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台湾不吸烟人群慢性阻塞性肺疾病与 PM2.5 的关系。

Association between chronic obstructive pulmonary disease and PM2.5 in Taiwanese nonsmokers.

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung City, 40201, Taiwan; Division of Thoracic Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan.

School of Medicine, Chung Shan Medical University, Taichung City, 40201, Taiwan; Division of Thoracic Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan.

出版信息

Int J Hyg Environ Health. 2019 Jun;222(5):884-888. doi: 10.1016/j.ijheh.2019.03.009. Epub 2019 Apr 5.

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the world. Not much is known regarding the influence of non-smoking-related risk factors on COPD in Taiwan. We examined the relationship between exposure to particulate matter <2.5 μm (PM) and COPD among nonsmokers in Taiwan.

METHODS

This population-based study involved 3941 nonsmoking Taiwanese adults who were recruited in the Taiwan Biobank project between 2008 and 2015. Air pollution data between 2006 and 2011 were obtained from the air quality monitoring database (AQMD). COPD was the outcome of interest and was identified using the National health insurance Research Database (NHIRD). The data were analyzed using multiple logistic regression models.

RESULTS

Compared with the lowest quartile (PM = 29.38), exposure to PM in the highest quartile (>38.98 μg/m) was significantly associated with COPD (OR, 1.29; CI 1.01-1.65) after multivariate adjustments. However, exposures to concentrations of 32.07-38.98 μg/m (OR, 1.12 CI 0.88-1.44) and 29.38-32.07 μg/m (OR, 1.09 CI 0.84-1.41) showed positive but non-significant associations. However, the test for trend was significant (Ptrend = 0.043). The ORs for exposure to sulfur dioxide (SO), ozone (O), carbon monoxide (CO) and NOx (nitrogen monoxide (NO were not significant.

CONCLUSIONS

Based on our data, exposure to PM at concentrations greater than 38.98 μg/m increased susceptibility to COPD among Taiwanese nonsmokers. Combatting COPD would involve integrating tobacco control and pollution management strategies.

摘要

背景

慢性阻塞性肺疾病(COPD)是世界上主要的死亡原因之一。关于非吸烟相关危险因素对台湾 COPD 的影响,人们知之甚少。我们研究了台湾非吸烟人群中暴露于小于 2.5μm 颗粒物(PM)与 COPD 之间的关系。

方法

这项基于人群的研究纳入了 2008 年至 2015 年间参加台湾生物库项目的 3941 名非吸烟台湾成年人。2006 年至 2011 年的空气污染数据来自空气质量监测数据库(AQMD)。COPD 是感兴趣的结局,并使用国家健康保险研究数据库(NHIRD)进行识别。使用多变量逻辑回归模型对数据进行分析。

结果

与最低四分位数(PM=29.38μg/m)相比,暴露于最高四分位数(>38.98μg/m)与 COPD 显著相关(OR,1.29;95%CI,1.01-1.65),经过多变量调整后。然而,暴露于 32.07-38.98μg/m(OR,1.12;95%CI,0.88-1.44)和 29.38-32.07μg/m(OR,1.09;95%CI,0.84-1.41)的浓度与 COPD 呈正相关但无统计学意义。然而,趋势检验具有统计学意义(Ptrend=0.043)。暴露于二氧化硫(SO)、臭氧(O)、一氧化碳(CO)和氮氧化物(NOx)的 OR 没有统计学意义。

结论

根据我们的数据,暴露于浓度大于 38.98μg/m 的 PM 会增加台湾非吸烟人群患 COPD 的易感性。防治 COPD 需要将烟草控制和污染管理策略相结合。

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