高风险老年人中的空气污染和严重出血事件
Rindala Fayyad1, Kevin Josey1, Poonam Gandhi2
1Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 2, 4th Floor, Boston, MA, 02115, USA.
Environmental research
|March 9, 2024
概括
暴露于细颗粒物 (PM2.5) 会增加老年人严重出血事件的风险,特别是胃肠道和内出血. 当与抗凝剂使用相结合时,这种风险会被放大,这凸显了污染意识的必要性.
科学领域:
- 环境健康 环境健康
- 流行病学 流行病学
- 心血管医学 心血管医学
背景情况:
- 与空气污染颗粒物 (PM2.5) 相关的临床显著出血事件,尽管具有生物学可信性,但仍未得到充分研究.
- 抗凝剂的使用在心血管和血栓栓塞事件的高风险的老年人中很常见.
研究的目的:
- 量化细颗粒物 (PM2.5) 暴露和抗凝药物使用对严重出血事件的独立和协同效应.
- 调查PM2.5与因胃肠道出血,内出血和表出血而住院的相关性.
主要方法:
- 一项回顾性队列研究,利用2008-2016年期间50%的Medicare D部分符合条件的服务费受益人的随机样本.
- 用逆概率加权的边际结构考克斯比例危险模型来估计PM2.5暴露的危险比率.
- 添加剂规模的相互作用被评估使用相对过度的风险由于相互作用,以评估PM2.5和抗凝剂使用之间的协同效应.
主要成果:
- 暴露在PM2.5中的10μg/m3的增加与胃肠道出血 (48%),内出血 (58%) 和表 (55%) 的风险显著增加有关.
- 在PM2.5暴露和在胃肠道和内出血时使用抗凝剂之间观察到显著的附加相互作用.
- 该研究包括186万名高风险老年人,其中30%使用抗凝剂,平均PM2.5暴露量为8.81μg/m3.
结论:
- 增加PM2.5暴露与老年人严重出血事件的风险更高,特别是那些服用抗凝剂的人.
- 临床医生应建议高危人群在PM2.5度升高期间尽量减少户外暴露.
- 调查结果支持环境政策的必要性,以保护弱势群体免受空气污染相关的健康风险.
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