我国大气PM_(10)污染对人群死亡率影响的meta分析

目的综合相关文献,建立我国PM_(10)与居民死亡率之间的暴露-反应关系。方法通过各数据库和文献检索平台收集2005—2015年发表的符合纳入标准的我国大气PM_(10)污染与居民每日总死亡率、呼吸系统及心脑血管疾病死亡率关系的文献,共纳入20篇共37组相关数据。采用Stata 12.0软件进行meta分析,提取PM_(10)与人群死亡的暴露-反应系数,利用随机或固定效应模型合并效应值,对结果进行敏感性分析、发表偏倚检验及校正。结果建立了我国大气PM_(10)与居民每日死亡之间的暴露-反应关系,我国大气PM_(10)每上升10μg/m3,人群每日总死亡率、呼吸系统疾病和心脑血管疾病死亡率的相对危险度(RR)及95%CI分别为1.001 4(95%CI:1.000 8~1.002 0),1.001 6(95%CI:0.999 9~1.003 3),1.002 5(95%CI:1.001 4~1.003 6)。结论大气PM_(10)浓度上升可导致我国居民总死亡率、呼吸系统疾病和心脑血管疾病死亡率增加。     

大气颗粒物污染对人群心脑血管疾病死亡急性效应的Meta分析

目的 了解大气颗粒物(PM10、PM2.5)短期暴露对人群心脑血管疾病死亡的影响,获取大气颗粒物污染对人群心脑血管疾病死亡急性效应的暴露-反应关系.方法 通过计算机联机检索及手工检索的方法收集1990年1月1日至2012年6月30日间公开发表的符合纳入标准的文献29篇,提取暴露-反应系数,采用Stata 12.0软件进行异质性分析、发表偏倚的检验及校正,利用固定效应或随机效应模型合并效应值.结果 校正发表偏倚后,大气中PM10每升高10μg/m3,人群心脑血管疾病死亡的风险增加0.29％(95％CI:0.18％～0.49％); PM2.5每升高10 μg/m3,心脑血管疾病死亡风险增加0.68％(95％CI:0.35％～1.02％),未发现明显的发表偏倚.亚组分析显示,亚洲人群PM10与PM2.5对心脑血管疾病急性死亡的暴露-反应关系效应估计值低于欧美地区;病例交叉设计得到的暴露-反应关系效应估计值高于时间序列分析.结论 大气中PM10、PM2.5浓度的上升会导致人群心脑血管疾病死亡率增加,其中PM2.5导致的心脑血管疾病死亡风险更高.     

大气污染物(SO_2、NO2_)对中国居民健康效应影响的meta分析

目的了解大气污染物(SO_2、NO_2)短期暴露对居民每日总死亡率和心脑血管疾病、呼吸系统疾病死亡率以及门诊、住院率的影响,获取大气污染物SO_2、NO-2对人群健康效应的暴露—反应关系。方法通过计算机联机检索及手工检索的方法收集2000—2015年间公开发表的符合纳入标准的文献36篇,提取暴露-反应系数,采用Stata 12.0软件进行异质性分析、发表偏倚的检验,利用固定效应或随机效应模型合并效应值。结果大气SO_2浓度每升高10μg/m~3,对应的短期内居民每日总死亡率的风险、居民呼吸系统疾病死亡率风险、居民心脑血管疾病死亡率风险、居民呼吸系统疾病门诊、住院率的风险以及居民心脑血管疾病门诊、住院率风险的合并效应值(OR/RR)及95%的置信区间(CI)分别为1.009(1.006~1.011)、1.012(1.009~1.016)、1.007(1.005~1.008)、1.008(1.006~1.01)、1.009(1.005~1.014);大气NO-2浓度每升高10μg/m~3,对应的短期内居民每日总死亡率的风险,居民呼吸系统疾病死亡率风险,居民心脑血管疾病死亡率风险,居民呼吸系统疾病门诊、住院率的风险,居民心脑血管疾病门诊、住院率风险的合并效应值(OR/RR)及95%的置信区间(CI)分别为1.014(1.011~1.016)、1.016(1.012~1.019)、1.014(1.011~1.015)、1.009(1.004~1.013)、1.013(1.009~1.016)。结论大气中SO_2、NO_2浓度的上升会导致居民每日总死亡率和心脑血管疾病、呼吸系统疾病的死亡率以及门诊、住院率风险的增加。     

