Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France.
Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 IMPECS (IMPact of Environmental ChemicalS on human health), F-59000 Lille, France.
Sci Total Environ. 2020 Apr 20;714:136608. doi: 10.1016/j.scitotenv.2020.136608. Epub 2020 Jan 29.
Geographical variations in cardiovascular disease rates have been linked to individual air pollutants. Investigating the relation between cardiovascular disease and exposure to a complex mixture of air pollutants requires holistic approaches. We assessed the relationship between exposure to multiple air pollutants and the incidence of coronary heart disease (CHD) in a general population sample. We collected data in the Lille MONICA registry (2008-2011) on 3268 incident cases (age range: 35-74). Based on 20 indicators, we derived a composite environmental score (SEnv) for cumulative exposure to air pollution. Poisson regression models were used to analyse associations between CHD rates on one hand and SEnv and each single indicator on the other (considered in tertiles, where T3 is the most contaminated). We adjusted models for age, sex, area-level social deprivation, and neighbourhood spatial structure. The incidence of CHD was a spatially heterogeneous (p=0.006). There was a significant positive association between SEnv and CHD incidence (trend p=0.0151). The relative risks [95%CI] of CHD were 1.08 [0.98-1.18] and 1.16 [1.04-1.29] for the 2nd and 3rd tertile of SEnv exposure. In the single pollutant analysis, PM, NO, cadmium, copper, nickel, and palladium were significantly associated with CHD rates. Multiple air pollution was associated with an increased risk of CHD. Single pollutants reflecting road traffic pollution were the most strongly associated with CHD. Our present results are consistent with the literature data on the impact of road traffic on the CHD risk in urban areas.
心血管疾病发病率的地域差异与个体空气污染物有关。研究心血管疾病与暴露于复杂空气污染物混合物之间的关系需要整体方法。我们评估了暴露于多种空气污染物与一般人群中冠心病（CHD）发病率之间的关系。我们在里尔 MONICA 登记处（2008-2011 年）收集了 3268 例新发病例（年龄范围：35-74 岁）的数据。基于 20 个指标，我们得出了一个累积空气污染暴露的综合环境评分（SEnv）。我们使用泊松回归模型分析了 CHD 发生率与 SEnv 之间的关系，以及每个单一指标（分为三分位数，其中 T3 是污染最严重的）。我们调整了模型以考虑年龄、性别、地区社会剥夺程度和邻里空间结构。CHD 的发病率存在空间异质性（p=0.006）。SEnv 与 CHD 发病率之间存在显著正相关（趋势 p=0.0151）。CHD 的相对风险[95%CI]分别为 1.08[0.98-1.18]和 1.16[1.04-1.29]，对应于 SEnv 暴露的第 2 和第 3 三分位。在单一污染物分析中，PM、NO、镉、铜、镍和钯与 CHD 发病率显著相关。多空气污染与 CHD 风险增加相关。反映道路交通污染的单一污染物与 CHD 相关性最强。我们目前的结果与关于道路交通对城市地区 CHD 风险影响的文献数据一致。
