School of Architecture and Urban-Rural Planning, Fuzhou University, Fuzhou 350108, China.
Center for Global and Regional Environmental Research, Department of Chemical and Biochemical Engineering, Iowa Technology Institute, University of Iowa, Iowa City, IA 52242, USA.
Int J Environ Res Public Health. 2021 Oct 2;18(19):10386. doi: 10.3390/ijerph181910386.
Ozone air pollution has been increasingly severe and has become another major air pollutant in Chinese cities, while PM is more harmful to human health than coarser PMs. However, nationwide studies estimating the effects of ozone and PM are quite limited in China. This study aims to assess the spatial associations between ozone (and PM) and the incidence rate of female lung cancer in 436 Chinese cancer registries (counties/districts). The effects of ozone and PM were estimated, respectively, using statistical models controlling for time, location and socioeconomic covariates. Then, three sensitivity analyses including the adjustments of smoking covariates and co-pollutant (SO) and the estimates of ozone, PM1 and SO effects in the same model, were conducted to test the robustness of the effects of the two air pollutants. Further still, we investigated the modifying role of urban-rural division on the effects of ozone and PM. According to the results, a 10 μg/m increase in ozone and PM was associated with a 4.57% (95% CI: 4.32%, 16.16%) and 4.89% (95% CI: 4.37%, 17.56%) increase in the incidence rate of female lung cancer relative to its mean, respectively. Such ozone and PM effects were still significant in three sensitivity analyses. Regarding the modifying role of urban-rural division, the effect of PM was greater by 2.98% (95% CI: 1.01%, 4.96%) in urban than in rural areas when PM1 changed by 10 μg/m. However, there was no modification effect of urban-rural division for ozone. In conclusion, there were positive associations between ozone (and PM) and the incidence rate of female lung cancer in China. Urban-rural division may modify the effect of PM on the incidence rate of female lung cancer, which is seldom reported. Continuous and further prevention and control measures should be developed to alleviate the situation of the two air pollutants.
臭氧空气污染日益严重，已成为中国城市的另一种主要空气污染物，而 PM 对人体健康的危害大于较粗的 PM。然而，全国范围内评估臭氧和 PM 影响的研究在中国相当有限。本研究旨在评估臭氧（和 PM）与 436 个中国癌症登记处（县/区）女性肺癌发病率之间的空间关联。使用控制时间、地点和社会经济协变量的统计模型分别估计臭氧和 PM 的影响。然后，进行了三项敏感性分析，包括调整吸烟协变量和共污染物（SO）以及在同一模型中估计臭氧、PM1 和 SO 的影响，以检验两种空气污染物影响的稳健性。此外，我们还研究了城乡划分对臭氧和 PM 影响的调节作用。结果表明，臭氧和 PM 每增加 10μg/m，女性肺癌发病率分别相对其平均值增加 4.57%（95%CI：4.32%，16.16%）和 4.89%（95%CI：4.37%，17.56%）。在三项敏感性分析中，臭氧和 PM 的这种影响仍然显著。关于城乡划分的调节作用，当 PM1 变化 10μg/m 时，PM 对城市地区女性肺癌发病率的影响比农村地区高 2.98%（95%CI：1.01%，4.96%）。然而，城乡划分对臭氧没有修饰作用。总之，在中国，臭氧（和 PM）与女性肺癌发病率之间存在正相关关系。城乡划分可能会改变 PM 对女性肺癌发病率的影响，这一点很少有报道。应制定持续和进一步的预防和控制措施，以缓解这两种空气污染物的状况。
