Chen Gongbo, Guo Yuming, Yue Xu, Tong Shilu, Gasparrini Antonio, Bell Michelle L, Armstrong Ben, Schwartz Joel, Jaakkola Jouni J K, Zanobetti Antonella, Lavigne Eric, Nascimento Saldiva Paulo Hilario, Kan Haidong, Royé Dominic, Milojevic Ai, Overcenco Ala, Urban Aleš, Schneider Alexandra, Entezari Alireza, Vicedo-Cabrera Ana Maria, Zeka Ariana, Tobias Aurelio, Nunes Baltazar, Alahmad Barrak, Forsberg Bertil, Pan Shih-Chun, Íñiguez Carmen, Ameling Caroline, De la Cruz Valencia César, Åström Christofer, Houthuijs Danny, Van Dung Do, Samoli Evangelia, Mayvaneh Fatemeh, Sera Francesco, Carrasco-Escobar Gabriel, Lei Yadong, Orru Hans, Kim Ho, Holobaca Iulian-Horia, Kyselý Jan, Teixeira João Paulo, Madureira Joana, Katsouyanni Klea, Hurtado-Díaz Magali, Maasikmets Marek, Ragettli Martina S, Hashizume Masahiro, Stafoggia Massimo, Pascal Mathilde, Scortichini Matteo, de Sousa Zanotti Stagliorio Coêlho Micheline, Valdés Ortega Nicolás, Ryti Niilo R I, Scovronick Noah, Matus Patricia, Goodman Patrick, Garland Rebecca M, Abrutzky Rosana, Garcia Samuel Osorio, Rao Shilpa, Fratianni Simona, Dang Tran Ngoc, Colistro Valentina, Huber Veronika, Lee Whanhee, Seposo Xerxes, Honda Yasushi, Guo Yue Leon, Ye Tingting, Yu Wenhua, Abramson Michael J, Samet Jonathan M, Li Shanshan
Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Lancet Planet Health. 2021 Sep;5(9):e579-e587. doi: 10.1016/S2542-5196(21)00200-X.
Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM and mortality across various regions of the world.
For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfire-related PM were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM exposure was calculated.
65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM exposure were 1·019 (95% CI 1·016-1·022) for all-cause mortality, 1·017 (1·012-1·021) for cardiovascular mortality, and 1·019 (1·013-1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48-0·75) of all-cause deaths, 0·55% (0·43-0·67) of cardiovascular deaths, and 0·64% (0·50-0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM exposure during the study period.
Short-term exposure to wildfire-related PM was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires.
Australian Research Council, Australian National Health & Medical Research Council.
世界上许多地区现在正面临着更加频繁且规模空前的野火。然而，与野火相关的细颗粒物（PM）与死亡率之间的关联尚未得到充分描述。我们旨在全面评估短期暴露于与野火相关的PM与全球各地区死亡率之间的关联。
在这项时间序列研究中，收集了2000年至2016年期间43个国家和地区749个城市的全因死亡、心血管疾病死亡和呼吸道疾病死亡的每日计数数据。使用三维化学传输模型GEOS-Chem以0.25°×0.25°的分辨率估算与野火相关的PM的每日浓度。在每个城市中，使用准泊松时间序列模型检查与野火相关的PM暴露与死亡率之间的关联，同时考虑当日和滞后效应，然后使用随机效应荟萃分析汇总效应估计值。基于这些汇总的效应估计值，计算了因急性野火相关PM暴露导致的年度死亡率的人群归因分数和相对风险（RR）。
我们的分析纳入了6560万例全因死亡、1510万例心血管疾病死亡和680万例呼吸道疾病死亡。与野火相关的PM暴露的3天移动平均值（滞后0至2天）每增加10μg/m³，全因死亡率的汇总RR为1.019（95%CI 1.016至1.022），心血管死亡率为1.017（1.012至1.021），呼吸道死亡率为1.019（1.013至1.025）。总体而言，在研究期间，全因死亡的0.62%（95%CI 0.48至0.75）、心血管疾病死亡的0.55%（0.43至0.67）和呼吸道疾病死亡的0.64%（0.50至0.78）每年可归因于野火相关PM暴露的急性影响。
短期暴露于与野火相关的PM与死亡风险增加有关。需要采取紧急行动以降低野火增加带来的健康风险。
澳大利亚研究理事会、澳大利亚国家卫生与医学研究理事会。
