Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; Department of Epidemiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Environ Pollut. 2018 Nov;242(Pt A):492-499. doi: 10.1016/j.envpol.2018.06.097. Epub 2018 Jul 2.
Severe and persistent haze accompanied by high concentrations of fine particulate matter (PM) has become a great public health concern in urban China. However, research on the health effects of PM in China has been hindered by the lack of high-quality exposure estimates. In this study, we assessed the excess mortality associated with both short- and long-term exposure to ambient PM simultaneously using satellite-derived exposure data at a high spatiotemporal resolution. Adult registries of non-accidental, respiratory and cardiovascular deaths in urban Beijing in 2013 were collected. Exposure levels were estimated from daily satellite-based PM concentrations at 1 km spatial resolution from 2004 to 2013. Mixed Poisson regression models were fitted to estimate the cause-specific mortality in association with PM exposures. With the mutual adjustment of short- and long-term exposure of PM, the percent increases associated with every 10 μg/m increase in short-term PM exposure were 0.09% (95% CI: -0.14%, 0.33%; lag 01), 1.02% (95% CI: 0.08%, 1.97%; lag 04) and 0.09% (95% CI: -0.23%, 0.42%; lag 01) for non-accidental, respiratory and cardiovascular mortality, respectively; those attributable to every 10 μg/m increase in long-term PM exposure (9-year moving average) were 16.78% (95% CI: 10.58%, 23.33%), 44.14% (95% CI: 20.73%, 72.10%) and 3.72% (95% CI: -3.75%, 11.77%), respectively. Both associations of short- and long-term exposure with the cause-specific mortality decreased after they were mutually adjusted. Associations between short-term exposure to satellite-based PM and cause-specific mortality were larger than those estimated using fixed measurements. Satellite-based PM predictions help to improve the spatiotemporal resolution of exposure assessments and the mutual adjustment model provide better estimation of PM associated health effects. Effects attributable to long-term exposure of PM were larger than those of short-term exposure, which should be more concerned for public health.
严重且持续的霾以及高浓度的细颗粒物（PM）在中国城市已成为重大公共卫生问题。然而，由于缺乏高质量的暴露评估，中国的 PM 健康效应研究受到阻碍。本研究利用高时空分辨率的卫星衍生暴露数据，同时评估了短期和长期暴露于环境 PM 与超额死亡之间的关系。收集了 2013 年北京城区非意外、呼吸和心血管疾病死亡的成人登记数据。暴露水平根据 2004 年至 2013 年每天的卫星 PM 浓度数据（空间分辨率为 1 公里）进行估计。使用混合泊松回归模型来估计与 PM 暴露相关的特定原因死亡率。在共同调整短期和长期 PM 暴露后，短期 PM 暴露每增加 10μg/m，非意外、呼吸和心血管疾病死亡率的百分比增加分别为 0.09%（95%CI：-0.14%，0.33%；lag 01）、1.02%（95%CI：0.08%，1.97%；lag 04）和 0.09%（95%CI：-0.23%，0.42%；lag 01）；长期 PM 暴露（9 年移动平均值）每增加 10μg/m，非意外、呼吸和心血管疾病死亡率的百分比增加分别为 16.78%（95%CI：10.58%，23.33%）、44.14%（95%CI：20.73%，72.10%）和 3.72%（95%CI：-3.75%，11.77%）。在共同调整后，短期和长期暴露与特定原因死亡率之间的关联均减弱。基于卫星的短期 PM 暴露与特定原因死亡率之间的关联大于使用固定测量值估计的关联。基于卫星的 PM 预测有助于提高暴露评估的时空分辨率，并且共同调整模型能够更好地估计 PM 相关的健康影响。长期 PM 暴露的效应大于短期 PM 暴露的效应，这对公共健康更为重要。
