大气PM_(1)短期暴露与老年人心绞痛住院的关联研究  

Association of short-term exposure to ambient PM_(1) with hospital admissions for angina in older adults

作　　者：许露曦 许瑞君 叶韵韶 林巧绚 孙宏[4] 田琪 刘跃伟 XU Luxi;XU Ruijun;YE Yunshao;LIN Qiaoxuan;SUN Hong;TIAN Qi;LIU Yuewei(Department of Epidemiology,School of Public Health,Sun Yat-sen University,Guangzhou,Guangdong 510080,China;Institute of Environmental Health and Endemic Disease Control,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530028,China;Guangzhou Health Technology Identification&Human Resources Assessment Center,Guangzhou,Guangdong 510080,China;Institute of Environment and Health,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing,Jiangsu 210009,China)

机构地区：[1]中山大学公共卫生学院,广东广州510080 [2]广西壮族自治区疾病预防控制中心环境卫生与地方病防制所,广西南宁530028 [3]广州市卫生健康技术鉴定和人才评价中心,广东广州510080 [4]江苏省疾病预防控制中心环境与健康所,江苏南京210009

出　　处：《公共卫生与预防医学》2024年第2期6-11,共6页Journal of Public Health and Preventive Medicine

基　　金：国家重点研发计划大气专项(2016YFC0206500)。

摘　　要：目的 定量评估大气亚微米颗粒物(PM_(1))短期暴露与老年人心绞痛住院的关联。方法 以2016—2019年因心绞痛在广州市医疗机构住院的46 687名老年患者为研究对象开展病例交叉研究,从中国高分辨率大气污染物数据集(CHAP)获取广州市大气PM_(1)浓度网格数据,根据家庭住址评估研究对象的PM_(1)暴露水平,利用条件logistic回归模型分析PM_(1)与老年人心绞痛住院之间的暴露-反应关系。结果 2016—2019年间,研究对象心绞痛住院当天(lag 0)PM_(1)的平均暴露水平为21.0±11.5μg/m^(3)。主模型分析结果显示,PM_(1)暴露(lag 0)与老年人心绞痛住院风险存在正向关联,暴露水平每增加10μg/m^(3),老年人因心绞痛住院的风险增加1.31%(95%CI:0.05%~2.59%);调整O_(3)的双污染物模型结果提示,PM_(1)短期暴露与老年人心绞痛住院风险之间的关联保持稳定。根据以上模型结果估计,广州市2016—2019年间可归因于大气PM_(1)暴露的超额住院占总住院人次数的2.46%(95%CI:0.09%~4.76%),超额住院人次数为1 539(95%CI:54~2 976)。分层分析结果显示,性别、年龄和季节对上述关联无显著的效应修饰作用。结论 大气PM_(1)短期暴露与老年人心绞痛住院风险升高有关。Objective To quantitatively evaluate the association of short-term exposure to ambient submicron particulate matter(PM_(1))with hospital admissions for angina in older adults.Methods A case-crossover study was conducted among 46687 older adults hospitalized for angina from 2016 to 2019 in Guangzhou medical institutions.Grid data on ambient PM_(1) concentrations in Guangzhou were obtained from the China High Air Pollutants(CHAP)dataset.Exposure to PM_(1) was assessed according to each subject′s residential addresses.Conditional logistic regression model was used to analyze the the exposure-response association between PM_(1) and hospital admissions for angina.Results From 2016 to 2019,the average exposure level of PM_(1) on the same day of hospital admissions(lag 0)for angina was 21.0±11.5μg/m 3.The results of main model analysis showed that lag 0 day exposure to ambient PM_(1) was significantly associated with a higher odds of hospital admissions for angina in older adults.Each 10μg/m 3 increase of PM_(1) exposure level was significantly associated with a 1.31%(95%CI:0.05%-2.59%)increased odds of angina admissions.Results from a two-pollutant model adjusting for O 3 showed that the association between short-term exposure to PM_(1) and odds of hospitalization for angina remained stable.According to the results of the above model,it was estimated that the excess hospitalization attributable to ambient PM_(1) exposure accounted for 2.46%(95%CI:0.09%-4.76%)of the total admissions in Guangzhou during 2016-2019,corresponding to 1539(95%CI:54-2976)admissions.No significant effect modification on the associations was observed by sex,age,or season.Conclusion Short-term exposure to ambient PM_(1) was significantly associated with an increased odds of hospital admissions for angina in older adults.

关 键 词：颗粒物 老年人 心绞痛 PM_(1) 住院 

分 类 号：R123[医药卫生—环境卫生学]