预先存在的多病症预测了与长期PM2.5暴露相关的更大的死亡风险
Ziqing Tang1, Po-Wen Ku2, Yang Xia3
1Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China.
长期暴露于细颗粒物 (PM2.5) 显著增加了多种慢性疾病患者的死亡风险. 这项研究揭示了PM2.5和多病症之间的协同效应,突出了随着更多条件和更高污染水平的增加风险.
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:
- 环境细颗粒物 (PM2.5) 暴露是已知的健康风险,但它对多病症患者的影响还未得到充分研究.
- 暴露于PM2.5和多病症都与增加的死亡率独立相关.
- 需要进一步研究PM2.5和多病症之间的结合效应和相互作用.
研究的目的:
- 评估长期PM2.5暴露与所有原因,心血管和呼吸道死亡率在具有和没有多病症的个体之间的关联.
- 检查PM2.5暴露和多病症对死亡风险的联合影响和相互作用.
- 量化PM2.5诱导死亡率的过度风险和可归因比例,与多病症状况相关.
主要方法:
- 对3个潜在队列的交叉队列分析,从2005年至2022年招募了869,038名成年人 (年龄≥18岁).
- 在基线使用9种常见慢性疾病确定多病症.
- 考克斯的比例危害模型用于分析关联,联合效应和相互作用,根据慢性疾病的数量进行分层分析.
主要成果:
- 在713,119名符合条件的参与者中,有65,490人患有多发病.
- 暴露于PM2.5在多病症患者中与无多病症患者相比,与所有原因和心血管死亡率的相关性更强 (异质性P<0.05).
- 观察到显著的附加性相互作用:PM2.5和多病症协同增加死亡率,风险随着PM2.5水平的提高和更多的慢性疾病而升级.
结论:
- 长期暴露于PM2.5对具有先前多种疾病的个体来说,死亡风险显著增加.
- 暴露于PM2.5和多病症之间的协同效应加剧了死亡风险,特别是那些患有多种慢性疾病的人.
- 公共卫生战略应考虑多病症人口对空气污染的高度脆弱性.
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