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。     

大气细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大气细颗粒物(PM2.5)短期暴露与人群死亡关系的流行病学资料,以获取大气PM2．5-居民死亡的暴露-反应关系。方法在联机检索文献的基础上,对多篇文献的综合评价采用Meta分析的方法进行,定量确定PM2.5居民每日死亡的暴露-反应关系。结果建立了居民短期接触大气PM2.5污染的暴露-反应关系,即大气PM2.5浓度每升高100μg／m^3,居民死亡发生增加的百分比为12．07％(95％可信区间：8．31％-15．82％)。结论本研究建立的暴露-反应关系,可用于我国及各城市大气细颗粒物污染的健康危险度评价工作。     

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.     

我国大气可吸入颗粒物污染对人群死亡率的影响

目的 综合相关文献并以暴露-反应关系的形式探讨中国可吸入颗粒物( PM10)污染对人群死亡率的影响.方法 收集符合纳入标准的中国大气颗粒物污染与居民总死亡率、心脑血管疾病死亡率、呼吸系统疾病死亡率关系的文献,共纳入21篇文献.采用Stata9.0软件进行统计分析,提取PM10与人群死亡率的暴露-反应系数,利用固定或随机效应模型合并效应值,并对结果进行敏感性分析、发表偏倚检验与校正.结果 我国大气PM10每上升10 μg/m3,人群每日总死亡率、心脑血管疾病和呼吸系统疾病死亡率的相对危险度(RR)分别为1.0033(95％ CI:1.0022～1.0044)、1.0045(95％ CI:1.0029 ～1.0062)和1.0056(95％CI:1.0033～1.0079);校正发表偏倚后,人群每日总死亡率、心脑血管疾病和呼吸系统疾病死亡率的RR值降为1.0012(95％CI:1.0002～1.0022)、1.0011(95％ CI:0.9996～1.0026)和1.0023(95％ CI:1.0001～1.0045).结论 大气中PM10浓度的上升会导致我国人群每日总死亡率、心脑血管疾病死亡率和呼吸系统疾病死亡率的增加.     

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.     

北京市大气PM10浓度与居民呼吸系统疾病死亡的时空分析研究

目的探讨北京市2008—2009年大气PM10浓度的时空分布特征和人群暴露水平,分析北京市大气PM10浓度对居民呼吸系统疾病死亡的暴露-反应关系。方法采用克里格插值模型对研究期间北京市大气PM10的日均浓度进行估计,采用时间序列的广义相加混合效应模型分析大气PM10浓度对居民呼吸系统疾病死亡的暴露-反应关系。结果北京市2008—2009年大气PM10的日均浓度为118.6μg/m3,高于GB 3095—1996《环境空气质量标准》二级标准。研究期间大气PM10浓度呈现自北向南逐渐升高的空间分布规律。北京市大气PM10浓度每升高10μg/m3对呼吸系统疾病死亡的超额危险度为0.56%(95%CI:0.28%~0.83%)。引入多污染物模型后大气PM10浓度对呼吸系统疾病死亡的超额危险度略有减小,但仍有统计学意义(P0.05)。结论采用克里格插值模型能够较为精确地估计北京市大气PM10浓度的空间分布状况;大气PM10浓度对北京市居民呼吸系统死亡存在一定的暴露-反应关系。     

镇江市大气颗粒物（PM10和PM2.5）对居民每日死亡率影响的时间序列分析

目的评价镇江市大气颗粒物(PM10和PM2.5)短期暴露对居民每日死亡率的影响。方法采用基于广义相加模型的时间序列分析方法评估大气颗粒物对镇江市居民死亡率的影响。结果 PM10和PM2.5对人群死亡影响存在滞后效应和累积滞后效应,对女性和≥65岁人群的影响更为显著。PM10和PM2.5分别在累积滞后1 d和2 d时效应最大,PM10和PM2.5每升高10μg/m3,居民死亡率分别增加0.52%(95%CI:0.10%～0.94%)和0.79%(95%CI:0.14%～1.43%)。结论镇江市大气颗粒物与居民的超额死亡风险显著相关。     

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。     

大气颗粒物与居民脑卒中发作 或死亡之间关系的Meta分析

目的 研究大气颗粒物污染(PM10、PM25)与居民脑卒中发作或死亡之间的关系.方法 检索文献数据库,应用Meta分析法对符合文献纳入标准的16个有关大气颗粒物与居民脑卒中每日发作或死亡关系的定量研究进行综合分析.根据异质性检验结果选用固定效应模型或随机效应模型,采用大气颗粒物每上升10 μg/m3,居民脑卒中死亡的危险度(OR)为效应值进行效应值合并,做敏感性分析.结果 PM10浓度每上升10 μg/m3,居民脑卒中发作的OR=1.011(95%CI:1.001～1.021),即发作增加1.09%(95%CI:0.10%～2.08%),死亡的OR=1.007(95%CI:1.006～1.008),即死亡增加0.70%(95%CI:0.60%～0.80%),说明PM10浓度上升与居民脑卒中发作或死亡均有统计学相关,敏感性分析结果均稳定;PM25浓度每上升10 μg/m3,居民脑卒中发作的OR=1.001(95%CI:0.992～1.010),死亡的OR=1.052(95%CI:0.958～1.154).结论 研究结果表明PM10的空气污染对居民脑卒中发作率和死亡率的增加有统计学相关,PM25浓度增高与脑卒中发作或死亡无统计学相关.     

