Center for Health and Applied Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
Centre for Tropical Climate Change System, Institute of Climate Change, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia; Department of Chemistry, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Ecotoxicol Environ Saf. 2019 Apr 30;171:290-300. doi: 10.1016/j.ecoenv.2018.12.057. Epub 2019 Jan 3.
Rapid urbanisation in Malaysian cities poses risks to the health of residents. This study aims to estimate the relative risk (RR) of major air pollutants on cardiovascular and respiratory hospitalisations in Kuala Lumpur. Daily hospitalisations due to cardiovascular and respiratory diseases from 2010 to 2014 were obtained from the Hospital Canselor Tuanku Muhriz (HCTM). The trace gases, PM and weather variables were obtained from the Department of Environment (DOE) Malaysia in consistent with the hospitalisation data. The RR was estimated using a Generalised Additive Model (GAM) based on Poisson regression. A "lag" concept was used where the analysis was segregated into risks of immediate exposure (lag 0) until exposure after 5 days (lag 5). The results showed that the gases could pose significant risks towards cardiovascular and respiratory hospitalisations. However, the RR value of PM was not significant in this study. Immediate effects on cardiovascular hospitalisations were observed for NO and O but no immediate effect was found on respiratory hospitalisations. Delayed effects on cardiovascular and respiratory hospitalisations were found with SO and NO. The highest RR value was observed at lag 4 for respiratory admissions with SO (RR = 1.123, 95% CI = 1.045-1.207), followed by NO at lag 5 for cardiovascular admissions (RR = 1.025, 95% CI = 1.005-1.046). For the multi-pollutant model, NO at lag 5 showed the highest risks towards cardiovascular hospitalisations after controlling for O 8 h mean lag 1 (RR = 1.026, 95% CI = 1.006-1.047), while SO at lag 4 showed highest risks towards respiratory hospitalisations after controlling for NO lag 3 (RR = 1.132, 95% CI = 1.053-1.216). This study indicated that exposure to trace gases in Kuala Lumpur could lead to both immediate and delayed effects on cardiovascular and respiratory hospitalisations.
马来西亚城市的快速城市化给居民的健康带来了风险。本研究旨在估计主要空气污染物对吉隆坡心血管和呼吸系统住院的相对风险（RR）。从 2010 年至 2014 年，从 Hospital Canselor Tuanku Muhriz（HCTM）获得了心血管和呼吸系统疾病的每日住院数据。痕量气体、PM 和天气变量从马来西亚环境部（DOE）获得，与住院数据一致。RR 使用基于泊松回归的广义加性模型（GAM）进行估计。使用“滞后”概念，将分析分为即时暴露（滞后 0）和 5 天后暴露（滞后 5）的风险。结果表明，这些气体可能对心血管和呼吸系统住院产生重大风险。然而，在本研究中，PM 的 RR 值并不显著。NO 和 O 对心血管住院有即时影响，但对呼吸住院没有即时影响。心血管和呼吸系统住院存在 SO 和 NO 的延迟影响。呼吸系统入院的最高 RR 值出现在滞后 4 时，SO（RR = 1.123，95%CI = 1.045-1.207），其次是滞后 5 时的心血管入院，NO（RR = 1.025，95%CI = 1.005-1.046）。对于多污染物模型，在控制 O 8 小时平均值滞后 1 后，滞后 5 时的 NO 显示出对心血管住院的最高风险（RR = 1.026，95%CI = 1.006-1.047），而滞后 4 时的 SO 显示出对呼吸住院的最高风险在控制滞后 3 时的 NO 后（RR = 1.132，95%CI = 1.053-1.216）。本研究表明，吉隆坡痕量气体的暴露可能导致心血管和呼吸系统住院的即时和延迟影响。
