Liang R M, Yin P, Wang L J, Li Y C, Liu J M, Liu Y N, You J L, Qi J L, Zhou M G
Division of Vital Statistics and Death Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Division of Integrated Prevention and Evaluation, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Mar 10;38(3):283-289. doi: 10.3760/cma.j.issn.0254-6450.2017.03.003.
To explore the effect of fine particulate matters with an aerodynamic diameter less than 2.5 μm (PM(2.5)) on daily cardiovascular disease mortality in seven cities of China. Daily average concentrations of PM(2.5), cardiovascular disease mortality data and environmental data were collected from January 1, 2013 to December 31, 2015 in seven cities of China, including Shijiazhuang, Haerbin, Shanghai, Wuhan, Guangzhou, Chengdu and Xi' an. We linked generalized additive model with Quasi-Poisson distribution to evaluate the association between daily concentrations of PM(2.5) and cardiovascular disease mortality at single-city level and multi-city level, after adjusting for the long-term and seasonal trend, as well as meteorological factors and the effect of " days of week" . The single-pollutant model indicated that there were marked differences in association strength in these cities, among which the effect in Guangzhou was strongest. At multi-city level, a 10 μg/m(3) increase of PM(2.5) was associated with an increase of 0.315% (95: 0.133%-0.497%) of daily cardiovascular disease mortality. From lag0 to lag2, the effect of PM(2.5) on cardiovascular disease mortality decreased, while it was strongest on lag01. In the two-pollutant model, the estimated effect decreased in all the cities with the adjustments of SO(2) or NO(2). The insignificant combined results suggested that PM(2.5) might have combined effect with other pollutants. Each 10 μg/m(3) increase of PM(2.5) was associated with increases of 0.371% (95: 0.141%-0.600%) and 0.199% (95: 0.077%-0.321%) of cardiovascular disease mortality in males and females, respectively. The effect of PM(2.5) on cardiovascular disease mortality increased with age and decreased with educational level, although the differences between different subgroups were insignificant. The dose-response relationship between PM(2.5) and cardiovascular disease mortality was non-linear and non-threshold, with a steeper curve at lower concentrations. The increases of PM(2.5) concentration can result in the increase of daily cardiovascular mortality.
为探究空气动力学直径小于2.5微米的细颗粒物（PM2.5）对中国七个城市每日心血管疾病死亡率的影响。收集了2013年1月1日至2015年12月31日中国七个城市（包括石家庄、哈尔滨、上海、武汉、广州、成都和西安）的PM2.5日平均浓度、心血管疾病死亡率数据及环境数据。我们将广义相加模型与拟泊松分布相联系，在调整长期和季节性趋势以及气象因素和“星期几”的影响后，评估单城市水平和多城市水平上PM2.5日浓度与心血管疾病死亡率之间的关联。单污染物模型表明这些城市的关联强度存在显著差异，其中广州的影响最强。在多城市水平上，PM2.5每增加10微克/立方米，与每日心血管疾病死亡率增加0.315%（95%可信区间：0.133% - 0.497%）相关。从滞后0天到滞后2天，PM2.5对心血管疾病死亡率的影响减弱，而在滞后01天最强。在双污染物模型中，随着对二氧化硫（SO2）或二氧化氮（NO2）的调整，所有城市的估计影响均减小。联合结果不显著表明PM2.5可能与其他污染物存在联合作用。PM2.5每增加10微克/立方米，男性和女性心血管疾病死亡率分别增加0.371%（95%可信区间：0.141% - 0.600%）和0.199%（95%可信区间：0.077% - 0.321%）。尽管不同亚组之间差异不显著，但PM2.5对心血管疾病死亡率的影响随年龄增加而增加，随教育水平降低而降低。PM2.5与心血管疾病死亡率之间的剂量反应关系是非线性且无阈值的，在较低浓度时曲线更陡峭。PM2.5浓度的增加可导致每日心血管死亡率的增加。
