大气污染物与气温交互作用对我国居民死亡影响的系统综述

Systematic review of synergistic effect between air pollutants and temperature on human mortality in China

  • 摘要:
    背景 大气污染物和不适宜气温对健康的独立不良影响已得到证实,但二者交互作用的研究结果并不一致。
    目的 系统回顾大气污染物与气温交互作用对我国居民死亡影响的相关文献,探析二者交互作用及其强度。
    方法 检索万方数据知识服务平台、中国知网、维普资讯中文期刊服务平台、PubMed、Web of Science、Science Direct、Embase数据库,选用“气温”“大气污染物”“死亡”等主题检索词,检索大气污染物与气温交互作用对我国居民死亡影响的相关文献。检索时限为2000年1月1日至2022年7月31日,发表语言限制为中文和英文。由2名研究者根据纳排标准独立筛选文献,提取资料后对文献结果进行整合研究,使用R软件的“meta”程序包对文献研究结果进行meta分析。
    结果 最终纳入符合标准的文献27篇,涉及污染物主要包括PM10、PM2.5、O3、SO2、NO2、CO等。与中等温度相比,高温条件下PM10和PM2.5对人群死亡的交互作用更强,PM10每上升10 μg·m−3,非意外总死亡、心血管系统疾病死亡和呼吸系统疾病死亡危险度增加百分比及其95%CI分别为2.30%(1.34%~3.26%)、1.23%(0.64%~1.82%)、1.42%(0.63%~2.22%);PM2.5每上升10 μg·m−3,非意外总死亡、心血管系统疾病死亡和呼吸系统疾病死亡危险度增加百分比及其95%CI分别为2.56%(2.00%~3.13%)、2.37%(1.64%~3.12%)、2.14%(1.03%~3.25%)。低温条件下SO2、NO2对心血管系统疾病和呼吸系统疾病死亡的交互作用更强。
    结论 大气污染物与气温对我国居民死亡存在交互作用,高温或低温条件下大气污染物与气温对健康的交互作用强于中等温度,在此条件下应进一步加强健康防护。

     

    Abstract:
    Background Air pollutants and extreme temperature both pose significant threats to human health, but the synergistic effect between air pollutants and temperature on health is inconsistent.
    Objective To explore a potential synergistic effect between air pollutants and temperature on the mortality in China through literature review.
    Methods Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, VIP Information Chinese Journal Service Platform, PubMed, Web of Science, Science Direct, and Embase databases were searched. "Temperature" "air pollution" "mortality" were selected as keywords to collect literature on synergistic effect between air pollutants and temperature on mortality in China. Literature was published from 2000-01-01 to 2022-07-31 in Chinese or English. Two researchers screened the literature independently according to the inclusion criteria, and the results were integrated and analyzed after data extraction. The "meta" package of R software was used for meta-analysis.
    Results Twenty-seven studies met the inclusion criteria and associated air pollutants included PM10, PM2.5, O3, SO2, NO2, and CO. The impact of PM10 and PM2.5 on mortality in high temperature days was higher than that in moderate temperature days. In high temperature days, a 10 μg·m−3 increment in PM10 concentration corresponded to pooled estimates of 2.30% (95%CI: 1.34%-3.26%), 1.23% (95%CI: 0.64%-1.82%), and 1.42% (95%CI: 0.63%-2.22%) increase in non-accidental, cardiovascular, and respiratory mortalities, respectively. A 10 μg·m−3 increment in PM2.5 concentration corresponded to pooled estimates of 2.56% (95%CI: 2.00%-3.13%), 2.37% (95%CI: 1.64%-3.12%), and 2.14% (95%CI: 1.03%-3.25%) increase in non-accidental, cardiovascular, and respiratory mortalities, respectively. The synergistic effect of SO2 and NO2 on cardiovascular and respiratory mortalities in low temperature days was higher than that in moderate temperature days.
    Conclusion The synergistic effects of air pollutants and temperature on mortality in low temperature days or in high temperature days are higher than that in moderate temperature days. The health protection related to these pollutants should be strengthened in these days.

     

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