Meta-analysis of Association between Air Fine Particular and Daily Mortality of Residents

目的 分析国内外PM2.5污染对居民每日死亡率的影响.方法 通过Endnote软件在线搜集国内外关于PM2.5的暴露与居民每日死亡率关系的流行病学文献资料,提取文献中相关的数据,通过Meta分析方法评价国内外PM2.5暴露与居民每日死亡率的暴露-效应关系.结果 PM2.5浓度每升高10μg/m3,我国、北美和欧洲地区居民每日死亡率分别上升0.31％( 95％CI:0.24％～0.37％)、1.26％(95％CI:1.15％～ 1.38％)和1.65％(95％CI:0.99％～2.30％);我国、美国、欧洲和日本地区居民呼吸系统疾病每日死亡率分别上升1.00％ (95％CI:0.00％～1.90％)、1.78％(95％CI:0.20％～3.36％),1.32％ (95％CI:1.17％～1.49％)、0.74％(95％CI:0.43％～1.05％),心血管系统疾病每日死亡率分别上升0.50％(95％CI:0.10％～1.00％)、0.94％(95％CI:-0.14％～2.02％)、1.11％(95％CI:1.06％～1.16％)、0.55％( 95％CI:0.37％～0.73％).结论 不同地区居民在PM2.5浓度升高后每日死亡率、相关呼吸系统和心血管系统疾病死亡率均有所升高,但我国PM2.5污染的影响小于北美和欧洲地区.     

北美、欧洲和亚洲地区PM2.5暴露与人群死亡率关系Meta分析的对比

目的 采用Meta分析方法评价近年来国内外大气细颗粒物(PM2.5)暴露对人群每日死亡率的影响.方法 检索PubMed和Web of Science数据库,收集并筛选所有近年来PM2.5暴露与人群死亡关系的文献资料,并对文献中相关的数据信息进行提取,通过Meta分析对近年来亚洲、北美洲和欧洲3个地区的PM2.5暴露与每日死亡率的关系进行分析评价.结果 经过分析得出亚洲地区、北美地区和欧洲地区的PM2.5的浓度每升高10 μg/m3,居民死亡率百分比分别增加0.96％ (95％CI:0.94％～0.97％)、1.05％ (95％ CI:1.03％～1.08％)和1.80％(95％CI:1.23％～2.36％).结论 不同地区PM2.5浓度升高后居民死亡率均有所升高,但亚洲地区的死亡率增幅低于欧洲、北美地区.     

我国大气污染物一氧化碳短期暴露对人群死亡影响的Meta分析

目的分析我国大气污染物一氧化碳短期暴露对人群总死亡率、心血管疾病死亡率、呼吸系统疾病死亡率的影响。方法通过检索Pubmed、Web of Science、万方、中国知网等数据库,收集我国1990-2018年发表的一氧化碳短期暴露与人群死亡风险的流行病学研究文献,采用Stata11对纳入文献进行Meta分析。结果共收集我国一氧化碳短期暴露与人群死亡风险的文献14篇,Meta分析结果显示,一氧化碳浓度每升高1 mg/m3,人群总死亡率、心血管疾病死亡率、呼吸系统疾病死亡率各增加3.2%(95%CI:2.0%～4.4%)、4.0%(95%CI:2.8%～5.3%)、3.2%(95%CI:1.6%～4.9%)。结论一氧化碳浓度上升会导致人群总死亡率、心血管疾病死亡率、呼吸系统疾病死亡率增加。     

大气污染对女性健康效应的时间序列分析

为定量研究广东省某市大气污染对女性居民日死亡率的急性影响,采用Poisson广义相加模型对该市大气NO2、PM10、SO2的日平均浓度与女性居民日死亡人数进行相关回归分析,并控制时间长期趋势、气象、季节等混杂因素的影响.结果显示,当大气NO2、PM10、SO2浓度分别每上升100 μg/m3时,对女性总死亡率的急性效应相对危险度最高值分别为1.075 (95％CI:1.040～1.111),1.055(95％CI:1.027～1.084),1.073(95％CI:1.006～1.140);且NO2、PM10、SO2日平均浓度的升高与女性居民日心脑血管疾病死亡数的增加之间有正向统计学关联(P＜0.05).提示该市大气NO2、PM10、SO2污染对女性居民日死亡率具有急性影响,尤其是对心脑血管疾病.     

