Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
Unit of Biostatistics, Institute of Environmental Medicine, KarolinskaInstitutet, Stockholm 17177, Sweden.
J Expo Sci Environ Epidemiol. 2018 May;28(3):297-304. doi: 10.1038/jes.2016.21.
Owing to lack of data from multiple air quality monitoring stations, studies about spatial association between concentrations of ambient pollutants and mortality in China are rare. To investigate the spatial variation of association between concentrations of particulate matter less than 10 μm in aerodynamic diameter (PM), nitrogen dioxide (NO) and carbon monoxide (CO) and cardiovascular mortality in Beijing, China, we collected data including daily deaths, concentrations of PM, NO and CO, and meteorological factors from 1 January 2009 to 31 December 2010 in all 16 districts of Beijing. Generalized additive model (GAM) and generalized additive mixed model (GAMM) were used to examine the citywide and district-specific effects of PM, NO and CO on cardiovascular mortality. The citywide effect derived from GAMM was lower than that derived from GAM, and the strongest effects were identified for 2-day moving average lag 0-1. The interquartile increases in concentrations of PM, NO and CO were associated with 2.46 (95% confidence interval (CI), 1.22-3.72), 4.11 (95%CI, 2.82-5.42) and 2.23 (95%CI, 1.14-3.33) percentage increases in daily cardiovascular mortality by GAMM, respectively. The relative risk of each district compared with reference district was generally statistically significant. The death risk associated with air pollutants varies across different geographic districts in Beijing. The data indicate that the risk is high in suburban areas and rural counties. We found significant and spatially varied adverse effects of air pollution on cardiovascular deaths across the rural and urban areas in Beijing.
由于缺乏来自多个空气质量监测站的数据，因此在中国，关于环境污染物浓度与死亡率之间的空间关联的研究很少。为了研究中国北京市大气中直径小于 10μm 的颗粒物（PM）、二氧化氮（NO）和一氧化碳（CO）浓度与心血管死亡率之间的空间变化关系，我们收集了 2009 年 1 月 1 日至 2010 年 12 月 31 日期间北京市全部 16 个区的每日死亡人数、PM、NO 和 CO 浓度以及气象因素数据。我们采用广义加性模型（GAM）和广义加性混合模型（GAMM）来检验 PM、NO 和 CO 对心血管死亡率的全市和区特异性影响。GAMM 得出的全市影响低于 GAM 得出的结果，且最强的影响出现在滞后 0-1 天的 2 天移动平均值。浓度升高的四分位间距与 PM、NO 和 CO 浓度升高相关，每日心血管死亡率分别增加 2.46%（95%置信区间（CI），1.22-3.72）、4.11%（95%CI，2.82-5.42）和 2.23%（95%CI，1.14-3.33）。GAMM 表明，与参照区相比，每个区的相对风险通常具有统计学意义。与空气污染相关的死亡风险在北京市不同地理区域存在差异。数据表明，郊区和农村县的风险较高。我们发现北京市城乡地区空气污染对心血管死亡存在显著的、空间变化的不利影响。
