Associations of fine particulate matter with incident cardiovascular disease; comparing models using ZIP code-level and individual-level fine particulate matter and confounders.
Associations of fine particulate matter with incident cardiovascular disease; comparing models using ZIP code-level and individual-level fine particulate matter and confounders.
复制标题
细颗粒物与心血管疾病的关联；
DOI：
10.1016/j.scitotenv.2024.171866
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Laden,Francine
中科院分区：
文献类型：
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作者：
Klompmaker,JochemO;Hart,JaimeE;Dominici,Francesca;James,Peter;Roscoe,Charlie;Schwartz,Joel;Yanosky,JeffD;Zanobetti,Antonella;Laden,Francine
研究背景PM2.5与心血管疾病（CVD）发病率呈正相关。大多数证据来自队列和行政数据库。队列通常具有关于潜在混杂因素和居民水平暴露的广泛信息。管理数据库通常更具代表性，但通常缺乏关于潜在混杂因素的信息，并且通常仅在较粗糙的地理区域（例如，邮政编码）。在这两种类型的研究的弱点已被批评为潜在的危害其研究结果的有效性为regulatory purpose.MethodsWe以下101，870参与者从美国的护士健康研究（2000-2016）和链接的住宅级PM2.5和个人级混杂因素，和邮政编码级PM2.5和混杂因素。我们使用随时间变化的考克斯比例风险模型来研究与CVD发病率的关系。我们指定的基本模型（调整个人水平的年龄，种族和日历年），个人水平的混杂模型，和邮政编码水平的混杂models.ResultsResidential和邮政编码水平的PM2.5强相关（Pearsonr= 0.88）。对于居民水平PM2.5，基础模型中每增加5 μg/m3的风险比（HR，95%置信区间）为1.06（1.01，1.11），个体水平混杂模型中为1.04（0.99，1.10）。对于邮政编码水平的PM2.5，HR每5 μg/m3为1.04（0.99，1.08）在基本和1.02（0.97，1.08）在邮政编码水平的混淆model.ConclusionWe观察到提示性的积极，但没有统计学意义，长期PM2.5和CVD发病率之间的关联，无论暴露或混淆模型。尽管差异很小，但与个人水平混杂因素和居民水平PM2.5的模型的关联略强于与邮政编码水平混杂因素和PM2.5的模型的关联。
BackgroundPM2.5has been positively associated with cardiovascular disease (CVD) incidence. Most evidence has come from cohorts and administrative databases. Cohorts typically have extensive information on potential confounders and residential-level exposures. Administrative databases are usually more representative but typically lack information on potential confounders and often only have exposures at coarser geographies (e.g., ZIP code). The weaknesses in both types of studies have been criticized for potentially jeopardizing the validity of their findings for regulatory purposes.MethodsWe followed 101,870 participants from the US-based Nurses' Health Study (2000–2016) and linked residential-level PM2.5and individual-level confounders, and ZIP code-level PM2.5and confounders. We used time-varying Cox proportional hazards models to examine associations with CVD incidence. We specified basic models (adjusted for individual-level age, race and calendar year), individual-level confounder models, and ZIP code-level confounder models.ResultsResidential- and ZIP code-level PM2.5were strongly correlated (Pearsonr= 0.88). For residential-level PM2.5, the hazard ratio (HR, 95 % confidence interval) per 5 μg/m3increase was 1.06 (1.01, 1.11) in the basic and 1.04 (0.99, 1.10) in the individual-level confounder model. For ZIP code-level PM2.5, the HR per 5 μg/m3was 1.04 (0.99, 1.08) in the basic and 1.02 (0.97, 1.08) in the ZIP code-level confounder model.ConclusionWe observed suggestive positive, but not statistically significant, associations between long-term PM2.5and CVD incidence, regardless of the exposure or confounding model. Although differences were small, associations from models with individual-level confounders and residential-level PM2.5were slightly stronger than associations from models with ZIP code-level confounders and PM2.5.