Lu Feng, Zhou Lian, Chen Xiaodong, Li Chengcheng, Wang Haochen, Xu Yan, Zheng Xiaoying
Institute of Population Research, Peking University, Beijing 100871, China.
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Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Sep;49(9):817-21.
To explore the short-term effects of ambient PM10 pollution on mortality due to circulatory diseases, and to study the modifying effect of season on the association between ambient PM10 concentration and mortality in Nanjing.
Daily mortality, air pollution, and meteorological data from 1 January 2009 to 31 December 2013 in Nanjing were collected; Time-stratified case-crossover design was used to analyze the associations between daily average concentration of inhalable particle (PM10) and mortality due to circulatory diseases; Odds ratios (OR) and 95% confidence intervals (CI) were calculated; And stratified analysis was conducted to compare the mortality risks of circulatory diseases exposed to outdoor PM10 in warm season (May-October) with that in cool season (November-April).
The mean daily average concentrations of PM10, NO2, and SO2 from 2009 to 2013 in Nanjing were 109.1, 51.5, and 35.4 µg/m(3), respectively. During our study period, a total of 78 299 circulatory disease deaths were recorded. On average, there were approximately 43 circulatory disease deaths per day; and deaths due to cardiac diseases, ischemic heart disease and cerebrovascular diseases were 19, 10 and 24 per day, respectively. After adjusting for the meteorological variables such as daily temperature, relative humidity and air pressure, a10 µg/m(3) increment of PM10 was associated with the mortality on values of (OR) 1.002 4 (95% CI: 1.000 1-1.004 8) for total circulatory diseases, 1.004 8 (95% CI: 1.001 3-1.008 3) for cardiac diseases, 1.007 3 (95% CI: 1.002 4-1.012 3) for ischemic heart disease and 1.000 5 (95% CI: 0.998 5-1.002 4) for cerebrovascular diseases, respectively. In summer season, the OR values of daily mortality for total circulatory diseases and cerebrovascular diseases were 1.008 0 (95% CI: 1.003 9-1.012 2) and 1.005 7 (95% CI: 1.002 0-1.009 4), respectively, the corresponding OR values in cool season were 1.001 4 (95% CI: 0.998 5-1.004 2) and 0.998 8 (95% CI: 0.996 4-1.001 2), respectively; The effect estimates in warm season were higher than that in cool season.
The elevated levels of ambient PM10 were positively associated with the increase of mortality due to circulatory diseases, and season may modify the effects of outdoor PM10 pollution on mortality.
探讨环境细颗粒物（PM10）污染对循环系统疾病死亡率的短期影响，并研究季节对南京市环境PM10浓度与死亡率之间关联的修饰作用。
收集南京市2009年1月1日至2013年12月31日的每日死亡率、空气污染和气象数据；采用时间分层病例交叉设计分析可吸入颗粒物（PM10）日均浓度与循环系统疾病死亡率之间的关联；计算比值比（OR）和95%置信区间（CI）；并进行分层分析，比较暖季（5 - 10月）和冷季（11月至次年4月）暴露于室外PM10的循环系统疾病死亡风险。
2009年至2013年南京市PM10、二氧化氮（NO2）和二氧化硫（SO2）的日均浓度均值分别为109.1、51.5和35.4 μg/m³。在研究期间，共记录了78299例循环系统疾病死亡病例。平均每天约有43例循环系统疾病死亡；其中，每天因心脏病、缺血性心脏病和脑血管病死亡的病例分别为19例、10例和24例。在调整了每日温度、相对湿度和气压等气象变量后，PM10每增加10 μg/m³，总循环系统疾病死亡率的OR值为1.0024（95%CI：1.0001 - 1.0048），心脏病死亡率的OR值为1.0048（95%CI：1.0013 - 1.0083），缺血性心脏病死亡率的OR值为1.0073（95%CI：1.0024 - 1.0123），脑血管病死亡率的OR值为1.0005（95%CI：0.9985 - 1.0024）。在夏季，总循环系统疾病和脑血管病每日死亡率的OR值分别为1.0080（95%CI：1.0039 - 1.0122）和1.0057（95%CI：1.0020 - 1.0094），冷季相应的OR值分别为1.0014（95%CI：0.9985 - 1.0042）和0.9988（95%CI：0.9964 - 1.0012）；暖季的效应估计值高于冷季。
环境PM10水平升高与循环系统疾病死亡率增加呈正相关，季节可能会修饰室外PM10污染对死亡率的影响。
