Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
Sci Total Environ. 2020 May 10;716:136985. doi: 10.1016/j.scitotenv.2020.136985. Epub 2020 Jan 31.
Studies of the health effects of air pollution have traditionally controlled for ambient temperature as a confounder, and vice versa. However, season might be an important factor contributing to adverse health effects of air pollution. Given the current inconsistencies in results of previous studies on the effect modification of air pollution on morbidity by season, a systematic review and meta-analysis was conducted to synthesize the current evidence on effects of season on air pollution and morbidity. The electronic databases including PubMed, Web of Science, Embase, CNKI, and Wanfang were used to identify papers published up to the 30st of November in 2019. We identified 4284 articles, after screening, eighty papers met the inclusion criteria. Significant effect modification of CO, O, SO and NO on morbidity by season was observed, with corresponding ratio of relative risk of 1.0009 (95% CI: 1.0001-1.0018), 1.0080 (95% CI: 1.0021-1.0138), 0.9828 (95% CI: 0.9697-0.9962) and 0.9896 (95% CI: 0.9824-0.9968), respectively. Season significantly modified the effect of CO on pneumonia, the effect of SO on cardiovascular disease, the effect of PM on stroke, and the effect of O on stroke, asthma and pneumonia. The effect modifications of air pollution by season were similar among males and females, while the effect estimates seem to be higher among children under 18 years old and the elderly aged 75 or over. Further research is needed to better understand the mechanisms underlying the seasonal variance of the effect of air pollutants on morbidity.
空气污染对健康影响的研究通常将环境温度作为混杂因素进行控制，反之亦然。然而，季节可能是导致空气污染对健康产生不利影响的一个重要因素。鉴于先前关于季节对空气污染发病率影响的修饰作用的研究结果存在不一致性，我们进行了系统评价和荟萃分析，以综合当前关于季节对空气污染和发病率影响的证据。我们使用电子数据库（包括 PubMed、Web of Science、Embase、CNKI 和万方），检索截至 2019 年 11 月 30 日发表的文献。经过筛选，我们确定了 4284 篇文章，其中 80 篇符合纳入标准。结果观察到 CO、O、SO 和 NO 对发病率的季节修饰作用显著，相应的相对风险比分别为 1.0009（95%CI：1.0001-1.0018）、1.0080（95%CI：1.0021-1.0138）、0.9828（95%CI：0.9697-0.9962）和 0.9896（95%CI：0.9824-0.9968）。季节显著修饰了 CO 对肺炎、SO 对心血管疾病、PM 对中风、O 对中风、哮喘和肺炎的影响。季节对空气污染的影响修饰作用在男性和女性中相似，而在 18 岁以下儿童和 75 岁或以上老年人中，效应估计值似乎更高。需要进一步研究以更好地理解空气污染物对发病率影响的季节性差异的机制。