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。     

北京城区强沙尘天气对人群短期健康影响的调查分析

目的研究北京城区沙尘天气对人群以呼吸系统症状为主的急性健康影响。方法采用自填式问卷调查法,在2005年春季的一次强沙尘天气期间,对北京市崇文区4所小学845例4～5年级学生及1653例成人进行调查,内容包括被调查者一般情况、浮尘天气过程自觉不适症状及诊疗情况等。同时收集浮尘天气过程PM10,NO2及SO2的日平均浓度,对大气各污染物与人群症状发生率做多元回归分析,并对儿童与成人的症状发生率进行比较。结果浮尘天气导致儿童与成人组发生眼、口、鼻、咽喉等部位的不适症状,大气PM10浓度与人群多数症状的发生率间存在正相关,此外,儿童对浮尘污染的刺激更为敏感。结论浮尘天气导致大气PM10浓度的升高,可以对人体呼吸系统产生急性不良影响。     

Effects of particulate matter on daily mortality in 13 Japanese cities

BACKGROUND: In recent years, numerous reports demonstrating the relationship between an increase in the concentration of fine particulate matter (PM2.5) and daily mortality have been released in the United States and Europe. There have been few studies that clearly characterize the short-term effects of particulate matter on the mortality in Japan. We conducted data analysis to investigate the short-term effects of suspended particulate matter (SPM) on mortality in Japan. METHODS: In this study, we used data sets from the 13 largest cities containing data on the daily mortality of residents aged 65 years or older, concentrations of air pollutants including SPM, temperature, and humidity. Risk ratios for mortality resulting from respiratory diseases, cardiovascular diseases, and all causes other than accidents, from 1990 through 1994, were summarized using a generalized additive model (GAM) and a meta-analysis of random effect model. RESULTS: The risk ratios for an increase of 10 microg/m3 in SPM concentrations adjusted for SO2, NO2, CO, Ox, temperature, and humidity were 1.0077 for all causes of mortality, 1.0109 for respiratory diseases, and 1.0091 for cardiovascular diseases, and the lower limits of the 95% confidence intervals for the risk ratios were greater than one for all cases. With regards to the effects of time lag, risk ratios were higher for the SPM concentrations on the day when the mortality was recorded, and the preceding day. CONCLUSIONS: These results suggest a positive relationship between SPM concentrations and daily mortality in Japan.     

The short-term effect of 24-h average and peak air pollution on mortality in Oslo, Norway

Numerous epidemiological studies have shown associations between increases in outdoor air pollution and all-cause mortality as well as cardiovascular and respiratory related mortality. The majority of studies has used the routine monitoring network and thus has not been able to characterize the small-scale variation in daily averages and peak concentrations within urban settings. To address possible short term impact on mortally by air pollution we used a time-stratified case-crossover design to estimate associations of traffic-related air pollution and wood burning and daily mortality during a period of 10?years among residents above 50?years of age in Oslo, Norway. A dispersion model was used to assess short-term air pollution for daily (24-h) averages and peak concentrations of nitrogen dioxide (NO₂) from exhaust and particulate matter with a diameter of 2.5?μm or less (PM_2.5) from exhaust and wood-burning at residential neighbourhood level for each individual. We found an overall increased risk from exposure at the lag of 0–5?days before the day of death for both pollutants. The excess risk was highest for PM_2.5 with a 2.8?% (95?% confidence interval: 1.2–4.4) increase per 10?μg per cubic meter change in daily exposure. Short-term traffic-related air pollution was associated with increased risk for mortality among individuals above 50?years of age, especially for circulatory outcomes.     

沈阳市日均气温与呼吸疾病死亡率关系

目的定量评价辽宁省沈阳市日平均气温短期变化对居民呼吸系统疾病日均死亡率的影响。方法运用半参数一般递加模型,在控制长期趋势、气压和季节等混杂因素的基础上,分析沈阳市1992～2000年日间平均气温与居民日呼吸系统疾病死亡的关系。结果呼吸系统疾病死亡率与日平均气温呈反\     

Potential confounding of particulate matter on the short-term association between ozone and mortality in multisite time-series studies

