Mortality in small geographical areas and proximity to air polluting industries in the Basque Country (Spain)
Mortality in small geographical areas and proximity to air polluting industries in the Basque Country (Spain)
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DOI：
10.1136/oem.2009.048215
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发表时间：
2010-09
影响因子：
4.9
通讯作者：
K. Cambra;T. Martínez-Rueda;E. Alonso-Fustel;F. Cirarda;B. Ibáñez;S. Esnaola;M. Calvo;E. Aldasoro;I. Montoya
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文献类型：
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作者：
K. Cambra;T. Martínez-Rueda;E. Alonso-Fustel;F. Cirarda;B. Ibáñez;S. Esnaola;M. Calvo;E. Aldasoro;I. Montoya
目的研究1996-2003年期间巴斯克地区（西班牙）空气污染工业设施与死亡率之间的关系。方法采用横断面生态学研究方法，以1465个人口普查断面（CS）为分析单元，平均人口1257人。CS死亡率与接近欧洲污染物排放登记册的行业的协会进行了研究的工业活动类型和社会剥夺调整。两个距离阈值（1公里和2公里）被用作“近与远”分析中暴露的代理。研究的死亡原因包括：所有原因;气管、支气管和肺癌;血液肿瘤;缺血性心脏病;脑血管疾病;下呼吸道慢性疾病;乳腺癌（妇女）。泊松广义线性混合模型（GLMM）与两个随机效应（异质性和结构化空间变异性）在完全贝叶斯环境中使用。结果居住在距能源生产企业1 km以内的人群，气管、支气管和肺癌的死亡率高于居住在离能源生产企业1 km以内的人群[CI 90% 6%~ 53%]。距离金属加工行业2公里以内的女性因缺血性心脏病[CI 90% 1%至17%]和呼吸道疾病[CI 90% 1%至24%]而死亡率更高。相反，在距离矿业1公里的缓冲区内，妇女的所有原因死亡率[CI 90%-20%至-6%]和缺血性心脏病死亡率[CI 90%-40%至-10%]较低，男子的呼吸系统疾病死亡率[CI 90%-39%至-4%]较低，而在2 km缓冲区内，女性乳腺癌的CI更高[CI 90% 2%至28%]。结论：人口普查部门的死亡率分析是一个有用的探索性工具，调查环境风险因素，并指导行动的网站和风险因素对健康的影响更大。需要对金属加工厂和能源生产厂进行进一步的流行病学和环境调查。
Objectives To study the association between proximity to air polluting industrial facilities and mortality in the Basque Country (Spain) in the 1996–2003 period. Methods A cross-sectional ecological study with 1465 census sections (CS) as units of analysis with a mean population of 1257 inhabitants. Association of CS mortality with proximity of industries of the European Pollutant Emission Register was studied by type of industrial activity and adjusted for social deprivation. Two distance thresholds (1 km and 2 km) were used as proxies for exposure in a ‘near versus far’ analysis. Causes of mortality studied were: all causes; tracheal, bronchial, and lung cancer; haematological tumours; ischaemic heart disease; cerebrovascular diseases; chronic diseases of the lower respiratory tract; and breast cancer (in women). Poisson's generalised linear mixed models (GLMM) with two random effects (heterogeneity and structured spatial variability) were used in a fully Bayesian environment. Results Men living in sections within 1 km from energy production industries had greater mortality from tracheal, bronchial, and lung cancer [CI90% 6% to 53%] as compared with people living further. Women had greater mortality from ischaemic heart disease [CI90% 1% to 17%] and respiratory illness [CI90% 1% to 24%] within 2 km from metal-processing industries. On the contrary, within the 1 km buffer from mineral industries, mortality was lower for all causes [CI90% −20% to −6%] and for ischaemic heart disease [CI90% −40% to −10%] in women, and from respiratory diseases in men [CI90% −39% to −4%], while it was greater for breast cancer in women [CI90% 2% to 28%] within the 2 km buffer. Conclusions Analysis of mortality by census sections is a helpful exploratory tool for investigating environmental risk factors and directing actions to sites and risk factors with a greater impact on health. Further epidemiological and environmental investigations around metal-processing and energy-producing plants are required.