暴露度量选择对短期暴露于户外颗粒物与肺功能变化之间的关联有重大影响：一项在慢性阻塞性肺疾病患者中进行的队列研究结果。
The exposure metric choices have significant impact on the association between short-term exposure to outdoor particulate matter and changes in lung function: Findings from a panel study in chronic obstructive pulmonary disease patients.
机构信息
Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
Department of Building Science, School of Architecture, Tsinghua University, Beijing, China.
出版信息
Sci Total Environ. 2016 Jan 15;542(Pt A):264-70. doi: 10.1016/j.scitotenv.2015.10.114. Epub 2015 Oct 29.
BACKGROUND
The use of ambient air pollution data obtained from central air-monitoring stations as surrogates for participants' exposures to outdoor air pollutants in previous studies may have introduced bias in the estimation of exposure-response associations.
OBJECTIVES
We investigated and compared the effects of short-term exposure to outdoor particulate matter (PMout) and outdoor-originated equivalent personal PM (PMeq) on lung function in chronic obstructive pulmonary disease (COPD) patients.
METHODS
A total of 33 doctor-diagnosed stable COPD patients were recruited and repeatedly measured for lung function (totally 170 measurements) in 2013-2014. Daily PMout concentrations were obtained from central-monitoring stations, and daily time-weighted average PMeq concentrations were estimated based on PMout over the study. Associations of PM with lung function were estimated using mixed-effects models.
RESULTS
Interquartile range increases in PM2.5out (111.0 μg/m(3), 5-day) and PM10out (112.0 μg/m(3), 3-day) were associated with a 3.3% (95% confidence interval [CI]: -5.8%, -0.8%) reduction and a 2.1% (95%CI: -3.9%, -0.3%) reduction in forced vital capacity (FVC), respectively. Similar results were found for forced expiratory volume in 1s (FEV1). An interquartile range increase in PM2.5eq (45.3 μg/m(3), 3-day), but not PM10eq, was still associated with a 1.7% (95%CI: -3.3%, -0.1%) reduction in FVC.
CONCLUSIONS
Our study may provide a novel approach to assess the association of ambient PM with health observations with improved accuracy.
背景
在之前的研究中，使用来自中心空气监测站的大气污染数据作为参与者暴露于室外空气污染物的替代物，可能会导致暴露-反应关系的估计产生偏差。
目的
我们研究并比较了短期暴露于室外颗粒物（PMout）和源自室外的等效个人颗粒物（PMeq）对慢性阻塞性肺疾病（COPD）患者肺功能的影响。
方法
共招募了 33 名经医生诊断的稳定期 COPD 患者，并于 2013-2014 年期间对其肺功能进行了重复测量（共 170 次测量）。从中心监测站获得每日 PMout 浓度，并根据研究期间的 PMout 来估计每日时间加权平均 PMeq 浓度。使用混合效应模型来估计 PM 与肺功能之间的关联。
结果
PM2.5out（111.0μg/m3，5 天）和 PM10out（112.0μg/m3，3 天）的四分位距增加分别与用力肺活量（FVC）降低 3.3%（95%置信区间[CI]：-5.8%，-0.8%）和 2.1%（95%CI：-3.9%，-0.3%）相关，用力呼气量（FEV1）也得到了类似的结果。PM2.5eq（45.3μg/m3，3 天）的四分位距增加与 FVC 降低 1.7%（95%CI：-3.3%，-0.1%）仍相关，但 PM10eq 没有关联。
结论
我们的研究可能为评估大气 PM 与健康观察之间的关联提供一种新的方法，以提高准确性。
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