The burden of ischemic heart disease related to ambient air pollution exposure in a coastal city in South China
The burden of ischemic heart disease related to ambient air pollution exposure in a coastal city in South China
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DOI：
10.1016/j.envres.2018.02.033
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发表时间：
2018-07-01
影响因子：
8.3
通讯作者：
Guo, Xinbiao
中科院分区：
文献类型：
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作者：
Huang, Jing;Li, Guoxing;Guo, Xinbiao
目的：空气污染被认为是缺血性心脏病（IHD）最重要的危险因素之一，这是一个主要的公共卫生问题。在过去的二十年里，IHD的疾病负担在中国持续上升。然而，在中国，研究空气污染与IHD之间关系的流行病学研究很少，唯一的研究是在空气污染严重的地区进行的，那里的空气污染水平严重超过世界卫生组织空气质量指南。在空气污染水平相对较低的地区，空气污染对IHD的影响是否与在研究较多的地区的高污染水平的影响不同，到目前为止还不清楚。此外，与空气污染相关的IHD疾病负担的估计非常有限。方法：我们进行了一项时间序列研究，基于2011年至2015年中国南方沿海城市宁波10 322例IHD死亡，使用寿命损失年数（YLL）指标估计环境空气污染对IHD的短期负担。细颗粒物（PM2.5）、二氧化硫（SO2）和二氧化氮（NO2）的平均浓度分别为49.58 μ g/m3、21.34 μ g/m3和43.41 μ g/m3。PM2.5、SO2和NO2每增加10 μ g/m3分别与0.71（95%CI：-0.21，1.64）、3.31（95%CI：0.78，5.84）和2.27（95%CI：0.26，4.28）年的YLL变化相关。气体污染物的影响比PM2.5相对更强。一个更大的增长YLL被发现在年轻的人口比在老年人口的NO2暴露。此外，估计的影响SO2和NO2的YLL男性高于女性。SO2暴露与丧偶组YLL呈正相关。结论：研究结果强调了严格控制空气污染的重要性，特别是气态污染物。此外，使用YLL指标，考虑到不同年龄段的死亡发生率，为资源分配和保护弱势群体提供了更多信息。
Objective: Air pollution is considered one of the most important risk factors for ischemic heart disease (IHD), which is a major public health concern. The disease burden of IHD has continued to rise in China in the past two decades. However, epidemiological studies examining the associations between air pollution and IHD have been scarce in China, and the only studies were conducted in severe air pollution areas, where air pollution levels seriously exceed the World Health Organization Air Quality Guidelines. Whether the influence of air pollution on IHD in areas with relatively low levels of air pollution differs from the influence of high pollution levels in heavily studied areas was unknown until now. Furthermore, the estimation of the disease burden of IHD related to air pollution has been very limited.Methods: We conducted a time-series study to estimate the short-term burden of ambient air pollution on IHD using the indicator of years of life lost (YLL), based on 10 322 IHD deaths from 2011 to 2015 in Ningbo, a coastal city in South China.Results: The mean concentrations of fine particle (PM2.5), sulfur dioxide (SO2) and nitrogen dioxide (NO2) were 49.58 mu g/m(3), 21.34 mu g/m(3) and 43.41 mu g/m(3), respectively. A 10 mu g/m(3) increase in PM2.5, SO2 and NO2 was associated with changes in YLL of 0.71 (95%CI: - 0.21,1.64), 3.31 (95%CI: 0.78, 5.84), and 2.27 (95%CI: 0.26, 4.28) years, respectively. Relatively stronger impacts were found for gaseous pollutants than PM2.5. A larger increase in YLL was found in the younger population than in the older population for NO2 exposure. In addition, estimations of the effects of SO2 and NO2 on YLL were higher for males than females. SO2 exposure was positively associated with YLL in widowed group.Conclusions: The findings highlighted the importance of stringent air pollution control, especially for gaseous pollutants. Furthermore, using the indicator of YLL, considering the occurrence of death at different ages, provided more information for resource allocation and protection of vulnerable populations.