大气一氧化碳短期暴露与哮喘死亡关系的时间分层病例交叉研究  

Short-term exposure to ambient carbon monoxide and asthma mortality:a time-stratified case-crossover study in China

作　　者：刘威 蔡苗 龙政 王黎君[1] 韦晶 周脉耕[1] 林华亮 殷鹏[1] LIU Wei;CAI Miao;LONG Zheng;WANG Li-jun;WEI Jing;ZHOU Mai-geng;LIN Hua-liang;YIN Peng(National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;School of Public Health,Sun Yat-sen University;Department of Atmospheric and Oceanic Science,Earth System Science Interdisciplinary Center,University of Maryland,U.S.A)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050 [2]中山大学公共卫生学院 [3]马里兰大学大气与海洋科学系地球系统科学交叉研究中心

出　　处：《环境卫生学杂志》2023年第4期243-249,301,共8页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：首都卫生发展科研专项(2022-1G-4241)。

摘　　要：目的在全国水平定量评估大气一氧化碳(carbon monoxide,CO)短期暴露与哮喘死亡之间的关联。方法基于2015—2020年全国疾病监测系统605个监测点的哮喘死亡数据,结合每个哮喘死亡个案的居住地址和中国高分辨率高质量近地表大气污染物数据集中大气CO污染数据,利用双线性插值法进行个体暴露估计,应用时间分层病例交叉设计,通过条件Logistic回归模型来探索CO短期暴露与哮喘死亡之间的暴露—反应关系。结果研究发现CO短期暴露与哮喘死亡风险增加之间存在显著关联。在5日累积滞后(lag04 d)时CO暴露时效应值最大,比值比(odds ratio,OR)及其95%可信区间(confidence interval,CI)为1.101(1.024~1.184)。暴露—反应关系曲线提示,哮喘死亡的风险随着CO质量浓度的增加呈上升趋势。双污染物模型及利用新型冠状病毒感染疫情前(2015—2019年)样本的敏感性分析显示,CO与哮喘死亡增加之间的关联与主模型基本保持一致。结论我国大气污染物CO短期暴露与人群哮喘死亡风险存在显著正向关联,提示我国政府仍应不断推进大气污染防控的相关决策和措施,进一步降低大气CO质量浓度,这对降低人群哮喘负担有重要的意义。Objective To quantitatively evaluate the association between short-term exposure to ambient carbon monoxide(CO)and asthma mortality at a nationwide level in China.Methods Based on asthma mortality data from the 605 surveillance points of the National Disease Surveillance System from 2015 to 2020,combined with the residential address of each asthma death case and atmospheric CO pollution data from ChinaHighAirPollutants(CHAP)dataset individual exposure estimation was performed by using the bi-linear interpolation method.Time-stratified case-crossover design was conducted to investigate the exposure-response relationship between short-term CO exposure and asthma mortality via the conditional logistic regression model.Results There is a significant association between short-term CO exposure and increased asthma mortality.The highest effective value of CO exposure was observed on 5-day cumulative lag(lag04 d),with an odds ratio of 1.101(95%confidence interval:1.024-1.184).The exposure-response curve showed that the risk of asthma mortality tended to increase with the increase of CO mass concentration.The sensitivity analysis of the samples before COVID-19 pandemic(2015—2019)and two-pollutant model showed that the association between CO mass concentration and increased risk of asthma mortality remained basically consistent with the main model.Conclusion Short-term exposure to ambient CO was positively associated with asthma mortality among the population in China,suggesting that the Chinese government should continue to promote relevant decision-making and measures for air pollution prevention and control and further reduce the mass concentration of ambient CO,which is of great significance to reduce asthma mortality.

关 键 词：哮喘死亡 一氧化碳(CO) 大气污染 时间分层病例交叉研究 

分 类 号：R122[医药卫生—环境卫生学]