National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
Sci Total Environ. 2018 Jan 15;612:111-118. doi: 10.1016/j.scitotenv.2017.08.243. Epub 2017 Sep 1.
Multiple sclerosis (MS) is the most prevalent neurological disease among young adults in Spain. A number of recent studies have linked traffic-related pollution, both chemical and acoustic, to the aetiology and exacerbation of neurodegenerative diseases.
To analyse the existence of a significant short-term association between daily emergency MS hospital admissions and chemical and acoustic pollution caused by traffic in Madrid.
We conducted a longitudinal ecological time series study, in which the dependent variable was the number of daily emergency MS hospital admissions (ICD-9: 340) registered in Madrid from 1 January 2001 to 31 December 2009. The independent variables were daily mean concentrations (μg/m) of PM, PM, O and NO. Equivalent diurnal (Leqd), nocturnal (Leqn) and daily equivalent noise levels (Leq24) were also considered. In addition, we controlled for linear trends, seasonality and the autoregressive nature of the series itself. Day of the week was also added as a covariate. Significant environmental variables were determined using Poisson GLM models. Relative risk (RR) and attributable risk (AR) values were calculated for increases of 10μg/m in the case of chemical pollutants and 1dB(A) in noise levels.
While there was no association between chemical pollutants caused by traffic and MS admissions, such an association was in evidence for Leqd at lag zero. This association is linear without a threshold, with there being a level above 67dB(A) from which this effect is more pronounced. The RRs were as follows: for all Leqd values, 1.21 (95% CI: 1.16, 1.26); and for Leqd >67dB(A), 1.62 (95% CI: 1.24, 2.13).
The above results indicate that traffic noise can exacerbate MS symptoms, leading to hospital admissions due to this cause.
多发性硬化症(MS)是西班牙年轻成年人中最常见的神经疾病。许多最近的研究将交通相关的化学和声学污染与神经退行性疾病的病因和恶化联系起来。
分析马德里交通引起的化学和声学污染与每日多发性硬化症急诊入院之间是否存在显著短期关联。
我们进行了一项纵向生态时间序列研究,其中因变量为马德里 2001 年 1 月 1 日至 2009 年 12 月 31 日期间每日多发性硬化症急诊入院的数量(ICD-9:340)。自变量为 PM、PM、O 和 NO 的日平均浓度(μg/m)。还考虑了等效昼夜(Leqd)、夜间(Leqn)和每日等效噪声水平(Leq24)。此外,我们还控制了线性趋势、季节性和序列本身的自回归性质。星期几也被作为协变量添加。使用泊松广义线性模型确定显著的环境变量。对于化学污染物,计算每增加 10μg/m 的相对风险(RR)和归因风险(AR)值;对于噪声水平,计算每增加 1dB(A)的 RR 和 AR 值。
虽然交通引起的化学污染物与多发性硬化症入院之间没有关联,但在滞后 0 时发现了 Leqd 与多发性硬化症入院之间的这种关联。这种关联是线性的,没有阈值,在超过 67dB(A)的水平上,这种效应更为明显。RR 值如下:所有 Leqd 值,1.21(95%置信区间:1.16,1.26);以及 Leqd >67dB(A),1.62(95%置信区间:1.24,2.13)。
上述结果表明,交通噪声会加重多发性硬化症的症状,导致因该原因住院。