Bobak M, Leon D A
Department of Epidemiology, 3rd Medical Faculty, Charles University, Prague, Czechoslovakia.
Lancet. 1992 Oct 24;340(8826):1010-4. doi: 10.1016/0140-6736(92)93017-h.
An ecological study of infant mortality and air pollution was conducted in the Czech Republic. Routinely collected data on infant mortality and air pollution in the period 1986-88 were analysed for the 46 of the 85 districts in the republic for which both were available. The independent effects of total suspended particulates (TSP-10), sulphur dioxide (SO2), and oxides of nitrogen (NOx) adjusted for district socioeconomic characteristics, such as income, car ownership, and abortion rate, were estimated by logistic regression. We found weak positive associations between neonatal mortality and quintile of TSP-10 and SO2. Stronger adjusted effects were seen for postneonatal mortality, with a consistent increase in risk from the lowest to the highest TSP-10 quintile (p < 0.001). Weaker and less consistent evidence of a positive association with NOx (p = 0.061) was observed. The strongest effects were seen for postneonatal respiratory mortality, which increased consistently from lowest to highest TSP-10 quintile (p = 0.013). There was also a suggestion of a positive association with SO2 (p = 0.062). The highest to lowest quintile risk ratios for postneonatal respiratory mortality were 2.41 (95% Cl 1.10-5.28) for TSP-10, 3.91 (0.90-16.9) for SO2, and 1.20 (0.37-3.91) NOx. The specificity of the association between air pollution quintile (especially TSP-10) and postneonatal respiratory mortality is consistent with the known effects of air pollution on respiratory disease morbidity in children. These ecological associations require confirmation in an individually based study.
在捷克共和国开展了一项关于婴儿死亡率与空气污染的生态学研究。对该国85个区中的46个区在1986 - 1988年期间常规收集的婴儿死亡率和空气污染数据进行了分析，这46个区同时具备这两项数据。通过逻辑回归估计了经地区社会经济特征（如收入、汽车保有量和堕胎率）调整后的总悬浮颗粒物（TSP - 10）、二氧化硫（SO₂）和氮氧化物（NOₓ）的独立影响。我们发现新生儿死亡率与TSP - 10和SO₂的五分位数之间存在微弱的正相关。对于新生儿后期死亡率，调整后的影响更强，从TSP - 10最低五分位数到最高五分位数，风险持续增加（p < 0.001）。观察到与NOₓ呈正相关的证据较弱且不太一致（p = 0.061）。对于新生儿后期呼吸道死亡率，影响最为显著，从TSP - 10最低五分位数到最高五分位数持续增加（p = 0.013）。也有迹象表明与SO₂呈正相关（p = 0.062）。新生儿后期呼吸道死亡率从最高到最低五分位数的风险比，TSP - 10为2.41（95%可信区间1.10 - 5.28），SO₂为3.91（0.90 - 16.9），NOₓ为1.20（0.37 - 3.91）。空气污染五分位数（尤其是TSP - 10）与新生儿后期呼吸道死亡率之间关联的特异性与空气污染对儿童呼吸道疾病发病率的已知影响一致。这些生态学关联需要在个体层面的研究中得到证实。