可吸入大气颗粒物暴露对居民每日死亡短期影响的Meta分析

目的综合分析国内外可吸人大气颗粒物（PM10）短期暴露与人群死亡关系的流行病学资料,以获取大气PM10污染与居民死亡的暴露一反应关系。方法在计算机联机检索文献和手工检索的基础上,对近十年来发表的相关研究文献采用meta分析的方法进行综合评价,并检验、校正可能存在的发表偏倚,从而准确、定量地确定PM10污染与居民死亡的暴露一反应关系。结果建立了居民短期接触大气PM10污染的暴露一反应关系,即在未考虑发表偏倚的情况下,大气中PM10每增加100μg/m^3,居民死亡的相对危险度增加3．87％（95％CI：2．84％～5．02％）,在校正了发表偏倚后大气中PM10每增加100p．μg／m^3,死亡的相对危险度增加下降为1．41％（95％CI：0．30％-2．43％）,与考虑偏倚前相比下降了63．6％。结论该研究建立的暴露-反应关系较早注意到发表偏倚的影响,具有一定的代表性与科学性,可用于大气颗粒物暴露健康危险度评价工作参考,为制定相关环境决策提供科学依据。     

可吸入大气颗粒物污染与居民每日死亡关系的Meta分析

目的综合分析国内外可吸入大气颗粒物（PM10）短期暴露与人群死亡关系的流行病学资料,以获取大气PM10污染与居民死亡的暴露-反应关系。方法在计算机联机检索文献和手工检索的基础上,对近十年来发表的相关研究文献采用meta分析的方法进行综合评价,并检验、校正可能存在的发表偏倚,从而准确、定量地确定PM10污染与居民死亡的暴露-反应关系。结果建立了居民短期接触大气PM10污染的暴露一反应关系,即在未考虑发表偏倚的情况下,大气中PM10每增加1130μg／m3,居民死亡的相对危险度增加3．87％（95％CI：2．84％～5．02％）,在校正了发表偏倚后大气中PM10每增加100μg／m3,死亡的相对危险度增加下降为1．41％（95％CI：0．30％-2．43％）,与考虑偏倚前相比下降了63．6％。结论本研究建立的暴露-反应关系较早注意到发表偏倚的影响,具有一定的代表性与科学性,可用于大气颗粒物暴露健康危险度评价工作参考,为制定相关环境决策提供科学依据。     

我国PM2.5污染与儿童呼吸系统疾病门诊量关系的Meta分析

目的 探究我国PM2.5污染与儿童呼吸系统疾病门诊量的暴露反应关系。方法 通过搜集并整理国内外数据库中2010—2020年发表的我国PM2.5浓度变化与儿童呼吸系统疾病门诊量的相关文献,运用Stata 11.0软件进行meta分析。结果 共纳入21篇文献,22组数据。我国PM2.5质量浓度每升高10 μg/m3,儿童呼吸系统疾病门诊量的相对危险度RR为1.003（95%CI:1.003,1.004）,发表偏倚校正后的RR为1.002（95%CI:1.002,1.003）。结论 我国PM2.5污染与儿童呼吸系统疾病的门诊量之间呈正相关。     

