Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada.
Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
Chemosphere. 2021 Feb;265:128683. doi: 10.1016/j.chemosphere.2020.128683. Epub 2020 Oct 29.
Hospitalization and mortality (H-M) have been linked to air pollution separately. However, previous studies have not adequately compared whether air pollution is a stronger risk factor for hospitalization or mortality. This study aimed to investigate differences in H-M risk from short-term ozone and PM exposures, and determine whether differences are modified by season, age, and sex.
Daily ozone, PM, temperature, and all-cause H-M counts (ICD-10, A00-R99) were collected for 22-24 Canadian cities for up to 29 years. Generalized additive Poisson models were employed to estimate associations between each pollutant and health outcome, which were compared across season (warm, cold, or year-round), age (all ages or seniors > 65), and sex.
Overall, ozone and PM showed higher season-specific risk of mortality than hospitalization: warm-season ozone: 0.54% (95% credible interval, 0.20, 0.85) vs. 0.14% (0.02, 0.27) per 10 ppb; and year-round PM: 0.90% (0.33, 1.41) vs. 0.29% (0.03, 0.56) per 10 μg/m. While age showed little H-M difference, sex appeared to be a modifier of H-M risk. While females had higher mortality risk, males had higher hospitalization risk: for females, ozone 0.87% (0.36, 1.35) vs. -0.03% (-0.18, 0.11) and PM 1.19% (0.40, 1.90) vs. 0.19% (-0.10, 0.47); and for males ozone 0.20% (-0.28, 0.65) vs. 0.35% (0.18, 0.51).
This study found H-M differences attributable to ozone and PM, suggesting that both are stronger risk factors for mortality than hospitalization. In addition, there were clear H-M differences by sex: specifically, females showed higher mortality risk and males showed higher hospitalization risk.
住院和死亡（H-M）分别与空气污染有关。然而，以前的研究并没有充分比较空气污染是否是住院或死亡的更强风险因素。本研究旨在调查短期臭氧和 PM 暴露对 H-M 风险的差异，并确定这些差异是否受季节、年龄和性别影响。
收集了 22-24 个加拿大城市长达 29 年的每日臭氧、PM、温度和全因 H-M 计数（ICD-10，A00-R99）。采用广义加性泊松模型估计每种污染物与健康结果之间的关联，这些关联在季节（温暖、寒冷或全年）、年龄（所有年龄或>65 岁的老年人）和性别方面进行了比较。
总体而言，臭氧和 PM 对死亡的季节性风险高于住院：温暖季节臭氧：每 10ppb 增加 0.54%（95%可信区间，0.20，0.85）；全年 PM：每 10μg/m 增加 0.90%（0.33，1.41）。而年龄对 H-M 的影响很小，但性别似乎是 H-M 风险的一个修饰因子。虽然女性的死亡率风险较高，但男性的住院风险较高：对于女性，臭氧增加 0.87%（0.36，1.35）和-0.03%（-0.18，0.11）；PM 增加 1.19%（0.40，1.90）和 0.19%（-0.10，0.47）；对于男性，臭氧增加 0.20%（-0.28，0.65）和 0.35%（0.18，0.51）。
本研究发现臭氧和 PM 导致 H-M 差异，表明两者都是死亡的更强风险因素，而非住院。此外，性别对 H-M 有明显差异：具体而言，女性死亡率风险较高，男性住院风险较高。
