From the Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA.
Department of Biostatistics, T.H. Chan School of Public Health, Harvard University, Boston, MA.
Epidemiology. 2020 Jul;31(4):468-477. doi: 10.1097/EDE.0000000000001195.
Construction and manufacturing sites produce airborne toxins that may affect nearby residents' respiratory health. Living in heavy industrial sites has been linked to respiratory conditions such as asthma and pneumonia. However, limited information is available for risk of acute respiratory distress syndrome (ARDS), a form of acute respiratory failure with high incidence among older adults.
We conducted a nationwide ecologic study to investigate associations between annual ZIP code-level changes in industrial activity and annual changes in ZIP code-level hospital admission rates for older community residents. Using adjusted generalized linear mixed models, we analyzed data from nearly 30 million yearly Medicare beneficiaries for the years 2006 through 2012.
We found on average 92,363 hospital admissions for ARDS per year and 646,542 admissions over the course of 7 years. We found that an increase of 10 construction sites per year was associated with a 0.77% (95% confidence interval [CI] = 0.71, 0.84) increase in annual hospital admission rates for ARDS and an increase of 10 manufacturing industries per year was associated with a 1.21% (95% CI = 1.09, 1.33) increase in annual hospital admission rates for ARDS across all ZIP codes. The estimated effect of chemical product manufacturing industry on ARDS was higher than that of total manufacturing industries. Residing in ZIP codes with a high number of construction or manufacturing sites was associated with increased ARDS hospital admissions.
This nationwide ecologic study of older adults suggests that residence in areas with more construction and manufacturing sites is associated with increased ARDS risk.
建筑和制造场所会产生空气传播的毒素，可能影响附近居民的呼吸健康。居住在重工业场所与哮喘和肺炎等呼吸道疾病有关。然而，关于急性呼吸窘迫综合征（ARDS）的风险信息有限，ARDS 是一种急性呼吸衰竭形式，在老年人中的发病率较高。
我们进行了一项全国性的生态研究，以调查每年邮政编码层面工业活动的变化与老年社区居民每年邮政编码层面医院入院率的变化之间的关联。我们使用调整后的广义线性混合模型，分析了 2006 年至 2012 年期间近 3000 万 Medicare 受益人的数据。
我们发现每年平均有 92363 例 ARDS 住院治疗，7 年期间共有 646542 例住院治疗。我们发现，每年增加 10 个建筑工地与 ARDS 年住院率增加 0.77%（95%置信区间[CI]：0.71，0.84）相关，每年增加 10 个制造业与 ARDS 年住院率增加 1.21%（95%CI：1.09，1.33）相关所有邮政编码。化学产品制造业对 ARDS 的估计影响高于制造业总行业。居住在有大量建筑或制造业的邮政编码地区与 ARDS 住院人数增加有关。
这项针对老年人的全国性生态研究表明，居住在建筑和制造场所较多的地区与 ARDS 风险增加有关。
