Real-World Evidence of Multiple Air Pollutants and Mortality:A Prospective Cohort Study in an Oldest-Old Population  

作　　者：Linxin Liu Yi Zeng John S.Ji 

机构地区：[1]Vanke School of Public Health and School of Medicine,Tsinghua University,Beijing,China 100084 [2]Center for the Study of Aging and Human Development,School of Medicine,Duke University,Durham,North Carolina 27710,United States [3]Center for Healthy Aging and Development Studies,National School of Development,Peking University,Beijing,China 100091 [4]Vanke School of Public Health,Tsinghua University,Beijing,China 100084

出　　处：《Environment & Health》2024年第1期23-33,共11页环境与健康（英文）

基　　金：supported by the National Key R&D Program of China (2018YFC2000400 to Y.Z.);National Natural Sciences Foundation of China (72061137004,71490732 to Y.Z.);the U.S.National Institute of Aging of National Institute of Health (P01AG031719 to Y.Z.);supported by the National Natural Sciences Foundation of China (82250610230 to J.J.S.);Natural Science Foundation of Beijing (IS23105 to J.J.S.);Tsinghua University Vanke School of Public Health Research Grant (2021PY001 to J.J.S.);Tsinghua University Initiative Scientific Research Program (20233080015 to J.J.S.).

摘　　要：We aimed to report real-world longitudinal ambient air pollutants levels compared to WHO Air Quality Guidelines(AQG)and analyze multiple air pollutants’joint effect on longevity,and the modification and confounding from the climate and urbanization with a focus on the oldest-old.This study included 13,207 old participants with 73.3%aged 80 and beyond,followed up from 2008 to 2018 in 23 Chinese provinces.We used the Cox-proportional hazards model and quantile-based g-computation model to measure separate and joint effects of the multiple pollutants.We adjusted for climate and area economic factors based on a directed acyclic graph.In 2018,no participants met the WHO AQG for PM_(2.5) and O_(3),and about one-third met the AQG for NO_(2).The hazard ratio(HR)for mortality was 1.07(95%confidence interval-CI:1.05,1.09)per decile increase in all three pollutants,with PM_(2.5) being the dominant contributor according to the quantile-based g-computation model.In the three-pollutant model,the HRs(95%CI)for PM_(2.5) and NO_(2) were 1.27(1.25,1.3)and 1.08(1.05,1.12)per 10μg/m3 increase,respectively.The oldest-old experienced a much lower mortality risk from air pollution compared to the young-old.The mortality risk of PM_(2.5) was higher in areas with higher annual average temperatures.The adjustment of road density considerably intensified the association between NO_(2) and mortality.The ambient PM_(2.5) and O_(3) levels in China exceeded the WHO AQG target substantially.Multiple pollutants coexposure,confounding,and modification of the district economic and climate factors should not be ignored in the association between air pollution and mortality.

关 键 词：air quality multiple exposures climate district economic health equity 

分 类 号：X51[环境科学与工程—环境工程] R12[医药卫生—环境卫生学]