大气污染物短期效应对上海市浦东新区居民肺癌死亡影响的病例交叉研究

目的 分析大气污染物与浦东新区居民每日肺癌死亡人数的相关性,为制定针对肺癌病人的保护措施提供依据。方法 采集浦东新区2005年1月1日至2019年12月31日之间的每日大气污染物浓度、气象因素以及居民肺癌死亡资料,利用时间分层-病例交叉设计并结合分布滞后非线性模型,探讨大气污染物短期暴露对浦东新区居民肺癌死亡的影响。结果 大气污染物(PM₁₀, SO₂, NO₂)浓度与浦东新区居民肺癌死亡风险呈正相关。PM₁₀, SO₂, NO₂浓度对居民肺癌死亡风险的影响均在累积8 d(Lag 0～7)最强。PM₁₀, SO₂, NO₂浓度上升10 μg/m³累积8 d(Lag 0～7)居民肺癌死亡风险分别上升1.09%(95%CI:0.35%～1.83%), 3.78%(95%CI:1.98%～5.61%)与2.76%(95%CI:1.10%～4.44%)。女性人群肺癌死亡对PM₁₀与NO₂的影响不敏感(P>0.05)。大气污染物对高龄人群与低文化水平人群肺癌死亡效应较强,人群间效应差异不显著。结论 大气污染物短期暴露可以升高浦东新区居民肺癌死亡风险,以累积8 d(Lag 0～7)效应最强。

A case-crossover study on the short term impact of air pollution on lung cancer mortality in Pudong New Area,Shanghai

Objective To analyze the impact of air pollution on daily lung cancer mortality in Pudong New Area, so as to provide the reference for the development of the strategy to protect lung cancer patients. Methods The data including the concentration of air pollutants, meteorology and daily deaths from lung cancer in Pudong New Area from January 1, 2005 to December 31, 2019 had been collected, and a time stratified case-crossover study with distributed lag non-linear model was performed to assess the association between air pollution and daily deaths from lung cancer. Results The concentration of ambient air pollutants including PM₁₀, SO₂ and NO₂ was positive associated with daily deaths from lung cancer of residents in Pudong New Area. The strongest cumulative effects for PM₁₀, SO₂ and NO₂ were observed on eight days lag(Lag 0-7). For a 10 μg/m³ increase of the concentrations of PM₁₀, SO₂ and NO₂, the corresponding increase of cumulative deaths from lung cancer was 1.09%(95%CI: 0.35%-1.83%), 3.78%(95%CI: 1.98%-5.61%)and 2.76%(95%CI: 1.10%-4.00%), respectively. The risk of death from lung cancer in females was not susceptible to PM₁₀ and NO₂ (P>0.05). The impact of air pollution on the old and low educated population was stronger, and the difference among the impact of air pollution on different subgroups was not significant. Conclusion The short term exposure to ambient air pollution was positively associated with deaths from lung cancer of residents in Pudong New Area, and the impact was strongest in Lag 0-7.