我国空气污染物与人群呼吸系统疾病死亡急性效应的Meta分析  

A Meta analysis on the associations between air pollution and respiratory mortality in China

作　　者：刘昌景[1] 黄飞[1] 杨志洲[1] 孙兆瑞[1] 黄昌保[1] 刘红梅[1] 邵旦兵[1] 张炜[1] 任艺[1] 唐文杰[1] 韩小琴[1] 聂时南[1] 

机构地区：[1]南京军区南京总医院急救医学科,210002

出　　处：《中华流行病学杂志》2015年第8期889-895,共7页Chinese Journal of Epidemiology

基　　金：全军后勤面上项目（CNJ14L002）;江苏省博士后科研资助计划（1402140C）

摘　　要：目的回顾我国空气污染与呼吸系统疾病健康效应的研究，定量分析空气污染物[空气动力学直径〈2．5gm的细颗粒物（PM2.5）和〈10gm的可吸入颗粒物（PM10）、二氧化硫（SO2）、二氧化氮（NO2）和臭氧（O3）]与人群呼吸系统疾病急性死亡的关系。方法系统收集1989--2014年在PubMed、SpringerLink、Embase、Medline、中国期刊全文数据库、中国生物医学文献数据库和维普中文科技期刊全文数据库公开发表的有关我国空气污染与呼吸系统疾病健康效应的研究文献，总结该类研究在我国各省份的覆盖情况；并依据Meta分析法分别对PM10、PM2.5、NO2、SO2和O3，与人群呼吸系统疾病急性死亡关系的定量研究进行分析，采用Stata12．0软件进行异质性分析后利用固定或随机效应模型合并效应值，并检验发表偏倚。结果共收集到有关空气污染与人群呼吸系统疾病健康效应的研究文献157篇，覆盖我国79．4％的省份。Meta分析结果显示，PM10、PM2.5、NO2、SO2和O3浓度每上升10μg／m3，人群呼吸系统疾病死亡率分别增加0．50％（95％CI：0—0．90％）、0．50％（95％Ch0．30％～0．70％）、1．39％（95％CI：0．90％～1．78％）、1．00％（95％CI：0．40％-1．59％）和0．10％（95％CI：-1．21％～1．39％），各研究均未发现明显发表偏倚。结论我国PM10、PM2.5、NO2、SO2浓度的上升均会导致人群呼吸系统疾病急性死亡的增加。Objective To analyze the associations between air pollution and adverse health outcomes on respiratory diseases and to estimate the short-term effects of air pollutions[EParticulate matter with particle size below 10 microns（PM10）, PM10 particulate matter with particle size below 2.5 microns （PM2.5） , nitrogen dioxide （NO2） , sulphur dioxide （SO2） and ozone （O3） ] on respiratory mortality in China. Methods Data related to the epidemiological studies on the associations between air pollution and adverse health outcomes of respiratory diseases that published from 1989 through 2014 in China, were collected by systematically searching databases of PubMed, SpringerLink, Embase, Medline, CNKI, CBM and VIP in different provinces of China. Short-term effects between （PM10, PM2.5, NO2, SO2, O3） and respiratory mortality were analyzed by Meta-analysis method, and estimations were pooled by random or fixed effect models, using the Stata 12.0 software. Results A total of 157 papers related to the associations between air pollution and adverse health outcomes of respiratory diseases in China were published, which covered 79.4% of all the provinces in China. Results from the Meta-analysis showed that a 10 μg/m3 increase in PM10, PM2.5, NO2, SO2, and O3 was associated with mortality rates as 0.50% （95%CI： 0-0.90% ）, 0.50% （95%CI： 0.30%-0.70% ）, 1.39% （95% CI： 0.90%-1.78% ）, 1.00% （95% CI： 0.40%-1.59% ） and 0.10% （95% CI： -1.21%-1.39% ） inrespiratory tracts, respectively. No publication bias was found among these studies. Conclusion There seemed positive associations existed between PM10/PM2.5/NO2/SO2 and respiratory mortality in China that the relationship called for further attention on air pollution and adverse health outcomes of the respiratory diseases.

关 键 词：空气污染物 呼吸系统疾病 死亡率 META分析 

分 类 号：X51[环境科学与工程—环境工程] R56[医药卫生—呼吸系统]