Aga E, Samoli E, Touloumi G, Anderson H R, Cadum E, Forsberg B, Goodman P, Goren A, Kotesovec F, Kriz B, Macarol-Hiti M, Medina S, Paldy A, Schindler C, Sunyer J, Tittanen P, Wojtyniak B, Zmirou D, Schwartz J, Katsouyanni K
Dept Hygiene-Epidemiology, University of Athens, Athens, Greece.
Eur Respir J Suppl. 2003 May;40:28s-33s. doi: 10.1183/09031936.03.00402803.
Within the framework of the APHEA2 (Air Pollution on Health: a European Approach) project, the effects of ambient particles on mortality among persons > or = 65 yrs were investigated. Daily measurements for particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10) and black smoke (BS), as well as the daily number of deaths among persons > or = 65 yrs of age, from 29 European cities, have been collected. Data on other pollutants and meteorological variables, to adjust for confounding effects and data on city characteristics, to investigate potential effect modification, were also recorded. For individual city analysis, generalised additive models extending Poisson regression, using a locally weighted regression (LOESS) smoother to control for seasonal effects, were applied. To combine individual city results and explore effect modification, second stage regression models were applied. The per cent increase (95% confidence intervals), associated with a 10 microg x m(-3) increase in PM10, in the elderly daily number of deaths was 0.8%, (0.7-0.9%) and the corresponding number for BS was 0.6%, (0.5-0.8%). The effect size was modified by the long-term average levels of nitrogen dioxide (higher levels were associated with larger effects), temperature (larger effects were observed in warmer countries), and by the proportion of the elderly in each city (a larger proportion was associated with higher effects). These results indicate that ambient particles have effects on mortality among the elderly, with relative risks comparable or slightly higher than those observed for total mortality and similar effect modification patterns. The effects among the older persons are of particular importance, since the attributable number of events will be much larger, compared to the number of deaths among the younger population.
在APHEA2（空气污染与健康：欧洲研究方法）项目框架内，研究了环境颗粒物对65岁及以上人群死亡率的影响。收集了来自29个欧洲城市的每日空气动力学直径50%截止值为10微米的颗粒物（PM10）和黑烟（BS）测量数据，以及65岁及以上人群的每日死亡人数。还记录了其他污染物和气象变量的数据，以调整混杂效应，以及城市特征数据，以调查潜在的效应修正。对于单个城市分析，应用了扩展泊松回归的广义相加模型，使用局部加权回归（LOESS）平滑器来控制季节效应。为了合并单个城市的结果并探索效应修正，应用了第二阶段回归模型。PM10每增加10微克×立方米（-3），老年人每日死亡人数增加的百分比（95%置信区间）为0.8%（0.7 - 0.9%），BS的相应数字为0.6%（0.5 - 0.8%）。效应大小因二氧化氮的长期平均水平（较高水平与较大效应相关）、温度（在较温暖国家观察到较大效应）以及每个城市老年人的比例（较大比例与较高效应相关）而有所改变。这些结果表明环境颗粒物对老年人死亡率有影响，相对风险与总死亡率观察到的相当或略高，且效应修正模式相似。老年人中的影响尤为重要，因为与年轻人群的死亡人数相比，可归因事件的数量会大得多。
