Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China.
Environ Int. 2017 Jul;104:69-75. doi: 10.1016/j.envint.2017.04.004. Epub 2017 Apr 25.
Exposure to particulate matter pollution is associated with various cardiopulmonary diseases, which are closely related with disability. The direct relationship between air pollution and disability, however, has not been fully explored.
We used data from 45,625 participants in the Study on global AGEing and adult health in six low- and middle-income countries. The 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) was used to measure the disability with six domains (cognition, mobility, self-care, getting along, life activities, and participation in society). Participants' community addresses were used to estimate annual concentration of PM using satellite data. We used linear mixed models to examine the effects of PM on overall and domain-specific WHODAS scores.
Exposure to PM was significantly associated with greater disability score (a higher score implies a greater disability); each 10μg/m increase corresponded to 0.72 (95% CI: 0.22, 1.22) increase in overall disability score. Compared with low PM level (<14.33μg/m), moderate (14.33-27.83μg/m) and high exposure levels (>27.83μg/m) were associated with 3.43 (95% CI: 1.43, 5.43) and 3.72 (95% CI: 1.59, 5.86) increase in disability scores. Among the six domains, cognition, mobility and getting along were found to be associated with PM. Stratified analyses found that women and older subjects were more sensitive to this effect.
Exposure to ambient PM might be one risk factor of disability in the low- and middle-income countries, women and older adults are the vulnerable population; and among the six domains, cognition, mobility and getting along are more relevant to this effect.
暴露于颗粒物污染与各种心肺疾病有关，而这些疾病与残疾密切相关。然而，空气污染与残疾之间的直接关系尚未得到充分探索。
我们使用了来自六个中低收入国家的全球老龄化和成人健康研究中的 45625 名参与者的数据。使用世界卫生组织残疾评估量表（WHODAS 2.0）的 12 项版本来衡量六个领域（认知、行动能力、自理能力、人际交往、生活活动和参与社会）的残疾程度。参与者的社区地址被用来使用卫星数据估计每年的 PM 浓度。我们使用线性混合模型来研究 PM 对整体和特定领域 WHODAS 评分的影响。
暴露于 PM 与更大的残疾评分显著相关（得分越高表示残疾程度越大）；每增加 10μg/m，整体残疾评分就会增加 0.72（95%CI：0.22，1.22）。与低 PM 水平（<14.33μg/m）相比，中（14.33-27.83μg/m）和高暴露水平（>27.83μg/m）与残疾评分分别增加 3.43（95%CI：1.43，5.43）和 3.72（95%CI：1.59，5.86）有关。在六个领域中，认知、行动能力和人际交往与 PM 有关。分层分析发现，女性和老年人对这种影响更为敏感。
暴露于环境 PM 可能是中低收入国家残疾的一个风险因素，女性和老年人是易受影响的人群；在六个领域中，认知、行动能力和人际交往与这一效应更为相关。
