Long-term ozone exposure and mortality.
Long-term ozone exposure and mortality.
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DOI：
10.1056/nejmoa0803894
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发表时间：
2009-03-12
期刊：
影响因子：
--
通讯作者：
Thun M
中科院分区：
文献类型：
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作者：
Jerrett M;Burnett RT;Pope CA 3rd;Ito K;Thurston G;Krewski D;Shi Y;Calle E;Thun M
尽管许多研究将对流层臭氧升高与不利的健康后果联系起来，但长期暴露于臭氧对空气污染相关死亡率的影响仍然不确定。我们研究了臭氧暴露对心肺原因死亡风险的潜在贡献，特别是对呼吸原因死亡的潜在贡献。美国癌症协会癌症预防研究II的研究队列数据与美国96个大都市统计区的空气污染数据相关。分析了448，850名受试者的数据，在18年的随访期内有118，777人死亡。从1977年到2000年，从4月1日到9月30日获得了臭氧日最高浓度的数据。获得了1999年和2000年关于细颗粒物（空气动力学直径≤2.5 μm的颗粒[PM2.5]）浓度的数据。臭氧浓度和死亡风险之间的关联进行了评估与使用标准和多级考克斯回归模型。在单一污染物模型中，PM2.5或臭氧浓度的增加与心肺原因导致的死亡风险增加显著相关。在两种污染物模型中，PM2.5与心血管原因导致的死亡风险相关，而臭氧与呼吸道原因导致的死亡风险相关。与臭氧浓度增加10 ppb相关的呼吸道原因死亡的估计相对风险为1.040（95%置信区间为1.010至1.067）。臭氧与呼吸道疾病死亡风险之间的关联对混杂因素的调整和所用统计模型的类型不敏感。在这项大型研究中，当考虑到PM2.5的浓度时，我们无法检测到臭氧对心血管原因死亡风险的影响。然而，我们确实证明了与臭氧浓度增加相关的呼吸道疾病死亡风险的显着增加。
Although many studies have linked elevations in tropospheric ozone to adverse health outcomes, the effect of long-term exposure to ozone on air pollution–related mortality remains uncertain. We examined the potential contribution of exposure to ozone to the risk of death from cardiopulmonary causes and specifically to death from respiratory causes. Data from the study cohort of the American Cancer Society Cancer Prevention Study II were correlated with air-pollution data from 96 metropolitan statistical areas in the United States. Data were analyzed from 448,850 subjects, with 118,777 deaths in an 18-year follow-up period. Data on daily maximum ozone concentrations were obtained from April 1 to September 30 for the years 1977 through 2000. Data on concentrations of fine particulate matter (particles that are ≤2.5 μm in aerodynamic diameter [PM2.5]) were obtained for the years 1999 and 2000. Associations between ozone concentrations and the risk of death were evaluated with the use of standard and multilevel Cox regression models. In single-pollutant models, increased concentrations of either PM2.5 or ozone were significantly associated with an increased risk of death from cardiopulmonary causes. In two-pollutant models, PM2.5 was associated with the risk of death from cardiovascular causes, whereas ozone was associated with the risk of death from respiratory causes. The estimated relative risk of death from respiratory causes that was associated with an increment in ozone concentration of 10 ppb was 1.040 (95% confidence interval, 1.010 to 1.067). The association of ozone with the risk of death from respiratory causes was insensitive to adjustment for confounders and to the type of statistical model used. In this large study, we were not able to detect an effect of ozone on the risk of death from cardiovascular causes when the concentration of PM2.5 was taken into account. We did, however, demonstrate a significant increase in the risk of death from respiratory causes in association with an increase in ozone concentration.