Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China; Department of Environmental and Occupational Health, Public Health Ontario, Toronto, ON, Canada; Primary Care and Population Health Research Program, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
Environ Int. 2019 Jul;128:103-108. doi: 10.1016/j.envint.2019.04.036. Epub 2019 May 3.
Air pollution has been associated with elevated blood pressure in adults. However, epidemiological evidence from children and adolescents is limited. We investigated the associations between long-term exposure to particulate matter (PM) air pollution and blood pressure in a large population of children and adolescents.
A cross-sectional analysis was performed in a nationally representative sample consisting of 43,745 children and adolescents aged 7 to 18 years in seven provinces in China. Exposure to ambient fine particles (PM) and thoracic particles (PM) was estimated using spatiotemporal models based on satellite remote sensing, meteorological data and land use information. Mixed-effects (two-level) linear and logistic regression models were used to investigate the associations between PM exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension.
After adjustment for a wide range of covariates, every 10 μg/m increment in PM and PM concentration was associated with 1.46 [95% confidence interval (CI): 0.05, 2.88] and 1.36 (95% CI: 0.34, 2.39) mmHg increases in SBP, respectively. PM was also associated with higher prevalence of hypertension [odds ratio per 10 μg/m increment: 1.45 (95% CI: 1.07, 1.95)].
Long-term exposure to ambient PM air pollution was associated with increased blood pressure and higher prevalence of hypertension in children and adolescents. Our findings support air pollution reduction strategies as a prevention measure of childhood hypertension, a well-recognized risk factor of future cardiovascular health.
空气污染与成年人血压升高有关。然而，来自儿童和青少年的流行病学证据有限。我们调查了大气细颗粒物（PM）空气污染长期暴露与大量儿童和青少年血压之间的关系。
在中国七个省份的一个由 7 至 18 岁的 43745 名儿童和青少年组成的全国代表性样本中进行了横断面分析。使用基于卫星遥感、气象数据和土地利用信息的时空模型来估计环境细颗粒物（PM）和胸颗粒物（PM）的暴露情况。使用混合效应（两级）线性和逻辑回归模型来研究 PM 暴露与收缩压（SBP）、舒张压（DBP）和高血压之间的关系。
在调整了广泛的协变量后，PM 和 PM 浓度每增加 10μg/m，SBP 分别增加 1.46[95%置信区间（CI）：0.05，2.88]和 1.36（95% CI：0.34，2.39）mmHg。PM 还与高血压的更高患病率相关[每增加 10μg/m 的比值比：1.45（95% CI：1.07，1.95）]。
长期暴露于大气 PM 空气污染与儿童和青少年血压升高和高血压患病率增加有关。我们的研究结果支持减少空气污染的策略作为儿童高血压的预防措施，儿童高血压是未来心血管健康的一个公认的危险因素。
