季节和温度变化对中国深圳二氧化氮空气污染相关心血管死亡率的影响。

Effect of changes in season and temperature on cardiovascular mortality associated with nitrogen dioxide air pollution in Shenzhen, China.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Public Health Promotion, Shenzhen Center for Disease Control and Prevention, Shenzhen, China.

出版信息

Sci Total Environ. 2019 Dec 20;697:134051. doi: 10.1016/j.scitotenv.2019.134051. Epub 2019 Aug 23.

DOI:10.1016/j.scitotenv.2019.134051

PMID:31487586

Abstract

BACKGROUND

The intricate association of mortality risk with ambient air pollution and temperature is of growing concern. Little is known regarding effect of changes in season and temperature on daily cardiovascular mortality associated with air pollutant nitrogen dioxide (NO).

OBJECTIVES

Our study aimed to assess the effect of NO on cardiovascular mortality modified by season and daily air temperature in the effect, and further to identify the population highly susceptible to cardiovascular mortality associated with NO and air temperature.

METHODS

We collected daily cause-specific death data, weather conditions, and air pollutant concentrations in Shenzhen from 2013 to 2017. Distributed-lag linear models were employed to analyze the effect of season on the NO-associated mortality. Furthermore, generalized additive models were combined with stratification parametric analysis to estimate the interaction effect of NO with air temperature on cardiovascular mortality.

RESULTS

In the cold season, the percentage increase in daily mortality for every 10 μg/m increment in NO concentration over lags of 0-2 days was 4.45% (95% CI: 2.71-6.21%). However, no statistically significant effect of NO was observed in the warm season. Compared with high-temperature days (>median temperature), a 3.51% increase in mortality (95% CI: 2.04-5.01%) over low-temperature days (≤median temperature) for the same increase in NO was significant. Air temperature modified the effect of NO on daily mortality by 4.08% (95% CI: 2.28-5.91%) for the elderly (age ≥ 65 years) on low-temperature days vs. -0.82% (95% CI: -3.88-2.34%) on high-temperature days, and 3.38% (95% CI: 1.50-5.29%) for males on low-temperature days vs. -0.73% (95% CI: -3.83-2.47%) on high air temperature days.

CONCLUSIONS

The cold season and low temperatures could significantly enhance the effect of NO on cardiovascular mortality. The elderly and males suffering from cardiovascular disease should take precautions against low temperature and NO air pollution.

摘要

背景

死亡率与环境空气污染和温度之间复杂的关联日益受到关注。关于季节和温度变化对与空气污染物二氧化氮（NO）相关的每日心血管死亡率的影响知之甚少。

目的

本研究旨在评估 NO 对心血管死亡率的影响，这种影响受季节和每日空气温度的调节，并进一步确定对与 NO 和空气温度相关的心血管死亡率高度敏感的人群。

方法

我们收集了 2013 年至 2017 年深圳的每日特定原因死亡数据、天气条件和空气污染物浓度。我们采用分布式滞后线性模型分析季节对与 NO 相关的死亡率的影响。此外，广义相加模型与分层参数分析相结合，以估计 NO 与空气温度对心血管死亡率的交互作用。

结果

在寒冷季节，NO 浓度每增加 10μg/m，滞后 0-2 天的每日死亡率增加 4.45%（95%置信区间：2.71-6.21%）。然而，在温暖季节，NO 没有表现出统计学上的显著影响。与高温日（>中位数温度）相比，低温日（≤中位数温度）NO 相同增加时，死亡率增加 3.51%（95%置信区间：2.04-5.01%）具有统计学意义。对于低温日的老年人（年龄≥65 岁），空气温度对 NO 对每日死亡率的影响修正了 4.08%（95%置信区间：2.28-5.91%），而在高温日修正了-0.82%（95%置信区间：-3.88-2.34%），对于低温日的男性，空气温度对 NO 对每日死亡率的影响修正了 3.38%（95%置信区间：1.50-5.29%），而在高温日修正了-0.73%（95%置信区间：-3.83-2.47%）。