Department of Public Health, University of Otago, Wellington, New Zealand.
Department of Public Health, University of Otago, Wellington, New Zealand.
Sci Total Environ. 2021 Dec 20;801:149660. doi: 10.1016/j.scitotenv.2021.149660. Epub 2021 Aug 18.
To investigate associations between long-term exposure to PM, NO, mortality and morbidity in New Zealand, a country with low levels of exposure.
Retrospective cohort study.
The New Zealand resident population.
The main analyses included all adults aged 30 years and over with complete data on covariates: N = 2,223,507. People who died, or were admitted to hospital, (2013-2016) were linked anonymously to the 2013 census, and to estimates of ambient PM, and NO concentration. We fitted Poisson regression models of mortality and morbidity in adults (≥30) for all natural causes of death, and by sub- group of major cause. Person-time of exposure, censored at the time of death, was included as an offset. We adjusted for confounding by age, sex, ethnicity, income, education, smoking status and ambient temperature. Further analyses stratified by ethnic group, and investigated respiratory hospital admissions in children.
There were statistically significant positive associations between pollutants and natural causes of death: RR (per 10 μg/m) for PM 1.11 (1.07 to 1.15) and for NO 1.10 (1.07 to 1.12). For morbidity, the strongest associations were for PM and ischaemic heart disease in adults, RR: 1.29 (1.23 to 1.35) and for NO and asthma in children, RR: 1.18 (1.09 to 1.28). In models restricted to specific ethnic groups, we found no consistent differences in any of the associations.
The results for NO are higher than those published previously. Other studies have reported that the dose-response for PM may be higher at low concentrations, but less is known about NO. It is possible NO is acting as a proxy for other traffic-related pollutants that are causally related to health impacts. This study underlines the importance of controlling pollution caused by motor vehicles.
研究在新西兰这样一个暴露水平较低的国家，长期暴露于 PM、NO 与死亡率和发病率之间的关联。
回顾性队列研究。
新西兰居民。
主要分析包括所有年龄在 30 岁及以上且具有完整协变量数据的成年人：N = 2,223,507。对 2013-2016 年期间死亡或住院的人群（≥30 岁）进行匿名链接，链接到 2013 年人口普查和大气 PM 及 NO 浓度的估计数据。我们拟合了所有自然原因死亡率和发病率的成人（≥30 岁）的 Poisson 回归模型，并按主要死因的亚组进行拟合。将暴露的个体时间（截至死亡时截止）作为偏移量进行纳入。我们通过年龄、性别、种族、收入、教育、吸烟状况和环境温度来调整混杂因素。进一步的分析按种族群体分层，并调查儿童的呼吸道住院情况。
污染物与自然死因之间存在统计学上显著的正相关：每增加 10 μg/m 的 PM 的相对危险度（RR）为 1.11（1.07 至 1.15），NO 的 RR 为 1.10（1.07 至 1.12）。对于发病率，与 PM 和缺血性心脏病的关联最强，成人 RR 为 1.29（1.23 至 1.35），儿童 RR 为 1.18（1.09 至 1.28）。在仅限于特定种族群体的模型中，我们没有发现任何关联存在一致差异。
NO 的结果高于之前发表的结果。其他研究报告称，PM 的剂量-反应可能在低浓度时更高，但关于 NO 的研究较少。NO 可能是其他与交通相关的污染物的代理物，这些污染物与健康影响有关。本研究强调了控制机动车造成的污染的重要性。
