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南京市PM10短期暴露与肺癌死亡风险相关性
引用本文:卫斐然,熊丽林,洪忻,李伟,陈宝安.南京市PM10短期暴露与肺癌死亡风险相关性[J].中华疾病控制杂志,2020,24(7):801-807,834.
作者姓名:卫斐然  熊丽林  洪忻  李伟  陈宝安
作者单位:1.210009 南京, 东南大学医学院附属中大医院血液科
基金项目:江苏省医学重点项目;东南大学项目;江苏省社会发展项目;南京市卫生健康委员会医学科技发展基金
摘    要:   目的   分析南京市可吸入颗粒物(particle matter with diameter less 10 μm,PM10)与肺癌死亡风险之间滞后相关性。   方法   收集南京市2013―2017年每日因肺癌死亡人数、气象及空气污染数据,利用广义相加模型(generalized additive model,GAM)及滞后非线性模型(distributed lag non-linear models,DLNM)探讨短期暴露PM10对每日肺癌死亡率的影响。   结果   2013―2017年南京市因肺癌死亡14 693人,平均每日因肺癌死亡8.05人,男性占72.20%,高于女性(27.80%);PM10日均浓度为103.91 μg/m3,呈现季节性;2013―2017年PM10日均浓度呈逐年下降的趋势(χ2=120.16,P < 0.05);短期暴露PM10当日对肺癌死亡影响最大,滞后4 d天后相对危险度(relative risk,RR)效应消失,随着PM10浓度的增加肺癌死亡风险增加;在单日滞后效应中,PM10日均浓度每增加10 μg/m3,在滞后第3 d(lag3)对肺癌死亡危险影响最大,超额危险度(excess risk,ER)为1.004 3(95% CI:1.001 0~1.007 7);PM10暴露的滞后1~7天的累积效应,在滞后累积0~6天(lag0~6)对肺癌死亡危险影响最大,ER为1.008 0(95%CI:1.002 5~1.013 5);不同季节、不同性别、不同年龄段PM10日均浓度每增加10 μg/m3对肺癌死亡危险的单日效应及多日累积效应不同。   结论   南京市PM10日均浓度与肺癌死亡存在滞后相关性,PM10浓度越高肺癌死亡风险越大。

关 键 词:PM10    肺癌死亡    广义相加模型
收稿时间:2020-05-08

The correlation between PM10 and lung cancer death risk in Nanjing City
Institution:1.Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China2.Department of Environmental Health, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China3.Department of Non-communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China4.Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China
Abstract:   Objective   To explore the lag-correlation between Particulate matter with particle size below 10 mic(PM10) and the risk of lung cancer death in Nanjing, China.   Methods   We collected daily mortality and air pollution data of Nanjing from 2013 to 2017. Generalized additive model (GAM) and distributed lag non-linear models (DLNM) were used to estimate the effects of short-term exposure to PM10 on daily lung cancer mortality.   Results   A total of 14 693 deaths from lung cancer in Nanjing from 2013 to 2017, with the average daily death from lung cancer was 8.05. The proportion of men (72.20%) was higher than that of women (27.80%); The daily average PM10 concentration was 103.91 μg/m3, with obvious seasonality trend, and the daily average PM10 concentration exhibited a declining trend from 2013 to 2017 (χ2=120.16, P < 0.05); Short-term exposure to PM10 had the highest risk of mortality on the day (lag0), and the effect disappeared after lag4; with the increaseed of PM10 concentration, the risk of death increased; With each 10 μg/m3 increaseed in PM10 concentration, the maximum excess risk of death at lag 3 day was 1.004 3 (1.001 0-1.007 7) for the single-day effect, the maximum excess risk of death at lag 0-6 was 1.008 0 (1.002 5-1.013 5) for the multiple-day cumulative effect of PM10 exposure. The single-day effect and multi-day cumulative effect on the risk of lung cancer death among different seasons, different genders and different age groups were different, with each 10 μg/m3 increaseed in PM10 concentration.   Conclusions   There was a positive lag-association between PM10 and daily lung cancer mortality in Nanjing, with the concentrations of PM10 increased, the lung cancer death risk got higher.
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