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短期细颗粒物污染对拉丁美洲日常健康事件的影响:系统评价和荟萃分析。

Short-term effects of fine particulate matter pollution on daily health events in Latin America: a systematic review and meta-analysis.

机构信息

Laboratory of Experimental Air Pollution (LIM05), Department of Pathology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Institute for Advanced Studies of the University of São Paulo-IEA, São Paulo, SP, Brazil.

出版信息

Int J Public Health. 2017 Sep;62(7):729-738. doi: 10.1007/s00038-017-0960-y. Epub 2017 Mar 2.

Abstract

OBJECTIVES

Ambient air pollution is among the leading risks for health worldwide and by 2050 will largely overcome deaths due to unsafe sanitation and malaria, but local evidence from Latin America (LA) is scarce. We aimed to summarize the effect of short-term exposure to fine particulate air pollution (PM) on morbidity and mortality in Latin America and evaluate evidence coverage and quality, using systematic review and meta-analysis.

METHODS

The comprehensive search (six online databases and hand-searching) identified studies investigating the short-term associations between PM and daily health events in LA. Two reviewers independently accessed the internal validity of the studies and used random-effect models in the meta-analysis.

RESULTS

We retrieved 1628 studies. Nine were elected for the qualitative analysis and seven for the quantitative analyses. Each 10 µg/m increments in daily PM concentrations was significantly associated with increased risk for respiratory and cardiovascular mortality in all-ages (polled RR = 1.02, 95% CI, 1.02-1.02 and RR = 1.01, 95% CI , 1.01-1.02, respectively).

CONCLUSIONS

Short-term exposure to PM in LA is significantly associated with increased risk for respiratory and cardiovascular mortality. Evidence is concentrated in few cities and some presented high risk of bias.

摘要

目的

空气污染是全球主要的健康风险之一,到 2050 年,它将在很大程度上超过因不安全卫生设施和疟疾导致的死亡人数,但拉丁美洲(LA)的本地证据很少。我们旨在总结短期暴露于细颗粒物空气污染(PM)对拉丁美洲发病率和死亡率的影响,并使用系统评价和荟萃分析评估证据的覆盖范围和质量。

方法

全面检索(六个在线数据库和手工检索)确定了研究 PM 与 LA 日常健康事件之间短期关联的研究。两名审查员独立评估研究的内部有效性,并在荟萃分析中使用随机效应模型。

结果

我们检索到 1628 项研究。其中 9 项被选为定性分析,7 项用于定量分析。每日 PM 浓度每增加 10μg/m,所有年龄段的呼吸道和心血管死亡率风险均显著增加(汇总 RR=1.02,95%CI,1.02-1.02 和 RR=1.01,95%CI,1.01-1.02)。

结论

在 LA,短期暴露于 PM 与呼吸道和心血管死亡率风险增加显著相关。证据集中在少数几个城市,有些存在高偏倚风险。

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