银川市大气颗粒物对人群循环系统疾病死亡影响的时间序列分析

目的探讨银川市大气颗粒物污染水平及其对居民循环系统疾病死亡的暴露-反应关系。方法通过收集银川市2013—2015年空气质量监测数据、气象监测数据和居民死亡监测资料,采用广义相加模型,分析银川市大气颗粒物物对与居民循环系统疾病死亡的暴露-反应关系。结果大气PM_(10)和PM_(2.5)年均浓度均超过GB 3095—2012《环境空气质量标准》二级标准。大气PM_(10)和PM_(2.5)浓度每升高10μg/m~3对人群循环系统疾病死亡的超额危险度分别为0.56%(95%CI:0.15%~0.97%),1.33%(95%CI:0.46%~2.21%);大气PM_(10)和PM_(2.5)浓度对小于65岁组的循环系统疾病死亡的影响无统计学意义(P0.05),对65岁以上年龄组人群循环系统疾病死亡的超额危险度分别在滞后7、5 d时达到最大效应,分别为1.24%(95%CI:0.21%~2.28%)和0.57%(95%CI:0.08%~1.06%);大气PM_(10)、PM_(2.5)浓度对女性循环系统疾病死亡的超额危险度高于男性。结论研究期间银川市大气颗粒物浓度较高,且对人群循环系统疾病死亡存在一定的暴露-反应关系。     

成都市大气颗粒物对居民心脑血管疾病死亡的急性影响研究

目的 探讨成都市大气颗粒物的急性暴露与居民每日心脑血管疾病死亡的关系。方法 收集2013-2015年成都市大气PM2.5、PM10、SO2和NO2的日平均浓度、气象因素(包括日平均气温和相对湿度)及心脑血管疾病日死亡数。采用广义相加模型(Generalized Additive Models,GAM)建立单污染物、多污染物模型,分析大气PM2.5、PM10浓度对居民心脑血管疾病日死亡数的影响。结果 大气污染物PM2.5、PM10浓度分别为75.9、119.7μg/m3,PM2.5高于GB3095-2012《环境空气质量标准》 二级标准。单污染物模型中,大气PM2.5(lag1)和PM10(lag01)浓度每增加10μg/m3,心脑血管疾病日死亡数分别增加0.29%(95%CI:0.01%~0.56%)和0.27%(95%CI:0.09%~0.45%)。PM2.5和PM10浓度与心脑血管疾病死亡的暴露反应关系基本呈线性。多污染物模型中,PM2.5和PM10单独或同时引入SO2、NO2时,对心脑血管疾病日死亡数的影响消失(P>0.05)。结论 成都市大气PM2.5和PM10浓度升高可能导致居民心脑血管疾病日死亡数增加。     

京津两地不同温度水平下大气PM_(10)与居民每日死亡关系的时间序列研究

目的探讨北京市和天津市不同温度水平下大气可吸入颗粒物(PM_(10))与居民每日死亡的定量关系。方法收集北京市和天津市2007年1月1日至2009年12月31日的每日大气PM_(10)、每日平均温度、每日平均相对湿度、每日居民不同病因别死亡人数,建立时间序列数据库。将每日温度分成低(P_(50))、中(P_(50)~P_(75))、高(P_(75))3个层次,采用广义相加模型,分析两城市大气PM_(10)与居民每日不同病因别死亡的相关性。结果对于总死亡,北京市和天津市高、中温水平下大气PM_(10)的超额危险度(excess risk,ER)明显高于低温水平,且中温水平下效应值最大,两城市的ER分别为0.46%(95%CI:0.18%~0.75%)和0.87%(95%CI:0.34%~1.41%);对于循环系统死亡,北京市和天津市高、中温水平下大气PM_(10)的超额危险度明显高于低温水平,且高温水平下的超额危险度值更大,两城市的ER分别为0.52%(95%CI:0.07%~0.98%)和1.13%(95%CI:0.43%~1.83%);对于呼吸系统死亡,北京和天津市中温水平下大气PM_(10)的超额危险度最大,两城市的ER分别为0.99%(95%CI:0.16%~1.74%)和1.48%(95%CI:0.25%~1.95%)。结论不同温度水平下,北京市和天津市大气PM_(10)污染致居民死亡的急性效应不同,中高温水平下,大气PM_(10)的健康效应值更大。制定人群大气污染健康效应公共政策时,需考虑温度对其影响的修饰作用。     

