空气污染、身体活动与缺血性心脏病：交互作用的前瞻性队列研究。
Air pollution, physical activity and ischaemic heart disease: a prospective cohort study of interaction effects.
机构信息
Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, Sweden
Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, Sweden.
出版信息
BMJ Open. 2021 Apr 13;11(4):e040912. doi: 10.1136/bmjopen-2020-040912.
OBJECTIVE
To assess a possible interaction effect between physical activity and air pollution on first incidence of ischaemic heart disease (IHD).
DESIGN
Prospective cohort study.
SETTING
Umeå, Northern Sweden.
PARTICIPANTS
We studied 34 748 adult participants of Västerbotten Intervention Programme cohort from 1990 to January 2014. Annual particulate matter concentrations (PM and PM) at the participants' residential addresses were modelled and a questionnaire on frequency of exercise and active commuting was completed at baseline. Cox proportional hazards modelling was used to estimate (1) association with physical activity at different levels of air pollution and (2) the association with particulate matter at different levels of physical activity.
OUTCOME
First incidence of IHD.
RESULTS
Over a mean follow-up of 12.4 years, there were 1148 IHD cases. Overall, we observed an increased risk of IHD among individuals with higher concentrations of particles at their home address. Exercise at least twice a week was associated with a lower risk of IHD among participants with high residential PM (hazard ratio (HR) 0.60; 95% CI: 0.44 to 0.82) and PM (HR 0.55; 95% CI: 0.4 to 0.76). The same beneficial effect was not observed with low residential PM (HR 0.94; 95% CI: 0.72 to 1.22) and PM (HR 0.99; 95% CI: 0.76 to 1.29). An increased risk associated with higher long-term exposure to particles was only observed among participants that exercised in training clothes at most one a week and among those not performing any active commuting. However, only the interaction effect on HRs for exercise was statistically significant.
CONCLUSION
Exercise was associated with a lower risk of first incidence of IHD among individuals with higher residential particle concentrations. An air pollution-associated risk was only observed among those who exercised less. The findings support the promotion of physical activity and a mitigation of air pollution.
目的
评估体力活动与空气污染对缺血性心脏病（IHD）首次发病的可能交互作用。
设计
前瞻性队列研究。
地点
瑞典于默奥。
参与者
我们研究了 1990 年至 2014 年 1 月期间，来自维斯特博滕干预计划队列的 34748 名成年参与者。根据参与者的住址，对每年的颗粒物浓度（PM 和 PM）进行建模，并在基线时完成一份关于运动频率和积极通勤的问卷。使用 Cox 比例风险模型来估计：（1）不同空气污染水平下体力活动的相关性；（2）不同体力活动水平下与颗粒物的相关性。
结果
在平均 12.4 年的随访中，发生了 1148 例 IHD。总体而言，我们发现，家中颗粒物浓度较高的个体发生 IHD 的风险增加。每周至少运动两次与居住环境中 PM 浓度较高的参与者发生 IHD 的风险降低有关（危险比（HR）0.60；95%置信区间：0.44 至 0.82）和 PM（HR 0.55；95%置信区间：0.4 至 0.76）。然而，这一有益效果在低浓度的 PM（HR 0.94；95%置信区间：0.72 至 1.22）和 PM（HR 0.99；95%置信区间：0.76 至 1.29）中并不明显。仅观察到，在每周最多穿着运动服运动一次的参与者以及不进行任何积极通勤的参与者中，与长期暴露于高浓度颗粒物相关的风险增加。然而，只有运动对 HRs 的交互作用具有统计学意义。
结论
运动与居住环境中颗粒物浓度较高的个体发生 IHD 的风险降低有关。仅在运动较少的人群中观察到与空气污染相关的风险。这些发现支持促进体力活动和减轻空气污染。
Zotero 插件