Short-term exposures to PM2.5 and cause-specific mortality of cardiovascular health in China
Short-term exposures to PM2.5 and cause-specific mortality of cardiovascular health in China
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DOI：
10.1016/j.envres.2017.10.046
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发表时间：
2018-02-01
影响因子：
8.3
通讯作者：
Li, Tiantian
中科院分区：
文献类型：
--
作者：
Chen, Chen;Zhu, Pengfei;Li, Tiantian
背景资料：许多多中心流行病学研究已经有力地研究了发达国家暴露于低浓度细颗粒物（PM2.5）对心血管死亡率的急性健康影响。然而，数据的局限性导致在PM2.5暴露水平高的发展中国家进行的相关研究很少。近年来，我国心血管疾病负担较重的人群暴露于特别高浓度的PM2.5中。目的：我们进行了一项多县时间序列研究，调查PM2.5对中国心血管疾病死亡风险增加的急性效应，并探讨PM2.5暴露的易感亚群。应用中国30个县的特定泊松回归，我们估计了2013-2015年PM2.5对心血管健康全因死亡率和死因特异性死亡率的影响。我们还考虑了PM2.5对几个亚群的影响，包括男性、女性和三个年龄组（< 65岁、65-74岁和> 74岁）。我们使用随机效应荟萃分析按病因和亚群汇总了中国各地的特定结果。我们发现0.13%（95%置信区间（CI），0.04-0.22）全因死亡率增加0.12%（95% CI，0.001-0.25）心血管疾病（CVD）增加，0.42%（95% CI，0.03-0.81）AMI增加，0.17%（95%CI，-0.04-0.40）冠心病增加，0.13%（95%CI，- 0.12-0.33）同一天PM2.5浓度增加10 μ g/m3时卒中发生率增加。相关性的程度低于PM2.5水平较低的发达国家。一个脆弱的影响，全因死亡率在老年人口（65岁以上）和CVD在masculos.Conclusions：这项研究表明，积极的幅度PM2.5的影响，高暴露在所有的自然，心血管疾病，和特定原因的死亡率和易感人群在中国。这些发现补充了全球范围内短期暴露于PM2.5的高端的死亡率-死亡率关系的证据。
Background: Many multi-center epidemiological studies have robustly examined the acute health effects of exposure to low concentrations of fine particulate matter (PM2.5) on cardiovascular mortality in developed counties. However, data limitations have resulted in few related studies being conducted in developing counties with high levels of PM2.5 exposure. In recent years, people in China with a heavy cardiovascular disease burden have been exposed to particularly high levels of PM2.5.Objective: We conducted a multi-county time series study investigating the acute effects of PM2.5 on the increased risk of cardiovascular death across China, and explored subpopulations susceptible to PM2.5 exposure.Methods: Appling a county-specific Poisson regression in 30 Chinese counties, we estimated PM2.5 effects on all cause mortality and cause-specific mortality of cardiovascular health for 2013-2015. We also considered PM2.5 effects on several subpopulations, including males, females, and three age groups (< 65, 65-74 and > 74 years old). We pooled the county-specific results across China using a random effects meta-analysis by cause and by subpopulation.Results: We found a 0.13% (95% confidence interval (CI), 0.04-0.22) increase in all-cause mortality, a 0.12% increase (95% CI, 0.001-0.25) increase in cardiovascular disease (CVD), a 0.42% (95% CI, 0.03-0.81) increase in AMI, a 0.17% (95% CI,- 0.04-0.40) increase in coronary heart disease, and a 0.13% (95% CI,- 0.12-0.33) increase in stroke in association with a 10-mu g/m(3) increase in PM2.5 concentrations on the same day. The magnitudes of the associations were less than those reported in developed counties with lower PM2.5 levels. A vulnerable effect on all-cause mortality was observed in the elderly population (older than 65 years) and on CVD in males.Conclusions: This study showed the positive magnitude of PM2.5 effects with high exposure on all natural, CVD, and cause-specific mortality and on the susceptible populations in China. The findings complemented evidence related to exposure-mortality relationships at the higher end of short-term exposure to PM2.5 on a global scale.