The effect of air pollution on infant mortality appears specific for respiratory causes in the postneonatal period
The effect of air pollution on infant mortality appears specific for respiratory causes in the postneonatal period
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DOI：
10.1097/00001648-199911000-00004
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发表时间：
1999-11-01
期刊：
影响因子：
5.4
通讯作者：
Leon, DA
中科院分区：
文献类型：
--
作者：
Bobak, M;Leon, DA
为了研究个人终生平均空气污染暴露与新生儿后呼吸道死亡之间的关联，我们进行了一项基于人群的匹配病例对照研究，涵盖了 1989 年至 1991 年在捷克共和国登记的所有与死亡记录相关的出生。对于每例婴儿死亡病例，我们从病例死亡时同一天出生且存活的同性别婴儿中随机选择 20 名对照。暴露量被指定为每个病例居住区和指示病例出生到死亡期间对照的所有 24 小时空气污染测量值的算术平均值。我们使用条件逻辑回归来估计悬浮颗粒、二氧化硫和氮氧化物对新生儿和新生儿后期死亡风险的影响，并控制了母亲的社会经济状况以及出生体重、出生身长和胎龄。有 2,494 名婴儿死亡，其中有至少一种污染物的暴露数据，其中 133 名婴儿死于呼吸道疾病。所有污染物的影响在新生儿后期最为强烈，并且对呼吸道疾病具有特异性。除此之外，在控制所有协变量后，颗粒物、二氧化硫和氮氧化物增加 50 μg/m(3) 的比率分别为 1.95 [95% 置信区间 (CI) = 1.09-3.50]、1.74 (95% CI = 1.01 - 2.98) 和 1.66 (95% CI = 0.98 - 2.81)。当所有污染物都输入一个模型时，只有颗粒表现出一致的关联。我们没有发现任何污染物与其他原因造成的死亡之间存在关系的证据。这些结果表明，空气污染对婴儿死亡率的影响是针对新生儿后期呼吸系统原因的，与社会经济因素无关，并且不受出生体重或胎龄的调节。
To examine the association between individual lifetime measures of mean exposure to air pollution and postneonatal respiratory deaths, we have conducted a matched population-based case-control study covering all births registered in the Czech Republic from 1989 to 1991 that were linked to death records. For each case of infant death, we have randomly selected 20 controls from infants of the same sex born on the same day and alive when the case died. Exposure was assigned as the arithmetic mean of all 24-hour air pollution measurements in the district of residence of each case and control for the period between the birth and death of the index case. We used conditional logistic regression to estimate the effects of suspended particles, sulfur dioxide, and nitrogen oxides on risk of death in the neonatal and postneonatal period, controlling for maternal socioeconomic status and birth weight, birth length, and gestational age. There were 2,494 infant deaths with exposure data on at least one pollutant, 133 of them from respiratory causes. The effects of all pollutants were strongest in the postneonatal period and were specific for respiratory causes. Far these, rate ratios for a 50 mu g/m(3) increase in particles, sulfur dioxide, and nitrogen oxides were 1.95 [95% confidence interval (CI) = 1.09-3.50], 1.74 (95% CI = 1.01 - 2.98), and 1.66 (95% CI = 0.98 - 2.81), respectively, after controlling for all covariates. Only particles showed a consistent association when, all pollutants were entered in one model. We found no evidence of a relation between any pollutant and mortality from other causes. These results indicate that the effects of air pollution on infant mortality are specific for respiratory causes in the postneonatal period, are independent of socioeconomic factors, and are not mediated by birth weight or gestational age.