School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
School of Mathematical Sciences, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.
Sci Total Environ. 2020 Oct 10;738:140195. doi: 10.1016/j.scitotenv.2020.140195. Epub 2020 Jun 18.
The relative risk (RR) of long-term exposure to PM in lung cancer mortality (LCM) may vary spatially in China. However, previous studies applying global regression have been unable to capture such variation. We aimed to employ a geographically weighted Poisson regression (GWPR) to estimate the RRs of LCM among the elderly (≥65 years) related to long-term exposure to PM and the LCM attributable to PM at the county level in China.
We obtained annual LCM in the elderly between 2013 and 2015 from the National Death Surveillance. We linked annual mean concentrations of PM between 2000 and 2004 with LCM using GWPR model at 148 counties across mainland China, adjusting for smoking and socioeconomic covariates. We used county-specific GWPR models to estimate annual average LCM in the elderly between 2013 and 2015 attributable to PM exposure between 2000 and 2004.
The magnitude of the association between long-term exposure to PM and LCM varied with county. The median of county-specific RRs of LCM among elderly men and women was 1.52 (range: 0.90, 2.40) and 1.49 (range: 0.88, 2.56) for each 10 μg/m increment in PM, respectively. The RRs were positively significant (P < 0.05) at 95% (140/148) of counties among both elderly men and women. Higher RRs of PM among elderly men were located at Southwest and South China, and higher RRs among elderly women were located at Northwest, Southwest, and South China. There were 99,967 and 54,457 lung cancer deaths among elderly men and women that could be attributed to PM, with the attributable fractions of 31.4% and 33.8%, respectively.
The relative importance of long-term exposure to PM in LCM differed by county. The results could help the government design tailored and efficient interventions. More stringent PM control is urgently needed to reduce LCM in China.
在中国，长期暴露于 PM 与肺癌死亡率（LCM）之间的相对风险（RR）可能存在空间差异。然而，先前应用全局回归的研究无法捕捉到这种差异。我们旨在使用地理加权泊松回归（GWPR）来估计中国县级老年人（≥65 岁）与长期暴露于 PM 相关的 LCM 风险比（RR）以及 PM 归因于 LCM 的风险比。
我们从国家死亡监测中获得了 2013 年至 2015 年期间老年人的 LCM 数据。我们使用 GWPR 模型，将 2000 年至 2004 年的 PM 年平均浓度与中国大陆 148 个县的 LCM 进行关联，调整了吸烟和社会经济协变量。我们使用县级特定的 GWPR 模型来估计 2013 年至 2015 年期间老年人的 LCM 年平均值，归因于 2000 年至 2004 年的 PM 暴露。
长期暴露于 PM 与 LCM 之间的关联程度因县而异。男性和女性老年人的 RR 中位数分别为 1.52（范围：0.90，2.40）和 1.49（范围：0.88，2.56），每增加 10μg/m3 的 PM 暴露量。男性和女性老年人中有 95%（140/148）的县的 RR 具有统计学意义（P<0.05）。男性老年人的 PM 更高 RR 位于中国西南部和南部，而女性老年人的 PM 更高 RR 位于中国西北部、西南部和南部。男性和女性老年人中有 99967 人和 54457 人可能归因于 PM 的肺癌死亡，归因比例分别为 31.4%和 33.8%。
长期暴露于 PM 在中国不同地区的 LCM 中相对重要性不同。这些结果可以帮助政府设计有针对性和有效的干预措施。中国迫切需要更严格的 PM 控制，以降低 LCM。
