AIR-POLLUTION AND DAILY MORTALITY - A REVIEW AND META ANALYSIS
AIR-POLLUTION AND DAILY MORTALITY - A REVIEW AND META ANALYSIS
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DOI：
10.1006/enrs.1994.1005
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发表时间：
1994-01-01
影响因子：
8.3
通讯作者：
SCHWARTZ, J
中科院分区：
文献类型：
--
作者：
SCHWARTZ, J
1952年发生在伦敦的空气污染灾难表明，高浓度的颗粒烟雾会导致每日死亡率急剧上升。最近，在低得多的颗粒浓度下进行的十几项研究报告了证据，表明暴露于较低水平的空气传播颗粒导致每日死亡率的增加较小，但非零。这些研究在荟萃分析中进行了检查。荟萃分析的主要焦点是检查潜在混杂因素水平及其与空气颗粒浓度相关性之间的巨大差异的效应量估计。在初步荟萃分析中，空气颗粒物浓度是死亡率升高的重要危险因素（RR = 1.06，95%CI = 1.05-1.07）。TSP浓度增加100 μg/m3时，相对风险为。虽然在所有地点，死亡率在寒冷的月份达到峰值，但在大多数研究中，空气中颗粒物浓度在温暖的月份最高，这表明季节性模式不是观察到的关联的原因。当分析仅限于夏季峰值污染的城市时，相对危险度为1.06（95%CI = 1.05-1.07）。年气温高于平均气温的城市和气候较冷的城市的相对风险相同。在更干燥和更潮湿的气候中也是相同的，并且在温度和空气中颗粒物浓度之间的广泛相关性中也是相似的。这些结果表明，不充分的天气控制是不负责的协会。对费城数据的详细研究表明，对季节和天气的控制足以从死亡率数据中去除所有长期的季节和亚季节模式，并且对天气因素使用非常灵活的非线性拟合不会干扰与TSP的关联。对这种结果模式最合理的解释是，这种关联是因果关系。这得到了其他研究的支持，这些研究报告说，颗粒空气污染与肺功能缺陷，症状增加和住院治疗增加有关。
The air pollution disaster in London in 1952 established that very high levels of particulate-based smog can cause dramatic increases in daily mortality. Recently, more than a dozen studies at much lower particle concentrations have reported evidence that exposure to lower levels of airborne particles results in smaller, but nonzero increases in daily mortality. These studies were examined in a meta-analysis. A primary focus of the meta-analysis was to examine effect size estimates across large differences in both the levels of potential confounding factors and in their correlation with airborne particle concentration. In the primary meta-analysis, airborne particle concentration was a significant risk factor for elevated mortality (RR = 1.06, 95% CI = 1.05-1.07). The relative risk is for a 100 μg/m3increase in TSP concentration. While mortality peaked in the cold months in all locations, in the majority of the studies airborne particle concentrations were highest in the warm months, indicating that seasonal patterns were not responsible for the observed associations. The relative risk was 1.06 (95% CI = 1.05-1.07) when the analysis was restricted to cities with summer peaking pollution. The relative risk was identical in cities with above average annual temperatures and cities with colder climates. It was also identical in drier and more humid climates, and similar across a wide range of correlations between temperature and airborne particle concentrations. These results suggest that inadequate weather control was not responsible for the association. A detailed examination of data from Philadelphia showed that control for season and weather was adequate for removing all long-term seasonal and subseasonal patterns from the mortality data, and that using a very flexible nonlinear fit to the weather factors did not disturb the association with TSP. The most reasonable interpretation of this pattern of results is that the association is causal. This is supported by other studies which have reported that particulate air pollution was associated with lung function deficits, increased symptoms, and increased hospitalization.