南京市大气PM10短期暴露对心血管疾病死亡的影响

Effect of short-term exposure to PM10 on mortality of cardiovascular diseases in Nanjing

  • 摘要:
    背景 PM10污染与人群健康关系的研究已经被广泛报道,大多数研究仅仅关注PM10污染与呼吸系统疾病、循环系统疾病等某一大类疾病的死亡风险,而PM10与特定心血管疾病死亡效应的研究也值得关注。
    目的 探讨南京市大气PM10短期暴露对心血管疾病死亡的影响。
    方法 收集南京市2014年1月1日—2018年12月31日每日心血管疾病死亡人数、大气污染物粗颗粒物(PM10)、二氧化硫(SO2)、二氧化氮(NO2)、一氧化碳(CO)、臭氧(O3)、细颗粒物(PM2.5)的平均每日质量浓度以及每日气象因素(包括气温、相对湿度),采用时间序列分析方法,分季节(冷季:10—3月;暖季:4—9月)研究大气PM10浓度对每日心血管疾病死亡人数的效应,并分析对不同性别、年龄、文化水平人群的影响。
    结果 大气污染物PM10、SO2、NO2、CO、O3、PM2.5质量浓度分别为(91.6±52.2)μg·m-3、(17.7±9.9)μg·m-3、(45.5±18.6)μg·m-3、(0.9±0.3)mg·m-3、(100.8±49.1)μg·m-3、(52.5±34.7)μg·m-3,其中PM10、NO2和PM2.5平均质量浓度超过国家二级标准限值。不同心血管疾病死亡效应:PM10质量浓度每增加10 μg·m-3,全年心血管疾病、高血压、急性心肌梗死、其他缺血性心脏病的死亡风险分别升高0.88%(95% CI:0.58%~1.18%)、1.74%(95% CI:0.96%~2.52%)、0.97%(95% CI:0.46%~1.49%)、0.79%(95% CI:0.33%~1.25%)。全年和冷季水平,PM10质量浓度每增加10 μg·m-3,女性心血管疾病总死亡的风险均高于男性;>65岁人群心血管疾病总死亡风险分别升高0.99%(95% CI:0.67%~1.31%)、0.94%(95% CI:0.58%~1.31%);高中以下学历人群心血管疾病总死亡风险分别升高0.96%(95% CI:0.62%~1.29%)、0.86%(95% CI:0.47%~1.24%)。暖季水平PM10质量浓度对心血管疾病总死亡的影响均无统计学意义(P>0.05)。
    结论 大气PM10短期暴露会增加人群心血管疾病总死亡、高血压、急性心肌梗死和其他缺血性心脏病的死亡风险。

     

    Abstract:
    Background Studies on the relationship between PM10 pollution and population health have been widely reported. Most studies only focus on the death risks of respiratory and circulatory diseases, rather than specific cardiovascular diseases which also deserve concern, linked to PM10 pollution.
    Objective This study explores the effect of short-term exposure to PM10 on mortality of cardiovascular diseases in Nanjing.
    Methods Daily deaths from cardiovascular diseases, daily average concentrations of air pollutantsincluding coarse particles (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), and fine particles (PM2.5), and meteorological factors (including temperature and relative humidity) from January 1, 2014 to December 31, 2018 in Nanjing were collected to analyze the relationship between season-specific (cold season:October to next March; warm season:April to September) PM10 concentration and daily cardiovascular mortality by time-series analysis, and the effect sizes in different gender, age, and educational level groups.
    Results The average concentrations of PM10, SO2, NO2, CO, O3, and PM2.5 were (91.6±52.2) μg·m-3, (17.7±9.9) μg·m-3, (45.5±18.6) μg·m-3, (0.9±0.3) mg·m-3, (100.8±49.1) μg·m-3, and (52.5±34.7) μg·m-3, respectively. The results of PM10, NO2, and PM2.5 exceeded the national class Ⅱ limits. For each 10 μg·m-3 increase in PM10 concentration at annual level, the mortality risks of cardiovascular diseases, hypertension, acute myocardial infarction, and other ischemic heart diseases increased by 0.88% (95% CI:0.58%-1.18%), 1.74% (95% CI:0.96%-2.52%), 0.97% (95% CI:0.46%-1.49%) and 0.79% (95% CI:0.33%-1.25%). At annual and cold season levels, for each 10 μg·m-3 increase in PM10 concentration, the total mortality risks of cardiovascular diseases in women were higher than that in men; the risks in residents over age of 65 increased by 0.99% (95% CI:0.67%-1.31%) and 0.94% (95% CI:0.58%-1.31%) respectively; the risks in residents under high school education increased by 0.96%(95% CI:0.62%-1.29%) and 0.86% (95% CI:0.47%-1.24%) respectively. There was no significant effect of PM10 in warm season on mortality of cardiovascular diseases.
    Conclusion Short-term exposure to PM10 increases the mortality risks of cardiovascular diseases, hypertension, acute myocardial infarction, and other ischemic heart diseases.

     

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