在医疗保险患者中长期暴露于PM2.5成分和心血管入院
Mahdieh Danesh Yazdi1, Yaguang Wei2, Allison Sonntag3
1Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA.
长期暴露于细颗粒物 (PM2.5) 组成部分,如和硫酸盐,与心血管疾病 (CVD) 住院病例的增加有关. 控制污染源可能会降低心血管疾病风险.
科学领域:
- 环境健康 环境健康
- 心血管流行病学心血管流行病学
- 毒理学 毒理学 毒理学
背景情况:
- 暴露于细颗粒物 (PM2.5) 是心血管疾病 (CVD) 的已知危险因素.
- PM2.5的特定毒性成分及其对心血管疾病风险的个人贡献尚未完全理解.
- 这项研究调查了长期暴露于PM2.5成分和医疗保险人口中心血管疾病住院治疗之间的关联.
研究的目的:
- 检查长期暴露于特定的PM2.5成分和因心血管疾病入院患者之间的关系.
- 确定有助于心血管疾病住院的关键PM2.5组件.
- 评估不同的人口群体在PM2.5相关心血管疾病风险的潜在差异.
主要方法:
- 对2000-2016年美国医疗保险收费服务受益者的数据进行分析.
- 利用超局部的时空模型来估计15个PM2.5成分的年度水平.
- 采用加权定量总和 (WQS) 回归方法来评估PM2.5成分对心血管疾病住院的综合和个体影响 (包括心肌梗塞,缺血性中风,心房动和心力衰竭).
- 进行了分层分析,以检查人口和社会经济特征的影响变化,并分析了低于当前美国标准 (8μg/m3) 的数据.
主要成果:
- 较高的PM2.5成分水平与心血管疾病住院增加有关,特别是心力衰竭.
- PM2.5水平增加10%与心血管疾病病例增加4.1%相关.
- 和硫酸盐被确定为PM2.5相关的CVD入院的主要贡献者.
- 女性和黑人个体的PM相关心血管疾病入院率较高,而白人和非医疗补助资格的个体的特定心血管疾病事件率较高,如中风和心力衰竭.
结论:
- 长期暴露于PM2.5成分,特别是和硫酸盐,会增加Medicare人口中心血管住院的风险.
- 减少燃料燃烧,交通,工业活动和煤炭使用等来源的PM2.5暴露可能会减轻心血管疾病的风险.
- 调查结果强调了空气质量法规在保护公共心血管健康方面的重要性.
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