2013-2020年上海市空气动力学直径≤2.5μm的颗粒物短期暴露导致的循环系统疾病超额死亡风险评估  

Risk assessment of excess circulatory disease mortality attributed to short-term exposure to particulate matter with aerodynamic diameter≤2.5μm in Shanghai,2013−2020

作　　者：方博[1] 李琦 晋珊 陈蕾 钱耐思[1] 蔡任之[1] 谷珍 陈磊 王春芳[1] 夏天[1] Fang Bo;Li Qi;Jin Shan;Chen Lei;Qian Naisi;Cai Renzhi;Gu Zhen;Chen Lei;Wang Chunfang;Xia Tian(Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Vital Stategies,Shanghai 200336,China)

机构地区：[1]上海市疾病预防控制中心,上海200336 [2]卫健策略,上海200336

出　　处：《疾病监测》2024年第12期1546-1554,共9页Disease Surveillance

摘　　要：目的研究上海市每日空气动力学直径≤2.5μm的颗粒物(PM_(2.5))浓度与居民循环系统疾病死亡数之间的相关性,分析二者之间的暴露反应关系,评估因PM_(2.5)浓度超标导致的循环系统疾病超额死亡。方法收集2013—2020年上海市每日大气污染、气象及户籍居民循环系统疾病死亡数据,使用自回归移动平均模型分析PM_(2.5)浓度和循环系统疾病死亡数的时间变化趋势,使用Spearman相关分析二者在各时间尺度的相关性,使用广义相加模型测算大气PM_(2.5)短期暴露导致的循环系统疾病超额死亡风险,使用大气污染短期暴露急性健康风险评估模型评估循环系统疾病超额死亡数。结果研究期间上海市居民循环系统疾病死亡39.84万例,占总死亡数的40.27%,每日循环系统疾病死亡中位数为131例。上海市大气PM_(2.5)浓度总体表现为逐年下降趋势,2013—2020年日均大气PM_(2.5)浓度中位数降幅达到48.98%。大气PM_(2.5)浓度和循环系统疾病死亡数在季节性尺度有显著正相关,二者均呈现出冬春季高峰、夏秋季低谷的典型季节性特征。大气PM_(2.5)浓度每升高10μg/m^(3),循环系统疾病死亡风险随之增加0.22%(95%置信区间:0.02%~0.42%),PM_(2.5)浓度升高导致的循环系统疾病死亡风险在中老年人群(45~65岁)高于其他人群。研究期间上海市有67.80%的天数大气PM_(2.5)浓度超过了世界卫生组织(WHO)推荐的限值标准(25μg/m^(3)),归因于PM_(2.5)浓度超标的循环系统疾病超额死亡数为4910例。结论大气PM_(2.5)暴露会显著增加循环系统疾病超额死亡风险,且无明显阈剂量。上海市大气PM_(2.5)浓度及其导致的循环系统疾病超额死亡数逐年下降,大气污染防治工作成效显著。研究期间上海市大气PM_(2.5)浓度远高于WHO推荐限值标准,大气污染治理和疾病预防控制措施仍需持续加强。Objective To estimate the exposure-response relationship between daily circulatory disease mortality and daily particulate matter with an aerodynamic diameter≤2.5μm(PM_(2.5))concentration in Shanghai,and analyze the excess mortality of circulatory diseases attributed to exposure to PM_(2.5).Methods The information about the daily PM_(2.5)concentration and the incidence data of circulatory disease death in Shanghai from 2013 to 2020 were collected.The trends of daily PM_(2.5)concentration and circulatory mortality were analyzed by using the auto-regressive integrated moving average model.The risk of premature death due to short-term exposure to PM_(2.5)was investigated by using the generalized additive model of Poisson distribution.The excess circulatory disease mortality was calculated by using acute health risk assessment model for short-term exposure to air pollution.Results During the study period a total of 398400 deaths due to circulatory diseases occurred in Shanghai,accounting for 40.27%of total recorded deaths,and the median number of daily deaths attributed to circulatory disease was 131.Atmospheric PM_(2.5)concentrations in Shanghai exhibited a general decline,with the median daily atmospheric PM_(2.5)concentration decreasing by 48.98%from 2013 to 2020.Both daily circulatory disease mortality and daily PM_(2.5)concentration exhibited clear seasonal patterns,with peak in winter and valley in summer,and there was a significant positive correlation between these two variables on a seasonal basis.The risk for death from circulatory diseases was observed to rise by 0.22%for per 10μg/m^(3)increase in PM_(2.5)concentration(95%confidential interval:0.02%−0.42%).The risk for mortality from circulatory diseases associated with PM_(2.5)exposure was found to increase in individuals aged 45−65 years compared with those in other age groups.During the study period,the atmospheric PM_(2.5)concentration in 67.80%of the days exceeded the limit recommended by World Health Organization(WHO)(25μg/m3)in Shanghai.Dur

关 键 词：空气动力学直径≤2.5μm的颗粒物 循环系统疾病 超额死亡 广义相加模型 

分 类 号：R211[医药卫生—中医学] R56R122