A meta-analysis of time-series studies of ozone and mortality with comparison to the national morbidity, mortality, and air pollution study
A meta-analysis of time-series studies of ozone and mortality with comparison to the national morbidity, mortality, and air pollution study
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DOI：
10.1097/01.ede.0000165817.40152.85
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发表时间：
2005-07-01
期刊：
影响因子：
5.4
通讯作者：
Samet, JM
中科院分区：
文献类型：
--
作者：
Bell, ML;Dominici, F;Samet, JM
背景资料：虽然许多时间序列的研究臭氧和死亡率已经确定了积极的关联，其他人都产生了无效或不确定的结果，这些研究的结果难以解释。方法：我们进行了荟萃分析，从39个时间序列研究的144效果估计，并估计汇总效果滞后，年龄组，原因特异性死亡率和浓度指标。我们将结果与全国发病率、死亡率和空气污染研究（NMMAPS）的汇总估计值进行了比较，NMMAPS是一项对1987年至2000年美国95个大城市中心的时间序列研究。荟萃分析和NMMAPS结果都提供了强有力的证据，证明臭氧与死亡率之间存在短期关联，对心血管和呼吸系统死亡率、老年人、和当前的臭氧暴露。在这两种分析中，结果对颗粒物和模型规格的调整不敏感。在荟萃分析中，滞后0、1或2天的单日或2天平均值每日臭氧增加10 ppb与总死亡率增加0.87%相关（95%后验区间= 0.55%至1.18%），而滞后0 NMMAPS估计值为0.25%（0.12%至0.39%）。几项发现表明可能存在发表偏倚：荟萃分析结果始终大于NMMAPS的结果;仅报告单个滞后时，滞后0或1的荟萃分析汇总估计值大于报告多个滞后时的估计值;荟萃分析中城市特定估计值的异质性大于NMMAPS。
Background: Although many time-series studies of ozone and mortality have identified positive associations, others have yielded null or inconclusive results, making the results of these studies difficult to interpret.Methods: We performed a meta-analysis of 144 effect estimates from 39 time-series studies, and estimated pooled effects by lags, age groups, cause-specific mortality, and concentration metrics. We compared results with pooled estimates from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS), a time-series study of 95 large U.S. urban centers from 1987 to 2000.Results: Both meta-analysis and NMMAPS results provided strong evidence of a short-term association between ozone and mortality, with larger effects for cardiovascular and respiratory mortality, the elderly, and current-day ozone exposure. In both analyses, results were insensitive to adjustment for particulate matter and model specifications. In the meta-analysis, a 10-ppb increase in daily ozone at single-day or 2-day average of lags 0, 1, or 2 days was associated with an 0.87% increase in total mortality (95% posterior interval = 0.55% to 1.18%), whereas the lag 0 NMMAPS estimate is 0.25% (0.12% to 0.39%). Several findings indicate possible publication bias: meta-analysis results were consistently larger than those from NMMAPS; meta-analysis pooled estimates at lags 0 or 1 were larger when only a single lag was reported than when estimates for multiple lags were reported; and heterogeneity of city-specific estimates in the meta-analysis were larger than with NMMAPS.