The short-term effects of air pollution on mortality: the results of the EMECAM project in the city of Huelva, 1993-96. Estudio Multicéntrico Espa?ol sobre la Relación entre la Contaminación Atmosférica y la Mortalidad]

BACKGROUND: The objective of this study was to estimate the relationship between the levels of air pollution and the daily mortality in the city of Huelva for the 1993-1996 period using the EMECAM methodology. METHODS: The number of daily deaths for all causes except external ones, the death rate of those over age 69, due to diseases of the circulatory system and for respiratory diseases were used as rate indicators. Four pollutants--SO2, PM10, NO2 and CO--were analyzed, the daily levels of which were furnished by the air pollution monitoring network in Huelva. Autoregressive Poisson regression models were constructed controlling by tendency, seasonality, temperature, humidity, flue and events out of the ordinary. RESULTS: For the mortality rate for all causes, a significant association impact was found to exist for the NO2 for the entire period (RR10 microgram/m3: 1.0414; CI95%: 1.0047-1.0794) and for the particles (PM10) for the cold half of the year (RR10 microgram/m3: 1.0358; CI95%: 1.007-1.0722). For the mortality in people over age 69, a significant relationship was found to exist for SO2 throughout the entire period (RR10 microgram/m3: 1.0606; CI95%: 1.0020-1.1227). A significant relationship to the mortality from respiratory disease particles (PM10) was found to exist for the cold half of the year (RR10 microgram/m3: 1.1412; IC95%: 1.0300-1.2644). There was no association of contaminants with cardiovascular mortality; also there was no association between levels of CO and mortality indicators. CONCLUSIONS: In Huelva, significant relationships have been found to exist between the current levels of air pollution resulting from particles, SO2 and NO2 and the daily mortality. The impact of these pollutants on the mortality is coherent with scientific literature, although in the case of Huelva, the extremely small number of daily deaths due to its small population and other factors limit the consistency thereof.     

Association of daily cause-specific mortality with ambient particle air pollution in Wuhan, China

In Asia, limited literature has been published on the association between daily mortality and ambient air pollution. We examined the associations of daily cause-specific mortality with daily mean concentrations of particulate matter (PM) with a mass median aerodynamic diameter less than 10 microm (PM(10)) in Wuhan, China using 4 years of data (2001-2004). There are approximately 4.5 million residents in Wuhan who live in the city core area of 201 km(2) where air pollution levels are higher and pollution ranges are wider than the majority of cities in the published literature. We use quasi-likelihood estimation within the context of the generalized additive models (GAMs) (natural spline (NS) models in R) to model the natural logarithm of the expected daily death counts as a function of the predictor variables. We found consistent PM(10) effects on mortality with the strongest effects on lag 0 day. Every 10 microg/m(3) increase in PM(10) daily concentration at lag 0 day was significantly associated with an increase in non-accidental (0.36%; 95% CI 0.19-0.53%), cardiovascular (0.51%; 95% CI 0.28-0.75%), stroke (0.44%; 95% CI 0.16-0.72%), cardiac (0.49%; 95% CI 0.08-0.89%), respiratory (0.71%; 95% CI 0.20-1.23%), and cardiopulmonary (0.46%; 95% CI 0.23-0.69%). In general, these effects were stronger among the elderly (65 years > or = 45 years) than among the young. The exploration of exposure-response relationships between PM(10) and cause-specific mortality suggests the appropriateness of assuming linear relationships, where the PM(10) concentration in Wuhan ranged from 24.8 to 477.8 microg/m(3). We conclude that there is consistent evidence of acute effects of PM(10) on cardiopulmonary mortality. A linear no threshold exposure-response relationship is suggested between PM(10) and the studied cause-specific mortality.     

