Pope C Arden, Burnett Richard T
Department of Economics, Brigham Young University, Provo, UT 84602-2363, USA.
Epidemiology. 2007 Jul;18(4):424-6; discussion 427-8. doi: 10.1097/EDE.0b013e318065c008.
Recent research appropriately suggests that caution is warranted when interpreting long-term trends of improving air quality and trends in reduced mortality rates as causal because of concerns about confounding. The use of long-term time trends as the primary source of exposure variability, however, has been avoided in most air pollution epidemiology studies. Multiple studies, using different study designs that exploit various temporal and spatial dimensions of exposure variability, have observed reasonably consistent and coherent associations between particulate air pollution and cardiopulmonary health. It's possible that these air pollution studies have experienced "epidemiological bad luck" with multiple confounders that are inadequately controlled for and coincidentally cause spurious correlations that are coherent across the different study designs. To be consistent with the overall epidemiologic results, these confounders must correlate with pollution across various dimensions of time and space and be stronger risk factors for cardiopulmonary disease than for other disease. The more likely explanation of recent air pollution epidemiology is that air pollution, especially fine particulate and related pollution, has measurable effects on cardiopulmonary health.
近期研究恰当地表明，由于存在混杂因素的担忧，在将空气质量改善的长期趋势和死亡率降低趋势解读为因果关系时，需要谨慎。然而，在大多数空气污染流行病学研究中，避免了将长期时间趋势作为暴露变异性的主要来源。多项研究采用了不同的研究设计，利用了暴露变异性的各种时间和空间维度，观察到了颗粒空气污染与心肺健康之间合理一致且连贯的关联。这些空气污染研究有可能遭遇了“流行病学厄运”，存在多个未得到充分控制的混杂因素，巧合地导致了在不同研究设计中都连贯的虚假相关性。为了与总体流行病学结果保持一致，这些混杂因素必须在时间和空间的各个维度上与污染相关，并且是比其他疾病更强的心肺疾病风险因素。近期空气污染流行病学更有可能的解释是，空气污染，尤其是细颗粒物及相关污染，对心肺健康有可测量的影响。
