School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China.
Department of Physics and Atmospheric Science, Dalhousie University, B3H 4R2 Halifax, Nova Scotia, Canada; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA.
Environ Int. 2021 Nov;156:106739. doi: 10.1016/j.envint.2021.106739. Epub 2021 Jun 30.
Few studies have investigated the association between exposure to fine particulate matter (PM) and infant mortality in developing countries, especially for the health effects of specific PM constituents.
We aimed to examine the association of long-term exposure to specific PM constituents with infant mortality in 15 African countries from 2005 to 2015.
Based on the Demographic and Health Surveys (DHS) dataset, we included birth history records from 15 countries in Africa and conducted a multicountry cross-sectional study to examine the associations between specific PM constituents and infant mortality. We estimated annual residential exposure using satellite-derived PM for mass and a chemical transport model (GEOS-Chem) for its six constituents, including organic matter (OM), black carbon (BC), sulfate (SO), nitrate (NO), ammonium (NH), and soil dust (DUST). Multivariable logistic regression analysis was employed by fitting single-constituent models, the constituent-PM models, and the constituent-residual models. We also conducted stratified analyses by potential effect modifiers and examined the specific associations for each country.
We found positive and significant associations between PM total mass and most of its constituents with infant mortality. In the single-constituent model, for an IQR increase in pollutant concentrations, the odds ratio (OR) of infant mortality was 1.03 (95 %CI; 1.01, 1.06) for PM total mass, and was 1.04 (95 %CI: 1.02, 1.06), 1.04 (95 %CI: 1.02, 1.05), 1.02 (95 %CI: 1.00, 1.03), 1.04 (1.01, 1.06) for BC, OM, SO, and DUST, respectively. The associations of BC, OM, and SO remained significant in the other two models. We observed larger estimates in subgroups with older maternal age, living in urban areas, using unclean cooking energy, and with access to piped water. The associations varied among countries, and by different constituents.
The carbonaceous fractions and sulfate play a major important role among PM constituents on infant mortality. Our findings have certain policy implications for implementing effective measures for targeted reduction in specific sources (fossil fuel combustion and biomass burning) of PM constituents against the risk of infant mortality.
鲜有研究调查发展中国家细颗粒物（PM）暴露与婴儿死亡率之间的关系，尤其是针对特定 PM 成分的健康影响。
我们旨在研究 2005 年至 2015 年期间，15 个非洲国家内长期暴露于特定 PM 成分与婴儿死亡率之间的关系。
基于人口与健康调查（DHS）数据集，我们纳入了来自非洲 15 个国家的生育史记录，并进行了一项多国横断面研究，以检验特定 PM 成分与婴儿死亡率之间的关系。我们使用卫星衍生的 PM 质量和化学输送模型（GEOS-Chem）来估计每年的居民暴露量，该模型包括有机物（OM）、黑碳（BC）、硫酸盐（SO）、硝酸盐（NO）、铵（NH）和土壤尘（DUST）等六种成分。我们通过拟合单成分模型、成分-PM 模型和成分残差模型，采用多变量逻辑回归分析。我们还按潜在的效应修饰物进行了分层分析，并检验了每个国家的特定关联。
我们发现 PM 总质量及其大部分成分与婴儿死亡率之间存在正相关且有统计学意义。在单成分模型中，对于污染物浓度的一个 IQR 增加，婴儿死亡率的比值比（OR）为 1.03（95%CI；1.01，1.06），PM 总质量为 1.04（95%CI：1.02，1.06），BC 为 1.04（95%CI：1.02，1.05），OM 为 1.02（95%CI：1.00，1.03），SO 为 1.04（1.01，1.06），DUST 为 1.04（1.01，1.06）。在其他两个模型中，BC、OM 和 SO 的关联仍然显著。我们在母亲年龄较大、居住在城市地区、使用不清洁烹饪能源和使用管道供水的亚组中观察到更大的估计值。这些关联在各国之间以及不同成分之间存在差异。
碳质成分和硫酸盐在 PM 成分对婴儿死亡率的影响中起着重要作用。我们的研究结果为实施针对特定来源（化石燃料燃烧和生物质燃烧）的有效措施提供了一定的政策意义，以降低 PM 成分对婴儿死亡率的风险。
