DeVries Rebecca, Kriebel David, Sama Susan
a Department of Work Environment , University of Massachusetts Lowell , Lowell , Massachusetts , USA.
COPD. 2017 Feb;14(1):113-121. doi: 10.1080/15412555.2016.1216956. Epub 2016 Aug 26.
A systematic literature review was performed to identify all peer-reviewed literature quantifying the association between short-term exposures of particulate matter <2.5 microns (PM), nitrogen dioxide (NO), and sulfur dioxide (SO) and COPD-related emergency department (ED) visits, hospital admissions (HA), and mortality. These results were then pooled for each pollutant through meta-analyses with a random effects model. Subgroup meta-analyses were explored to study the effects of selected lag/averaging times and health outcomes. A total of 37 studies satisfied our inclusion criteria, contributing to a total of approximately 1,115,000 COPD-related acute events (950,000 HAs, 80,000 EDs, and 130,000 deaths) to our meta-estimates. An increase in PM of 10 ug/m was associated with a 2.5% (95% CI: 1.6-3.4%) increased risk of COPD-related ED and HA, an increase of 10 ug/m in NO was associated with a 4.2% (2.5-6.0%) increase, and an increase of 10 ug/m in SO was associated with a 2.1% (0.7-3.5%) increase. The strength of these pooled effect estimates, however, varied depending on the selected lag/averaging time between exposure and outcome. Similar pooled effects were estimated for each pollutant and COPD-related mortality. These results suggest an ongoing threat to the health of COPD patients from both outdoor particulates and gaseous pollutants. Ambient outdoor concentrations of PM, NO, and SO were significantly and positively associated with both COPD-related morbidity and mortality.
进行了一项系统的文献综述，以识别所有经过同行评审的文献，这些文献量化了短期接触小于2.5微米的颗粒物（PM）、二氧化氮（NO）和二氧化硫（SO）与慢性阻塞性肺疾病（COPD）相关的急诊科（ED）就诊、住院（HA）和死亡率之间的关联。然后，通过随机效应模型的荟萃分析，将每种污染物的这些结果进行汇总。探索了亚组荟萃分析，以研究选定的滞后/平均时间和健康结果的影响。共有37项研究符合我们的纳入标准，为我们的荟萃估计贡献了总共约111.5万例与COPD相关的急性事件（95万例住院、8万例急诊科就诊和13万例死亡）。PM每增加10微克/立方米，与COPD相关的急诊科就诊和住院风险增加2.5%（95%置信区间：1.6 - 3.4%），NO每增加10微克/立方米，风险增加4.2%（2.5 - 6.0%），SO每增加10微克/立方米，风险增加2.1%（0.7 - 3.5%）。然而，这些汇总效应估计的强度因暴露与结果之间选定的滞后/平均时间而异。对于每种污染物和与COPD相关的死亡率，估计了类似的汇总效应。这些结果表明，室外颗粒物和气态污染物持续威胁着COPD患者的健康。环境室外PM、NO和SO的浓度与COPD相关的发病率和死亡率均呈显著正相关。
