2013―2019年南京市大气PM2.5短期暴露对人群超额死亡风险评估

目的  评估2013―2019年南京市大气细颗粒物(fine particulate matter, PM_2.5)短期暴露对人群死亡的影响及其所致超额死亡人数。方法  收集环保、气象、户籍人口和死因监测数据，采用广义相加模型分析PM_2.5对人群死亡的影响，得到暴露-反应关系系数，估算因PM_2.5短期暴露导致人群超额死亡人数。结果  在2013―2019年，南京市大气PM_2.5质量浓度增加，居民各系统疾病死亡风险随着升高(均有P < 0.05)。PM_2.5短期暴露引发的人群非意外总死亡中超额死亡人数为8 479人，占人群非意外总死亡的3.21%；呼吸系统疾病、恶性肿瘤疾病、循环系统疾病、脑血管疾病和心血管疾病的超额死亡人数及其占所属疾病类型总死亡人数的比例分别为1 202人(4.32%)、1 424人(1.60%)、4 505人(3.94%)、2 613人(3.79%)和1 856人(4.14%)。结论  2013―2019年南京市PM_2.5质量浓度和其造成的居民超额死亡人数呈降低趋势，南京市大气污染防治健康收益良好。

Assessing the excess mortality related to short-term exposure to PM2.5 in Nanjing from 2013 to 2019

  Objective  To estimate impact of residents death and excess mortality induced by fine particulate matter (PM_2.5) short-term exposure in Nanjing from 2013 to 2019.  Methods  Environmental data, meteorological data, population of community residents and death surveillance data in Nanjing was collected. Generalized additive model of time series analysis was used to analyze the effects of PM_2.5 on risk of death, and estimated excess mortality related to PM_2.5.  Results  The risk of residents death increased while the concentration of PM_2.5 increased in Nanjing from 2013 to 2019. The number of excess mortality due to PM_2.5, including non-accidental causes, respiratory diseases, cancer, circulatory diseases, cerebrovascular diseases, cardiovascular diseases was 8 479(3.21%), 1 202(4.32%), 1 424(1.60%), 4 505(3.94%), 2 613(3.79%) and 1 856(4.14%).  Conclusion  The excess mortality caused by PM_2.5 was decreasing while the concentration of PM_2.5 decreased in Nanjing from 2013 to 2019. The health benefits of air pollution prevention and control in Nanjing are good.