Martínez-López Elkin, Díaz-Valencia Paula A
Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.
Rev Salud Publica (Bogota). 2015 May;17(3):365-378. doi: 10.15446/rsap.v17n3.38428.
Objective We want to determine: ¿Which of the two factors is more harmful? ¿What is the magnitude of its effect? and ¿What happens when someone is exposed to both factors at once?. Methods An ecological study that evaluates the epidemiological association (relative risk) between air pollution and smoking with lung functions as assessed by functional spirometry in 489 adults. We compare two environments with different pollution levels 30 and 60 g/m³ of particulate matter (PM10) and groups of smokers against nonsmokers. Results Lung function is impaired (FEV1 <80 %) in smokers at higher rates than the non-smokers, with an excess risk of 52 % (RR. 1.52 CI 95 % 1.11 -2.07). People exposed to higher levels of pollution have a higher proportion of pulmonary dysfunction than those exposed to less polluted environments with an excess risk of 64 % (RR. 1,64 CI 95% 1.19-2.25). When subjects are exposed to both factors, that is smokers who also live in contaminated environments, the excess of risk reaches 129 % (RR 2.29 CI 95 % 1.45-3.61). Conclusions People who breathe in polluted environments have impaired lung function in a similar magnitude or greater than smokers. Therefore, we could say that breathing contaminated air is equivalent to smoking, but sadly it occurs against the affected party's will.
目的 我们想要确定：这两个因素中哪一个危害更大？其影响程度如何？以及当一个人同时暴露于这两个因素时会发生什么？方法 一项生态学研究，评估空气污染与吸烟之间的流行病学关联（相对风险），通过对489名成年人进行功能性肺量计测定来评估肺功能。我们比较了两种不同污染水平（颗粒物（PM10）分别为30和60微克/立方米）的环境，以及吸烟者组与非吸烟者组。结果 吸烟者肺功能受损（第一秒用力呼气容积<80%）的比例高于非吸烟者，额外风险为52%（相对风险1.52，95%置信区间1.11 - 2.07）。暴露于较高污染水平的人群肺功能障碍的比例高于暴露于污染程度较低环境的人群，额外风险为64%（相对风险1.64，95%置信区间1.19 - 2.25）。当受试者同时暴露于这两个因素时，即同时也是吸烟者且生活在污染环境中的人，额外风险达到129%（相对风险2.29，95%置信区间1.45 - 3.61）。结论 在污染环境中呼吸的人肺功能受损程度与吸烟者相似或更严重。因此，我们可以说呼吸污染空气等同于吸烟，但可悲的是这是在受影响者意愿之外发生的。
