Health equity and burden of childhood asthma - related to air pollution in Barcelona
Health equity and burden of childhood asthma - related to air pollution in Barcelona
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DOI：
10.1016/j.envres.2019.109067
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发表时间：
2020-07-01
影响因子：
8.3
通讯作者：
Rojas-Rueda, D.
中科院分区：
文献类型：
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作者：
Pierangeli, I;Nieuwenhuijsen, M. J.;Rojas-Rueda, D.
背景：空气污染是城市人口的主要健康风险因素之一。空气污染与儿童哮喘有关。空气污染也被认为在城市内分布不均，这可能导致城市健康不平等。 目的：我们的目的是估计由三种主要空气污染物引起的儿童哮喘病例数；西班牙巴塞罗那市的二氧化氮 (NO2)、颗粒物 (PM 2.5) 和黑碳 (BC)。我们还旨在根据巴塞罗那的社会剥夺指数来描述这些影响的分布。方法：我们通过应用定量健康影响评估（HIA）方法估计了巴塞罗那儿童哮喘病例的数量。使用土地利用回归模型估算空气污染（NO2、PM2.5 和 BC）暴露评估。对两种情景进行了评估，并将当前的空气污染水平与以下情况进行了比较：1) 达到世界卫生组织 (WHO) 关于 NO2 和 PM2.5 暴露水平的指南（情景 1）； 2) 在之前发表的荟萃分析（场景 2）中达到最低报告水平，从中我们还获得了暴露-反应函数。估计了每种情景和污染物的相对风险和人群归因分数（PAF）。利用西班牙的哮喘发病率，估算了每种情况下巴塞罗那因 NO2、PM2.5 和 BC 引起的哮喘病例的预期数量。结果：普查水平下 NO2、PM2.5 和 BC 的年平均水平分别为 56 μg/m(3)、17.11 μg/m(3) 和 2.88 μg/m(3)。情景 1 中估计的由 NO2 和 PM2.5 引起的哮喘病例数（占总病例数的百分比）分别为 454 例（18%）和 478 例（19%）。对于情景 2，由 NO2、PM2.5 和 BC 引起的估计病例数分别为 1230 例 (48%)、992 例 (39%) 和 789 例 (31%)。尽管 NO2 和 BC 在哮喘病例和不同贫困指数地区之间存在差异，但在贫困程度较低的地区和贫困程度较高的地区之间，只有 BC 差异具有统计学意义。 结论：这项研究估计，巴塞罗那每年多达 1230 例 (48%) 的哮喘病例可归因于空气污染。这项研究还发现，在巴塞罗那，社会贫困程度较低的群体可能比社会贫困程度较高的群体更容易受到与空气污染相关的哮喘的影响。
Background: Air pollution is one of the major health risk factors in urban populations. Air pollution has been associated with asthma in children. Air pollution has also been suggested to be distributed unequally within the cities, something that can lead to urban health inequalities.Aim: We aimed to estimate the number of childhood asthma cases attributable to three main air pollutants; Nitrogen dioxide (NO2), Particulate Matter (PM 2.5), and Black Carbon (BC) in the city of Barcelona, Spain. We also aimed to describe the distribution of those impacts depending on the social deprivation index in Barcelona.Methods: We estimated the number of childhood asthma cases in Barcelona by applying a quantitative Health Impact Assessment (HIA) approach. Air pollution (NO2, PM2.5, and BC) exposure assessment was estimated using a land-use regression model. Two scenarios were assessed and compared the current levels of air pollution with 1) achieving the World Health Organization (WHO) guideline on exposure levels for NO2 and PM2.5 (scenario 1); and 2) achieving the minimum reported levels in a previously published meta-analysis (scenario 2), from where we also obtained the exposure-response functions. The relative risk and population attributable fraction (PAF) for each scenario and pollutant were estimated. Using the asthma incidence rate in Spain the expected number of asthma cases in Barcelona attributable to NO2, PM2.5, and BC for each scenario was estimated.Results: The annual average levels of NO2, PM2.5, and BC at census levels were 56 mu g/m(3), 17.11 mu g/m(3), and 2.88 mu g/m(3), respectively. The number of asthma cases attributable to NO2 and PM2.5 (percentage of total cases) estimated in scenario 1 was 454 (18%) and 478 (19%) respectively. For scenario 2, the estimated number of cases attributable to NO2, PM2.5, and BC were 1230 (48%), 992 (39%) and 789 (31%) respectively. Although NO2 and BC showed differences between asthma cases and areas with different deprivation index, only BC differences were statistically significant between less and more deprived areas.Conclusions: This study estimated that up to 1230 (48%) of asthma cases in Barcelona could be attributable to air pollution each year. This study also found that in Barcelona, less socially deprived groups could be more affected by asthma-related to air pollution than those more socially deprived.