烟(µg/m(-3))与剥夺对死亡率的影响呈线性交互作用的参数模型的交互作用系数--相当于对卡斯泰尔分类的“线性趋势”的检验--对所有死亡率结果都具有重要意义。在其中针对每个剥夺类别独立地估计黑烟影响的模型中，在接下来的1个月中，平均黑烟浓度每增加10微克/立方米，呼吸死亡率估计增加8.0%(95%CI 5.1至10.9)，而居住在最贫困类别(Carstalle7级)的受试者的呼吸系统死亡率增加3.7%(95%CI-0.7至8.4)。结论黑烟对生活在更贫困地区的人的死亡率有更强的影响。对呼吸道死亡率的影响最大，尽管其他组也有明显的趋势。如果得到证实，这些发现可能会对公共卫生产生重要影响。
Objectives To investigate whether deprivation index modifies the acute effect of black smoke on cardiorespiratory mortality.Methods Generalised linear Poisson regression models were used to investigate whether deprivation index (as measured by the Carstairs deprivation index) modified the acute effect of black smoke on mortality in two largest Scottish cities (Glasgow and Edinburgh) between January 1981 and December 2001. Lag periods of up to 1 month were assumed for the effects of black smoke.Results Deprivation index significantly modified the effect of black smoke on mortality, with black smoke effects generally increasing as level of deprivation increased. The interaction coefficient from a parametric model assuming a linear interaction between black smoke (mu g/m(-3)) and deprivation in their effect on mortality-equivalent to a test of `linear trend' across Carstairs categories-was significant for all mortality outcomes. In a model where black smoke effects were estimated independently for each deprivation category, the estimated increase in respiratory mortality over the ensuing 1-month period associated with a 10 mu g/m(3) increase in the mean black smoke concentration was 8.0% (95% Cl 5.1 to 10.9) for subjects residing in the `most' deprived category (Carstairs category 7) compared to 3.7% (95% Cl - 0.7 to 8.4) for subjects residing in the `least' deprived category (Carstairs category 1).Conclusions The results suggest a stronger effect of black smoke on mortality among people living in more deprived areas. The effect was greatest for respiratory mortality, although significant trends were also seen for other groups. If corroborated, these findings could have important public health implications.