Air Pollution and Respiratory Status in Asthmatic Children: Hints for a Locally Based Preventive Strategy. AIRE Study

Respiratory health effects of short-term exposure to ambient air pollution have been examined in 120 'asthma-like' school-aged children in some areas of Emilia-Romagna (urban-industrial and rural area). They kept a daily diary, through 12 weeks, for respiratory symptoms, PEF measurements, drug consumption and daily activity. The average daily concentrations of air pollutants in the same period (TSP, NO2, CO, PM2.5) were higher in the industrial than the rural area. Asthma was diagnosed in 77% of cases, 85% of subjects took medical treatments for respiratory disease in the last year and 90% used medicine for respiratory diseases. Significantly lower variations in PEF, between morning and evening, were observed in the rural area, considering only the asthmatic or cough subsets of children. Symptom prevalence was higher in the urban-industrial area than the rural area; the most frequent symptoms were cough, phlegm and stuffed nose. The two area populations are homogeneous in individual features, family susceptibility, passive smoking exposure and atopy. The differences observed in the frequency of daily reported symptoms could be attributed to external situations like the different reported exposures to pollutants. Although most analyses revealed non-significant associations, panel analysis showed a significant statistical risk for the cough and phlegm group by an increase of 10 microg of TSP (RR 1.0017, 95% CI: 1.0002-1.0033) in the entire group. In the urban-industrial panel we observed a significant association between cough and phlegm together and PM2.5 (RR 1.0044, 95% CI: 1.0011-1.0077). The results of this investigation should be used in orienting local political decisions.     

石家庄市PM2.5浓度对居民死亡的急性影响分析

目的 了解石家庄市PM2.5污染特征及其对居民死亡率的影响。方法 收集2013 - 2015年该市逐日大气PM2.5浓度、平均气温、平均相对湿度和居民的死亡数据,利用广义相加模型分析PM2.5日均浓度和居民死亡的关系。结果 研究期间石家庄市日均非意外死亡32人,其中循环系统疾病死亡17人,呼吸系统疾病死亡5人;PM2.5浓度范围为6.3～771.3 μg/m3,平均浓度为118.8 μg/m3。时间序列分析结果表明,该市大气PM2.5浓度每升高10 μg/m3,居民非意外总死亡（lag05）、循环系统疾病死亡（lag05）和呼吸系统疾病死亡（lag1）的风险分别增加0.73%（95%CI:0.42%～1.04%）、1.04%（95%CI:0.64%～1.46%）和0.63%（95%CI:0.07%～1.19%）。结论 石家庄市大气PM2.5浓度的升高可能导致居民非意外总死亡,尤其是循环系统疾病和呼吸系统疾病死亡的增加。     

The short-term effects of air pollution on mortality. The results of the EMECAM project in the city of Valencia, 1994-96. Estudio Multcéntrico Espa?ol sobre la Relación entre la Contaminación Atmosférica y la Mortalidad]

BACKGROUND: To determine the short-term impact of air pollution on mortality in the city of Valencia throughout the 1994-1996 period by employing the analysis method of the Spanish multicenter study with regard to the relationship between air pollution and the mortality (EMECAM Project). METHODS: The daily levels of black smoke, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3) were obtained from the Valencia air pollution monitoring network. The death rate indicators analyzed were the daily number of death due to all causes, except the external ones, the deaths of those over age 70, and the deaths resulting from respiratory and cardiovascular diseases. Following the methods of the EMECAM Project, autoregressive Poison regression models were built up, controlling the different confounding factors (seasonality, trend, calendar, weather variables and flu impact). RESULTS: For total mortality except the external ones, a significant impact of black smoke (RR 10 micrograms/m3: 1.013; CI95% 1.003 to 1.023) and for CO 24 la (RR 1 mg/m3: 1.024; CI95% 1.003 to 1.046) was found. For the mortality of those individuals over 70, the estimated impact was somewhat greater than for black smoke (RR 10 micrograms/m3: 1.017; CI95% 1.005-1.029), as well as for CO2 1 h (RR 10 micrograms/m3: 1.007; CI95% 1.001-1.013). No significant relationship was found with the mortality due to respiratory or cardiovascular diseases for the entire period. CONCLUSIONS: The current levels of pollution in the city of Valencia show a significant impact on daily mortality. These findings are consistent with the previous research and are coherent with those obtained on analyzing the relationship between air pollution and morbidity indicators.