BACKGROUND: A critical question regarding the association between short-term exposure to ozone and mortality is the extent to which this relationship is confounded by ambient exposure to particles. OBJECTIVES: We investigated whether particulate matter < 10 and < 2.5 microm in aerodynamic diameter (PM(10) and PM(2.5)) is a confounder of the ozone and mortality association using data for 98 U.S. urban communities from 1987 to 2000. METHODS: We a) estimated correlations between daily ozone and daily PM concentrations stratified by ozone or PM levels; b) included PM as a covariate in time-series models; and c) included PM as a covariate as in d), but within a subset approach considering only days with ozone below a specified value. RESULTS: Analysis was hindered by data availability. In the 93 communities with PM(10) data, only 25.0% of study days had data on both ozone and PM(10). In the 91 communities with PM(2.5) data, only 9.2% of days in the study period had data on ozone and PM(2.5). Neither PM measure was highly correlated with ozone at any level of ozone or PM. National and community-specific effect estimates of the short-term effects of ozone on mortality were robust to inclusion of PM(10) or PM(2.5) in time-series models. The robustness remains even at low ozone levels (< 10 ppb) using a subset approach. CONCLUSIONS: Results provide evidence that neither PM(10) nor PM(2.5) is a likely confounder of observed ozone and mortality relationships. Further investigation is needed to investigate potential confounding of the short-term effects of ozone on mortality by PM chemical composition.     

广义相加模型在气温对人群死亡率影响研究中的应用

目的 了解气温等气象因素对城市居民每日疾病死亡的影响特点与规律,以采取针对性的预防措施,减少因气候变化导致的居民超额死亡率.方法 根据重庆市疾病预防控制中心提供的2003年1月1日至2007年12月31日的某县居民每日死亡资料和中国气象局提供的相应期间气象监测资料,采用时间序列的Poisson广义相加模型,在控制长期趋势、季节趋势、短期波动及双休日效应等混杂因素的基础上,分析气温、相对湿度、气压、降雨量、风速等气象因素及空气污染指数与居民每日死亡的关系.结果 气温每上升1℃,超额死亡率为12%;其他混杂因子中,相对湿度每下降1%,超额死亡率为4%;空气污染指数每上升1个单位,超额死亡率为0.6%.结论 气温的增加及其与相对湿度、空气污染等协同作用可导致该县居民超额死亡率的上升.

Abstract：

Objectives To study the impacts of air temperature and the other weather factors on the daily mortality of the residents in cities for targeting the preventive measures to decrease the excess mortality induced by climate change.Methods The daily mortality and weather surveillance data were provided by Chongqing Center for Disease Control and Prevention and China Meteorological Bureau respectively.The correlation between the weather factors (temperature,humidity,air pressure,rainfall,wind speed)and the daily mortality of residents in a county of Chongqing were analyzed by using the Poisson GAM of time series (increased by 1℃ for air temperate,decreased by 1% for relative humidity and one unit for air pollution index)adjusting for the secular trend,seasonal trend,short-term fluctuation and day of week.Results The excess mortality increased to 12%as the temperature increased 1℃,The excess mortality inereased to 4%and 0.6%respectively as the relative humidity decreased 1%and the air pollution index increased one unit.Conclusion High temperature,with humidity and air pollution,will cause increased excess mortality of residents in this county.     

上海市卢湾区居民日死亡数与大气污染关系的时间序列研究

[目的]分析上海市卢湾区大气污染急性暴露对居民每日死亡数的影响。[方法]分别采用时间序列的半参数广义相加模型(GAM)和广义线性模型(GLM),在控制死亡的长期趋势、气象因素、“星期几效应”等混杂因素的基础上,分析上海市卢湾区2001年1月1日~2004年12月31日大气污染与居民每日死亡数的关系。[结果]在GAM中大气可吸入颗粒物(PM10),SO2和NO2,48h平均浓度每增加10μg/m3,居民死亡的相对危险度分别为1.0003(95%CI1.0000~1.0007)、1.0009(95%CI0.9998~1.0019)和1.0012(95%CI1.0003~1.0021);在GLM中大气PM10,SO2和NO2,48h平均浓度每增加10μg/m3,居民死亡的相对危险度分别为1.0004(95%CI1.0001~1.0008)、1.0008(95%CI0.9998~1.0019)和1.0012(95%CI1.0002~1.0022)。[结论]GAM、GLM拟和结果相似,上海市卢湾区目前的PM10和NO2水平对居民日死亡数有影响。     

Relevance and feasibility of a surveillance system of the effects of atmospheric pollution

New regulations on the quality of air together with the epidemiological results obtained in the last 10 years on the short-term effects of air pollution on health have led the InVS to set up a program of epidemiological surveillance in 9 French cities. The first phase of this program was dedicated to the study of feasibility of such a surveillance system. Metrological and health data collection was conducted at both local and national levels in order to obtain significant data in close collaboration with experts of each field. The analysis of the relationship between temporal variations of daily series of the two types of indicators have allowed to obtain dose-response relationships between air pollution and mortality. The organisational and technical feasibility of such a surveillance system was confirmed in the first phase of the program.