Robust relationship between air quality and infant mortality in Africa
Robust relationship between air quality and infant mortality in Africa
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DOI：
10.1038/s41586-018-0263-3
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发表时间：
2018-07-12
期刊：
影响因子：
64.8
通讯作者：
Burke, Marshall
中科院分区：
文献类型：
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作者：
Heft-Neal, Sam;Burney, Jennifer;Burke, Marshall
空气质量差被认为是全球重要的死亡风险因素（1-3），但发展中国家几乎没有直接证据表明死亡风险如何随环境颗粒物暴露的变化而变化。目前的全球估计采用了大多来自富裕的中纬度国家的空间人口数据的确定性-反应关系（4），这些估计在地球仪的大部分地区仍然没有得到验证。在这里，我们结合了基于联合收割机的撒哈拉以南非洲地区近100万新生儿出生地点和时间的家庭调查信息，以及基于卫星的空气动力学直径小于2.5 μ m（PM2.5）的环境可吸入颗粒物暴露估计值，以估计空气质量对非洲婴儿死亡率的影响。我们发现，PM2.5浓度每增加10 μ g m（-3），整个数据集的婴儿死亡率就会增加9%（95%置信区间，4-14%）。这种影响在过去15年中没有减弱，也没有随着家庭财富水平的提高而减弱。我们的估计表明，PM2.5浓度高于最低暴露水平是22%的原因。（95%置信区间，9-35%）的婴儿死亡率，导致449，000（95%置信区间，194，000 - 709，000）2015年婴儿死亡人数增加，这一估计比现有的将婴儿死亡归因于这些国家空气质量差的估计高出三倍以上（2，6）。仅在非洲被研究国家，向上修正疾病负担估计数就将导致目前全球与空气污染有关的婴儿死亡估计数翻一番，预计非洲PM2.5暴露的适度减少对婴儿的健康益处大于大多数已知的健康干预措施。
Poor air quality is thought to be an important mortality risk factor globally(1-3), but there is little direct evidence from the developing world on how mortality risk varies with changing exposure to ambient particulate matter. Current global estimates apply exposure-response relationships that have been derived mostly from wealthy, mid-latitude countries to spatial population data(4), and these estimates remain unvalidated across large portions of the globe. Here we combine household survey-based information on the location and timing of nearly 1 million births across sub-Saharan Africa with satellite-based estimates(5) of exposure to ambient respirable particulate matter with an aerodynamic diameter less than 2.5 mu m (PM2.5) to estimate the impact of air quality on mortality rates among infants in Africa. We find that a 10 mu g m(-3) increase in PM2.5 concentration is associated with a 9% (95% confidence interval, 4-14%) rise in infant mortality across the dataset. This effect has not declined over the last 15 years and does not diminish with higher levels of household wealth. Our estimates suggest that PM2.5 concentrations above minimum exposure levels were responsible for 22% (95% confidence interval, 9-35%) of infant deaths in our 30 study countries and led to 449,000 (95% confidence interval, 194,000-709,000) additional deaths of infants in 2015, an estimate that is more than three times higher than existing estimates that attribute death of infants to poor air quality for these countries(2,6). Upward revision of disease-burden estimates in the studied countries in Africa alone would result in a doubling of current estimates of global deaths of infants that are associated with air pollution, and modest reductions in African PM2.5 exposures are predicted to have health benefits to infants that are larger than most known health interventions.