上海市大气污染与慢性阻塞性肺病死亡的关联性  

Association between Ambient Air Pollution and COPD Mortality in Shanghai

作　　者：钱轶峰[1] 韩明[1] 靳文正[1] 蔡任之[1] 方博[1] 虞慧婷[1] 钱耐思[1] 王春芳[1] 

机构地区：[1]上海市疾病预防控制中心生命统计科,上海200336

出　　处：《环境与职业医学》2015年第12期1093-1097,共5页Journal of Environmental and Occupational Medicine

基　　金：上海市卫生局重点项目(编号:20134022);上海市卫生局面上项目(编号:20134Y135);上海市卫生局青年科研基金(编号:20134Y071);上海市国际科技合作基金(编号:13430710200);上海市卫生和计划生育委员会科研项目(编号:20124383)

摘　　要：[目的]研究大气污染与慢性阻塞性肺病（COPD）死亡的关联,探讨大气污染环境中COPD死亡易感人群。[方法]收集上海市2003年至2012年大气污染及气象相关数据,并汇总该10年内户籍人口的全部COPD死亡病例,采用时间分层-病例交叉设计方法分析两者间关系。此外对年龄、性别及受教育程度等因素所划分的不同层间的效应值进行比较分析。[结果]收集106 525份上海市户籍居民COPD死亡病例。大气污染物PM10、二氧化硫（SO2）及二氧化氮（NO2）均与COPD死亡存在相关关系,上述3种污染物每增加10μg/m^3时,在滞后0-3 d（Lag03）时导致COPD死亡的OR值分别为1.005、1.014及1.014,95%CI分别为（1.003-1.007）、（1.010-1.018）及（1.009-1.019）;SO2每增加10μg/m3时,在滞后3 d（Lag3）时受教育程度较低人群COPD死亡的OR值（95%CI）为1.011（1.008-1.015）,高于在同等条件下受教育程度较高人群的COPD死亡风险0.995（0.980-1.010）。[结论]大气污染可增加人群COPD死亡风险,受教育程度较低人群在大气污染环境中更易诱发COPD。[Objective] To investigate the risks of chronic obstructive pulmonary disease（COPD） mortality associated with short-term exposure to air pollution, and to identify vulnerable populations. [Methods] COPD mortality cases and daily meteorological data including air pollution between 2003 and 2012 in Shanghai were collected. Time-stratified case-crossover approach was used to assess the association between daily concentrations of air pollutants and COPD mortality. The effects of age, gender, and educational attainment were also examined as effect modifiers. [Results] Altogether 106 525 mortality cases were collected. COPD was found to be significantly associated with PM10, sulfur dioxide（SO2）, and nitrogen dioxide（NO2）. The OR（95%CI） of COPD mortality for a 10- μg/m^3 increase of PM10, SO2, and NO2 was 1.005（1.003-1.007）, 1.014（1.010-1.018）, and 1.014（1.009-1.019） respectively for lag 0-3 days（Lag03）. For an increase of 10 μg/m3 for SO2, the OR（95%CI） of COPD mortality for people with low educational attainment was 1.011（1.008-1.015） for lag 3 days（Lag3）, which was substantially higher than those with high educational attainment [0.995（0.980-1.010）]. [Conclusion] This study provides new evidence for the association between exposure to ambient air pollution and COPD mortality risk. Our results also suggest that low educational attainment may increase the risk for COPD mortality in relation to air pollution exposure.

关 键 词：大气污染 慢性阻塞性肺病 死亡 病例交叉设计 条件LOGISTIC回归 

分 类 号：R122.2[医药卫生—环境卫生学]