低浓度一氧化碳对上海市闵行区居民心脑血管疾病死亡的影响  

Effect of low-concentration carbon monoxide on cardiovascular and cerebrovascular disease mortality of residents in Minhang District,Shanghai

作　　者：应圣洁[1] 陈丽[1] 顾怡勤 汪曦[2] 陈林利[3] 李传奇[4] YING Sheng-jie;CHEN Li;GU Yi-qin;WANG Xi;CHEN Lin-li;LI Chuan-qi(Department of Environmental and Occupational Health,Shanghai Minhang District Center for Disease Control and Prevention,Shanghai 201101,China;Department of Immunization Program,Shanghai Minhang District Center for Disease Control and Prevention,Shanghai 201101,China;Department of Information,Shanghai Minhang District Center for Disease Control and Prevention,Shanghai 201101,China;Department of Occupational Health and Poisoning Control,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市闵行区疾病预防控制中心环境职业卫生科,上海201101 [2]上海市闵行区疾病预防控制中心免疫预防科,上海201101 [3]上海市闵行区疾病预防控制中心信息科,上海201101 [4]上海市疾病预防控制中心健康危害因素监测与控制所职业卫生与中毒控制科,上海200336

出　　处：《环境与职业医学》2020年第8期747-752,共6页Journal of Environmental and Occupational Medicine

基　　金：上海市闵行区自然科学研究课题(2019MHZ005)。

摘　　要：[背景]针对低浓度一氧化碳(CO)暴露对人群心脑血管疾病死亡的短期效应,在不同地域不同的人群中开展流行病学研究,可为制定控制大气CO污染的行政决策提供参考,为CO毒理、生理学研究提供线索,具有一定的现实意义。[目的]定量评价低浓度CO对人群心脑血管疾病死亡的短期效应。[方法]收集2013年1月1日—2018年12月31日上海市闵行区居民总心脑血管疾病及冠心病、中风的每日死亡数据以及同期上海市大气污染物[CO、二氧化硫(SO2)、二氧化氮(NO2)、细颗粒物(PM2.5)、可吸入颗粒物(PM10)]浓度和气象资料(平均温度和相对湿度)。采用广义相加模型,在控制了长期趋势、星期几效应及气象因素等混杂因素的基础上,将当日至前5 d单日滞后(lag0~lag5)的污染物浓度和当日至前1、3、5 d的污染物浓度移动平均值(lag01、lag03、lag05)分别引入模型,分析低浓度CO与总心脑血管疾病、冠心病和中风死亡的关联性,然后同时引入其他大气污染物进行多污染物模型拟合。以超额危险度(ER)及其95%可信区间(CI)表示增加的死亡风险。[结果]研究期间,CO的每日质量浓度(下称浓度)为(0.74±0.28)mg·m^-3,远低于我国现行的环境空气质量标准(4 mg·m^-3),浓度呈现逐年下降趋势,且具有明显的季节周期性。闵行区因心脑血管疾病死亡总数为19544人。单污染模型中,CO与总心脑血管疾病、冠心病和中风死亡风险的关联均在lag05时最高,CO浓度每升高0.1 mg·m^-3,居民总心脑血管疾病、冠心病和中风死亡风险升高,其ER(95%CI)分别为2.23%(1.34%~3.12%)、1.53%(0.19%~2.89%)和2.76%(1.57%~3.97%)。双污染物模型中,在分别调整了PM2.5、PM10、SO2和NO2以后,其效应失去了统计学意义。在最大效应滞后时间(lag05)条件下,CO浓度与3类死因死亡的暴露-反应关系曲线均呈近似线性的缓慢上升状态,且无明显阈值。[结论]低浓度CO暴露对人群总心�[Background]Conducting epidemiological studies on the short-term effect of low-concentration carbon monoxide(CO)exposure on cardiovascular and cerebrovascular disease mortality among populations in different regions can provide reference for making administrative decisions to control ambient CO pollution,and provide clues for toxicological and physiological research of CO,which has certain practical significance.[Objective]This study quantitatively evaluates the short-term effect of low-concentration CO on cardiovascular and cerebrovascular disease mortality.[Methods]Daily cardiovascular and cerebrovascular disease,coronary heart disease,and stroke mortalities,air pollutant[CO,sulfur dioxide(SO2),nitrogen dioxide(NO2),fine particulate matters(PM2.5),and inhalable particulate matters(PM10)]concentrations,and meteorological data(average temperature and relative humidity)of Shanghai from January 1,2013 to December 31,2018 were collected.Associations between low-concentration CO and daily mortality due to cardiovascular and cerebrovascular disease,coronary heart disease,and stroke were estimated by generalized additive models,controlling for time trends,day-of-the-week effects,and meteorological variables.Different lag patterns were also included in the models including single-day lag effect(lag0-lag5)and cumulative lag effect(lag01,lag03,and lag05).Two-pollutant models were used after controlling for other ambient pollutants.Excess risk(ER)and 95%confidence interval(CI)were used to indicate the increase of mortality risk.[Results]Over the study period,the daily mean CO concentration was(0.74±0.28)mg·m^-3,which was far lower than the current ambient air quality standard in China(4 mg·m^-3).The CO concentration showed a downward trend year by year with obvious seasonal periodicity.The cardiovascular and cerebrovascular disease mortality in Minhang District was 19544.In the single-pollutant models,CO concentration at lag05 showed the strongest associations with cardiovascular and cerebrovascular disease,coronary hea

关 键 词：一氧化碳 心脑血管疾病 冠心病 中风 死亡 时间序列 

分 类 号：R122[医药卫生—环境卫生学]