温度和空气污染对伊朗心血管疾病和死亡的影响：德黑兰血脂和血糖研究的 15 年随访。
Impact of temperature and air pollution on cardiovascular disease and death in Iran: A 15-year follow-up of Tehran Lipid and Glucose Study.
机构信息
Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Sci Total Environ. 2019 Apr 15;661:243-250. doi: 10.1016/j.scitotenv.2019.01.182. Epub 2019 Jan 15.
In this, the first study to be conducted in the Middle East and North Africa (MENA) on the subject, we examined the impact of temperature and air pollution on cardiovascular disease (CVD) and all-cause mortality. The Tehran Lipid and Glucose Study followed 9731 participants, aged ≥30years (men=4409), during the period 1999-2014, reporting 1350 CVDs (men=796) and 725 deaths (men=447). Air pollution level was measured using the air quality index (AQI). Data were analyzed using the distributed lag nonlinear model, with 30°C temperature and AQI=50 minimum risk values, as the relative risks' (RR) reference values. Although for the whole sample, no significant effect of air pollution was observed on CVD, for the under 60year olds, two significant peaks occurred in AQI=180 at lags 2 and 6days (RR=1.94, 95% CI: 1.02-3.67 and 2.06, 95% CI: 1.09-3.88, respectively). Temperature had no significant effect on CVD, yet the closest case to significance happened at 36°C and lag 5days (RR=1.43, 95% CI: 0.97-2.11), for ages ≥60y. The largest significant effects of air pollution on death, occurred in AQI=180 and lag 1day (RR=2.40, 95% CI: 1.0.-5.59 and 3.29, 95% CI: 1.15-9.36, for the whole sample and the <60year olds, respectively). Interestingly, for those aged over 60years, the peak belonged to AQI=180 and lag 7days (RR=2.16, 95% CI: 1.11-4.19). Regarding the effect of temperature on death among the whole sample, the highest risk was for 6°C and lag 0 (RR=3.91, 95% CI: 1.12-13.61). For the ≥60year olds, it occurred in 9 and lag 0 (RR=6.81, 95% CI: 1.69-27.44), though notably, the peak went to -3°C and lag 3 (RR=5.69, 95% CI: 1.12-28.87), for those aged <60years. Overall, the effect of low temperature on death had the highest risk, for the over 60-year-olds, without any lag. Moreover, the <60-year-olds were the most vulnerable group to air pollution with a one day lag, in terms of mortality risk.
在这项首次在中东和北非（MENA）进行的关于该主题的研究中，我们研究了温度和空气污染对心血管疾病（CVD）和全因死亡率的影响。德黑兰血脂和血糖研究随访了 9731 名参与者，年龄≥30 岁（男性=4409），在 1999-2014 年期间报告了 1350 例 CVD（男性=796）和 725 例死亡（男性=447）。空气污染水平使用空气质量指数（AQI）进行测量。使用分布滞后非线性模型分析数据，以 30°C 温度和 AQI=50 为最低风险值，作为相对风险（RR）参考值。尽管对于整个样本，空气污染对 CVD 没有显著影响，但对于 60 岁以下的人群，在 AQI=180 时出现了两个显著的高峰，滞后 2 天和 6 天（RR=1.94，95%CI：1.02-3.67 和 2.06，95%CI：1.09-3.88）。温度对 CVD 没有显著影响，但最接近显著性的情况发生在 36°C 和滞后 5 天（RR=1.43，95%CI：0.97-2.11），年龄≥60 岁。空气污染对死亡的最大显著影响发生在 AQI=180 和滞后 1 天（RR=2.40，95%CI：1.0.-5.59 和 3.29，95%CI：1.15-9.36，对于整个样本和<60 岁的人群分别）。有趣的是，对于 60 岁以上的人群，峰值属于 AQI=180 和滞后 7 天（RR=2.16，95%CI：1.11-4.19）。关于温度对全样本死亡的影响，最高风险是 6°C 和滞后 0（RR=3.91，95%CI：1.12-13.61）。对于≥60 岁的人群，它发生在 9 和滞后 0（RR=6.81，95%CI：1.69-27.44），尽管值得注意的是，对于<60 岁的人群，峰值出现在-3°C 和滞后 3 天（RR=5.69，95%CI：1.12-28.87）。总体而言，对于 60 岁以上的人群，低温对死亡的影响风险最高，且没有滞后。此外，<60 岁的人群是最脆弱的群体，他们在一天的滞后时间内，面临更高的空气污染死亡率风险。
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