上海市大气污染与居民每日死亡关系的病例交叉研究

目的 以病例交叉的研究方法，估计大气污染急性暴露对上海市居民每日死亡的影响，并探讨该设计用于大气污染急性健康效应研究的可行性。方法 采用病例交叉设计的方法分析上海市2000年6月1日至2001年12月31日大气污染与居民每日总死亡和分疾病别死亡的关系，同时比较双向对照设计和单向回顾性对照设计研究结果的差异。结果 采用不同的对照选择方案，病例交叉设计的研究结果变化较大；采用双向1：6的对照设计，大气可吸入颗粒物(PMl0)、二氧化硫(SO2)、二氧化氮(NO2)48h平均浓度每增加10μg／m^3，上海市城区居民总死亡发生的相对危险度分别为1．003(95％CI：1．001～1．005)、1．016(95％CI：1．011～1．021)、1．020(95％CI：1．012～1．027)。结论 上海市城区目前的PMl0、SO2、NO2水平对居民死亡确有影响；病例交叉设计是一种研究大气污染急性健康效应的有效工具。

A case-crossover study of ambient air pollution and daily mortality in Shanghai

OBJECTIVE: Using case-crossover design to estimate the acute effect of ambient air pollution on daily mortality in Shanghai, and to explore the applicability of if in studying the acute health effects of air pollution. METHODS: Case-crossover technique was used to evaluate the relationship between air pollution and daily mortality from June 2000 to December 2001 in Shanghai. The results of the bi-directional control sampling approach were compared with unidirectional approach. RESULTS: The validity of relative risks in case-crossover studies varied greatly depending on the strategy used in control sampling. When a bi-directional six control sampling approach was used an increase of relative risk of non-accident mortality on each 10 micro g/m(3) over a 48-hr moving average of PM(10), SO(2) and NO(2) corresponds to 1.003 (95% CI: 1.001 - 1.005), 1.016 (95% CI: 1.011 - 1.021), and 1.020 (95% CI: 1.012 - 1.027) respectively was seen. CONCLUSION: The results reinforced the deleterious role of current air pollution level on human health in Shanghai, and provided information on the applicability of case-crossover design in studying the acute health effects of air pollution.