长期暴露于PM2.5和死亡率:国家医疗保险队列研究
Jeongmin Moon1, Ejin Kim2, Hyemin Jang1
1Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
International journal of epidemiology
|October 17, 2024
概括
长期暴露于细颗粒物 (PM2.5) 增加了因糖尿病,循环和癌症原因的死亡风险. 中年人群,特别是那些有心力衰竭风险因素的人,被确定为一个脆弱的人群.
科学领域:
- 环境健康 环境健康
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 现有的研究将细颗粒物 (PM2.5) 暴露与全因死亡率联系起来,但全国范围内对各年龄组因特定原因死亡率的研究有限.
- 以前的研究往往侧重于生态设计或具有广泛监测的城市区域.
- 这项研究通过使用全国范围的韩国队列来调查PM2.5与特定原因死亡率的关联,解决了这一差距.
研究的目的:
- 为了检查长期暴露于细颗粒物 (PM2.5) 和全国范围的韩国队列中特定原因死亡率之间的关联.
- 确定与PM2.5暴露相关的特定死亡原因.
- 为了确定年龄组是否影响PM2.5死亡率的关联.
主要方法:
- 利用了来自国家医疗保险服务-国家样本队列 (2002-2019) 的187,917名参与者 (50-79岁) 的纵向队列.
- 使用基于机器学习的组合模型 (R2 = 0.87) 评估年平均PM2.5暴露量.
- 采用时间变化的考克斯回归模型,并加上一般化倾向分数权重,以分析长期的PM2.5暴露和死亡风险.
主要成果:
- 长期暴露于PM2.5与糖尿病 (HR:1.03),循环系统疾病 (HR:1.02) 和癌症 (HR:1.01) 的死亡率增加显著相关.
- 循环死亡率与较长的PM2.5暴露滞后 (1-2年) 有关,而呼吸道死亡率与当年暴露相关.
- 与65-79岁的年龄组相比,在50-64岁的年龄组中,PM2.5死亡率的相关性更为明显,特别是在心力衰竭死亡方面.
结论:
- 长期暴露于PM2.5与死亡率的增加有关,因死亡原因而有不同的关联.
- 这些发现突出了中年成人,特别是那些心力衰竭风险因素,作为PM2.5.5的新型脆弱人群.
- 这项研究强调了空气质量管理对公共卫生的重要性,特别是对于特定的年龄人口统计和先前存在的疾病.
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