大气PM2.5与O3对宁夏地区人群循环系统疾病死亡的影响及其交互作用
Individual and interactive effects of atmospheric PM2.5 and O3 on mortality of circulatory system diseases in Ningxia
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摘要:
背景 大气细颗粒物（PM2.5）与臭氧（O3）对人群循环系统疾病死亡的影响不容忽视，有关PM2.5与O3的交互作用能否对人群健康产生影响的报道较少，有待研究。
目的 探究大气PM2.5与O3对宁夏地区人群循环系统疾病死亡的影响，以及二者的交互作用。
方法 使用2013—2020年宁夏地区119647例循环系统疾病死亡数据、大气污染物日均浓度资料和气象资料，将PM2.5按一级、二级浓度限值（35、75 μg·m−3）分为低、中、高浓度，同样，O3按浓度限值（100、160 μg·m−3）分为低、中、高浓度，采用基于类泊松分布的广义相加混合模型分析大气PM2.5与O3对宁夏地区人群循环系统疾病死亡影响的单独及交互作用。
结果 在研究期间内，因循环系统疾病中男性和≥65岁组人群的死亡占比大（55.47%，79.87%）；大气污染物PM2.5的日均值（40.25 μg·m−3）超过一级浓度限值。在单污染模型中，累积滞后1 d（lag01）的PM2.5和累积滞后2 d（lag02）的O3对循环系统疾病死亡影响的风险最大，其超额危险度（ER）分别为1.03%（95%CI：0.67%~1.40%）及1.02%（95%CI：0.57%~1.50%）；浓度分层分析结果显示，中浓度下的PM2.5和O3对循环系统疾病死亡的风险最为显著，ER（95%CI）分别为1.12%（95%CI：0.32%~1.92%）和0.95%（95%CI：0.13%~1.79%）。交互作用研究结果表明，在高于一级限值浓度时，PM2.5和O3共存（相对超额危险度=3.08%，交互作用归因比例=2.90%，交互效应指数=1.89）对循环系统疾病死亡风险存在协同作用。随着PM2.5与O3浓度的升高，协同作用对总人群、男性、女性以及≥65岁组人群因循环系统疾病死亡风险越大。
结论 大气PM2.5与O3均能增加人群循环系统疾病的死亡风险，且两污染物对人群循环系统疾病死亡风险存在协同作用。
Abstract:Background The impact of atmospheric fine particulate matter (PM2.5) and ozone (O3) on the mortality of circulatory system diseases cannot be ignored. However, whether the interaction between PM2.5 and O3 can affect population health is rarely reported and requires study.
Objective To investigate the individual and interactive impacts of atmospheric PM2.5 and O3 on the mortality of circulatory system diseases in the population of Ningxia region.
Methods The data of 119647 deaths due to circulatory system diseases, daily average concentrations of atmospheric pollutants, and meteorological data in Ningxia from 2013 to 2020 were retrieved. PM2.5 was divided into low, medium, and high concentrations according to the primary and secondary national limits (35 and 75 μg·m−3) of the
Ambient air quality standards . Similarly, O3 was divided into low, medium, and high concentrations according to the national limits (100 and 160 μg·m−3). Using a generalized additive mixed model based on quasi Poisson distribution, the impacts of atmospheric PM2.5 and O3 as well as their interaction on the mortality of circulatory system diseases were analyzed using the population data of Ningxia region.Results During the target period, males and the ≥ 65 year group accounted for larger proportions of deaths due to circulatory system diseases (55.47% and 79.87% respectively). The daily average concentration of PM2.5 (40.25 μg·m−3) exceeded the national primary limit. In the single pollution model, the highest cumulative lag effects for mortality from circulatory system diseases were PM2.5 exposure over previous 1 d (lag01) and O3 exposure for previous 2 d (lag02), and their excess risk (ER) values were 1.03% (95%CI: 0.67%, 1.40%) and 1.02% (95%CI: 0.57%, 1.50%), respectively. The results of concentration stratification analysis showed that the most significant risks of death from circulatory system diseases ER (95%CI): 1.12% (0.32%, 1.92%) and 0.95% (0.13%, 1.79%) respectively were found at medium PM2.5 and O3 concentrations. The interaction analysis revealed that under, a synergistic effect on the risk of death from circulatory system diseases was identified (relative excess risk due to interaction=3.08%, attributable proportion of interaction=2.90%, synergy index=1.89) when considering the coexistence of PM2.5 and O3 above the primary limit. As the concentrations of PM2.5 and O3 increased, the synergistic effect increased the risk of death from circulatory system diseases in the general population, men, women, and the ≥ 65 years group.
Conclusion Both atmospheric PM2.5 and O3 can increase the risk of death from circulatory system diseases, and the two pollutants have a synergistic effect on the risk of death from circulatory system diseases.
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