Occupational and Environmental Epidemiology and NetTeaching Unit, Institute for Occupational, Social and Environmental Medicine, University Hospital Munich (Ludwig Maximilians University), 80336 Munich, Germany.
Institute for Medical Informatics, Biometry and Epidemiology-IBE, Ludwig Maximilians University, 81377 Munich, Germany.
Int J Environ Res Public Health. 2017 Dec 27;15(1):39. doi: 10.3390/ijerph15010039.
In a town located in a desert area of Northern Chile, gold and copper open-pit mining is carried out involving explosive processes. These processes are associated with increased dust exposure, which might affect children's respiratory health. Therefore, we aimed to quantify the causal attributable risk of living close to the mines on asthma or allergic rhinoconjunctivitis risk burden in children. Data on the prevalence of respiratory diseases and potential confounders were available from a cross-sectional survey carried out in 2009 among 288 (response: 69 % ) children living in the community. The proximity of the children's home addresses to the local gold and copper mine was calculated using geographical positioning systems. We applied targeted maximum likelihood estimation to obtain the causal attributable risk (CAR) for asthma, rhinoconjunctivitis and both outcomes combined. Children living more than the first quartile away from the mines were used as the unexposed group. Based on the estimated CAR, a hypothetical intervention in which all children lived at least one quartile away from the copper mine would decrease the risk of rhinoconjunctivitis by 4.7 percentage points (CAR: - 4.7 ; 95 % confidence interval ( 95 % CI): - 8.4 ; - 0.11 ); and 4.2 percentage points (CAR: - 4.2 ; 95 % CI: - 7.9 ; - 0.05 ) for both outcomes combined. Overall, our results suggest that a hypothetical intervention intended to increase the distance between the place of residence of the highest exposed children would reduce the prevalence of respiratory disease in the community by around four percentage points. This approach could help local policymakers in the development of efficient public health strategies.
在智利北部沙漠地区的一个城镇，进行了金和铜露天开采，涉及爆炸过程。这些过程与粉尘暴露增加有关，可能会影响儿童的呼吸健康。因此，我们旨在量化居住在矿山附近对儿童哮喘或过敏性鼻结膜炎风险负担的因果归因风险。2009 年，在社区中进行的一项横断面调查中，获得了有关呼吸道疾病患病率和潜在混杂因素的数据，共有 288 名（应答率：69%）儿童参与。使用地理定位系统计算儿童家庭住址与当地金矿和铜矿的接近程度。我们应用有针对性的最大似然估计来获得哮喘、鼻结膜炎和两种结果综合的因果归因风险（CAR）。将居住距离矿山超过四分位数的第一四分位数的儿童作为未暴露组。基于估计的 CAR，如果所有儿童至少居住在距离铜矿四分位数之外的地方，那么这种假设性的干预措施将降低鼻结膜炎的风险 4.7 个百分点（CAR：-4.7；95%置信区间（95%CI）：-8.4；-0.11）；以及两种结果综合的风险 4.2 个百分点（CAR：-4.2；95%CI：-7.9；-0.05）。总体而言，我们的结果表明，旨在增加最高暴露儿童居住地与居住地之间距离的假设性干预措施，可能会将社区中呼吸道疾病的患病率降低约 4 个百分点。这种方法可以帮助地方政策制定者制定有效的公共卫生策略。
