固体燃料取暖和吸烟与呼吸系统疾病发病关联的前瞻性队列研究  

Association of solid fuel use for heating and smoking with respiratory diseases:a prospective cohort study

作　　者：于洋 田小草[2,3] 张华 胡丹[4] 吕筠 余灿清 裴培[6] 孙点剑一[5,6,7] 高汝钦 逄增昌 段海平 Yu Yang;Tian Xiaocao;Zhang Hua;Hu Dan;Lyu Jun;Yu Canqing;Pei Pei;Sun Dianjianyi;Gao Ruqin;Pang Zengchang;Duan Haiping(Department of Epidemiology,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Department of Chronic and Non-communicable Disease Control and Prevention,Qingdao Municipal Center for Disease Control and Prevention,Qingdao 266033,China;Qingdao Institute of Preventive Medicine,Qingdao 266033,China;Licang District Center for Disease Control and Prevention of Qingdao,Qingdao 266041,China;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Peking University Center for Public Health and Epidemic Preparedness&Response,Beijing 100191,China;Key Laboratory of Epidemiology of Major Diseases(Peking University),Ministry of Education,Beijing 100191,China;Qingdao Municipal Center for Disease Control and Prevention,Qingdao 266033,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院流行病学系,济南250012 [2]青岛市疾病预防控制中心慢性非传染病防制所,青岛266033 [3]青岛市预防医学研究院,青岛266033 [4]青岛市李沧区疾病预防控制中心,青岛266041 [5]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [6]北京大学公众健康与重大疫情防控战略研究中心,北京100191 [7]重大疾病流行病学教育部重点实验室(北京大学),北京100191 [8]青岛市疾病预防控制中心,青岛266033

出　　处：《中华流行病学杂志》2024年第10期1356-1361,共6页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(82192900,82192901,82192904,81390540,91846303);国家重点研发计划“精准医学研究”重点专项(2016YFC0900500);中国香港Kadoorie Charitable基金;英国WellcomeTrust(202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z);中国青岛市科技惠民示范专项(23-2-8-smjk-18-nsh)。

摘　　要：目的研究固体燃料取暖、吸烟与呼吸系统疾病的关联。方法基于中国慢性病前瞻性研究中的青岛项目点。经过筛选,纳入26165名研究对象。采用Cox比例风险回归模型,按风险年龄(以5年为间隔)和性别进行分层,并对职业、体力活动水平等协变量进行调整,分析固体燃料取暖、吸烟与呼吸系统疾病发病风险增加之间的关联。结果在26165名研究对象中,使用固体燃料取暖者年龄为(52.57±10.31)岁,女性占58.04%,曾经/现在吸烟者占65.38%。研究结果显示,使用固体燃料组和曾经/现在吸烟组呼吸系统疾病发病风险都较高,风险比(HR)值(95%CI)分别为1.21(1.04~1.41)和1.41(1.16~1.71)。使用固体燃料取暖年限≥20年的HR值(95%CI)为1.27(1.07~1.51),固体燃料与吸烟的相乘交互项有统计学意义。结论使用固体燃料取暖、吸烟增加呼吸系统疾病发病风险,并且固体燃料使用与吸烟之间可能存在相乘交互作用。Objective To investigate the association between solid fuel use for heating,smoking,and respiratory diseases.Methods This study is based on the Qingdao project of the China Kadoorie Biobank.After screening,26165 individuals were included in the study.We employed Cox proportional hazards regression models,stratified by risk age(in 5-year intervals)and sex while adjusting for confounding variables such as occupation and physical activity level to analyze the association between solid fuel use for heating,smoking,and increased risk of respiratory diseases.Results Among the 26165 participants,the average age of those using solid fuel for heating was(52.57±10.31)years,with females constituting 58.04%and former/current smokers accounting for 65.38%.The results indicated that both the solid fuel group and the former/current smoking group had a higher risk of respiratory diseases,with hazard ratios(HR)(95%CI)of 1.21(1.04-1.41)and 1.41(1.16-1.71),respectively.For the duration of solid fuel use,the HR(95%CI)for 20 years or more,it was 1.27(1.07-1.51).The multiplicative interaction term between solid fuel use and smoking was statistically significant.Conclusions The use of solid fuel for heating and smoking significantly increases the risk of respiratory diseases,and there may be a multiplicative interaction between solid fuel use and smoking.

关 键 词：固体燃料 吸烟 呼吸系统疾病 前瞻性队列 

分 类 号：R56[医药卫生—呼吸系统]