Schwartz J, Dockery D W
U.S. Environmental Protection Agency, Washington, D.C.
Am Rev Respir Dis. 1992 Mar;145(3):600-4. doi: 10.1164/ajrccm/145.3.600.
Cause-specific deaths by day for the years 1973 to 1980 in Philadelphia, Pennsylvania, were extracted from National Center for Health Statistics mortality tapes. Death from accidents (International Classification of Disease, Revision 9 greater than or equal to 800) and deaths outside of the city were excluded. Daily counts of deaths were regressed using Poisson regression on total suspended particulate (TSP) and/or SO2 on the same day and on the preceding day, controlling for year, season, temperature, and humidity. A significant positive association was found between total mortality (mean of 48 deaths/day) and both TSP (second highest daily mean, 222 micrograms/m3) and SO2 (second highest daily mean, 299 micrograms/m3). The strongest associations were found with the mean pollution of the current and the preceding days. Total mortality was estimated to increase by 7% (95% CI, 4 to 10%) with each 100-micrograms/m3 increase in TSP, and 5% (95% CI, 3 to 7%) with each 100-micrograms/m3 increase in SO2. When both pollutants were considered simultaneously, the SO2 association was no longer significant. Mortality increased monotonically with TSP. The effect of 100 micrograms/m3 TSP was stronger in subjects older than 65 yr of age (10% increase) compared with those younger than 65 yr of age (3% increase). Cause-specific mortality was also associated with a 100-micrograms/m3 increase in TSP: chronic obstructive pulmonary disease (ICD9 490-496), +19% (95% CI, 0 to 42%), pneumonia (ICD9 480-486 & 507), +11% (95% CI, -3 to +27%), and cardiovascular disease (ICD9 390-448), +10% (95% CI, 6 to 14%). These results are somewhat higher than previously reported associations, and they add to the body of evidence showing that particulate pollution is associated with increased daily mortality at current levels in the United States.
1973年至1980年宾夕法尼亚州费城按病因分类的每日死亡数据，取自美国国家卫生统计中心的死亡率磁带。排除了事故死亡（国际疾病分类第9版大于或等于800）以及城外死亡情况。每日死亡人数计数采用泊松回归法，以同一天及前一天的总悬浮颗粒物（TSP）和/或二氧化硫为自变量，并对年份、季节、温度和湿度进行控制。研究发现，总死亡率（平均每天48例死亡）与TSP（日均值第二高，222微克/立方米）和二氧化硫（日均值第二高，299微克/立方米）均存在显著正相关。相关性最强的是当前日和前一日的平均污染水平。TSP每增加100微克/立方米，总死亡率估计增加7%（95%置信区间，4%至10%）；二氧化硫每增加100微克/立方米，总死亡率估计增加5%（95%置信区间，3%至7%）。当同时考虑两种污染物时，二氧化硫的相关性不再显著。死亡率随TSP单调增加。与65岁以下人群（增加3%）相比，100微克/立方米TSP对65岁以上人群的影响更强（增加10%）。特定病因死亡率也与TSP增加100微克/立方米有关：慢性阻塞性肺疾病（国际疾病分类第9版490 - 496），增加19%（95%置信区间，0%至42%）；肺炎（国际疾病分类第9版480 - 486及507），增加11%（95%置信区间，-3%至+27%）；心血管疾病（国际疾病分类第9版390 - 448），增加10%（95%置信区间，6%至14%）。这些结果略高于此前报道的相关性，进一步证明了在美国当前污染水平下，颗粒物污染与每日死亡率增加相关。
