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大气细颗粒物污染导致老年人慢性阻塞性肺疾病的归因风险。

The attributable risk of chronic obstructive pulmonary disease due to ambient fine particulate pollution among older adults.

机构信息

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.

College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA.

出版信息

Environ Int. 2018 Apr;113:143-148. doi: 10.1016/j.envint.2018.01.029. Epub 2018 Feb 6.

Abstract

BACKGROUND

The linkage between ambient fine particle pollution (PM) and chronic obstructive pulmonary disease (COPD) and the attributable risk remained largely unknown. This study determined the cross-sectional association between ambient PM and prevalence of COPD among adults ≥50 years of age.

METHODS

We surveyed 29,290 participants aged 50 years and above in this study. The annual average concentrations of PM derived from satellite data were used as the exposure indicator. A mixed effect model was applied to determine the associations and the burden of COPD attributable to PM RESULTS: Among the participants, 1872 (6.39%) were classified as COPD cases. Our analysis observed a threshold concentration of 30 μg/m in the PM-COPD association, above which we found a linear positive exposure-response association between ambient PM and COPD. The odds ratio (OR) for each 10 μg/m increase in ambient PM was 1.21(95% CI: 1.13, 1.30). Stratified analyses suggested that males, older subjects (65 years and older) and those with lower education attainment might be the vulnerable subpopulations. We further estimated that about 13.79% (95% CI: 7.82%, 21.62%) of the COPD cases could be attributable to PM levels higher than 30 μg/m in the study population.

CONCLUSION

Our analysis indicates that ambient PM exposure could increase the risk of COPD and accounts for a substantial fraction of COPD among the study population.

摘要

背景

环境细颗粒物污染(PM)与慢性阻塞性肺疾病(COPD)之间的联系及其归因风险在很大程度上仍不清楚。本研究旨在确定环境 PM 与 50 岁及以上成年人 COPD 患病率之间的横断面关联。

方法

我们调查了 29290 名年龄在 50 岁及以上的参与者。使用卫星数据得出的 PM 年平均浓度作为暴露指标。应用混合效应模型来确定 PM 与 COPD 的关联及其归因风险。

结果

在参与者中,1872 人(6.39%)被归类为 COPD 病例。我们的分析发现,PM 与 COPD 之间存在 30μg/m 的阈值浓度,在此浓度以上,我们发现环境 PM 与 COPD 之间存在线性正暴露反应关系。环境 PM 每增加 10μg/m,OR 值为 1.21(95%CI:1.13,1.30)。分层分析表明,男性、年龄较大(65 岁及以上)和受教育程度较低的人群可能是易感亚人群。我们进一步估计,在研究人群中,约 13.79%(95%CI:7.82%,21.62%)的 COPD 病例可能归因于高于 30μg/m 的 PM 水平。

结论

我们的分析表明,环境 PM 暴露可能会增加 COPD 的风险,并导致研究人群中相当一部分 COPD 病例。

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