Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China.
Key laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China.
Int J Environ Res Public Health. 2019 Jul 14;16(14):2515. doi: 10.3390/ijerph16142515.
To investigate the association of long-term PM exposure with blood pressure (BP) outcomes in children aged 6-18 years, and to examine the population attributable risk (PAR) of PM exposure.
A total of 53,289 participants aged 6-18 years with full record of age, sex, BP, height, and local PM exposure from a cross-sectional survey conducted in 6 cities of China in 2013 were involved in the present study. PM data from 18 January 2013 to 31 December 2013 were obtained from the nearest environmental monitoring station for each selected school. Two-level linear and logistic regression models were used to evaluate the influence of PM on children's BP, and PAR was calculated in each sex and age group.
Participants had a mean age of 10.8 (standard deviation: 3.4) years at enrollment, 51.7% of them were boys. U-shaped trends along with increased PM concentration were found for both systolic blood pressure (SBP) and diastolic blood pressure (DBP), with the thresholds of 57.8 and 65.0 μg/m, respectively. Both increased annual mean of PM concentration and ratio of polluted days were associated with increased BP levels and high blood pressure (HBP), with effect estimates for BP ranging from 2.80 (95% CI: -0.51, 6.11) mmHg to 5.78 (95% CI: 2.32, 9.25) mmHg for SBP and from 0.77 (95% CI: -1.98, 3.52) mmHg to 2.66 (-0.35, 5.66) mmHg for DBP, and the odds ratios for HBP from 1.21 (0.43, 3.38) to 1.92 (0.65, 5.67) in the highest vs. the lowest quartiles. Overall, 1.16% of HBP in our participants could be attributed to increased annual mean of PM concentration, while 2.82% could be attributed to increased ratio of polluted days. These proportions increased with age.
The association between long-term PM exposure and BP values appeared to be U-shaped in Chinese children aged 6-18 years, and increased PM exposure was associated with higher risk of HBP.
探讨儿童期长期 PM 暴露与血压（BP）结局的关系，并检验 PM 暴露的人群归因风险（PAR）。
本研究共纳入 2013 年在中国 6 个城市进行的横断面调查中年龄为 6-18 岁、完整记录年龄、性别、BP、身高和当地 PM 暴露情况的 53289 名参与者。从每个选定学校最近的环境监测站获取 2013 年 1 月 18 日至 12 月 31 日的 PM 数据。使用两级线性和逻辑回归模型评估 PM 对儿童 BP 的影响，并在每个性别和年龄组中计算 PAR。
参与者入组时的平均年龄为 10.8（标准差：3.4）岁，其中 51.7%为男性。收缩压（SBP）和舒张压（DBP）均呈现出随着 PM 浓度增加而呈 U 型的趋势，其阈值分别为 57.8 和 65.0μg/m。年均 PM 浓度增加和污染天数比例增加均与 BP 水平升高和高血压（HBP）相关，BP 的效应估计值范围为 SBP 从 2.80（95%CI：-0.51，6.11）mmHg 到 5.78（95%CI：2.32，9.25）mmHg，DBP 从 0.77（95%CI：-1.98，3.52）mmHg 到 2.66（-0.35，5.66）mmHg，HBP 的比值比从最高四分位组的 1.21（0.43，3.38）到最低四分位组的 1.92（0.65，5.67）。总体而言，参与者中 1.16%的 HBP 归因于年均 PM 浓度增加，2.82%归因于污染天数比例增加。这些比例随着年龄的增长而增加。
中国 6-18 岁儿童长期 PM 暴露与 BP 值之间的关系呈 U 型，PM 暴露增加与 HBP 风险增加相关。
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