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哥伦比亚麦德林 2010-2016 年大气 PM 环境污染的地方可归因疾病负担。

Local attributable burden disease to PM ambient air pollution in Medellín, Colombia, 2010-2016.

机构信息

University of Antioquia, Medellin, Colombia.

出版信息

F1000Res. 2021 May 28;10:428. doi: 10.12688/f1000research.52025.2. eCollection 2021.

Abstract

Exposure to 2.5-micron diameter air pollutants (PM ) has been associated with an increased risk of illness and death worldwide; however, in Latin American health impacts assessment of this risk factor is scarce. Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk. A descriptive study of the disease burden was carried out using the city as the unit of observation. Health events were selected based on epidemiologic evidence and the availability of the population attributable fraction associated with PM The mortality records were taken from the module of deceased of the Single Registry of Affiliates of the Health System; the morbidity records were taken from the Individual Health Services Registries. For the estimation of the burden of disease, the current Global Burden of Disease guidelines were followed. Attributable disability-adjusted life years to exposure to ambient PM pollution (DALYs ) constituted 13.8% of total burden of the city. Males showed the greatest loss of DALYs due to acute events, while in women the greatest loss was due to chronic events. Ischemic heart disease, chronic diseases of the lower respiratory tract, and influenza and pneumonia were the events that contributed the most to DALYs . 71.4% of the DALYs corresponded to mortality, mainly in the population over 65 years of age. Regarding attributable morbidity, acute events were more prevalent in both sexes, especially due to respiratory diseases Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender.

摘要

暴露于直径 2.5 微米的空气污染物(PM )与全球范围内疾病和死亡风险的增加有关;然而,在拉丁美洲,对这一风险因素的健康影响评估却很少。麦德林是该地区污染最严重的城市之一,人口增长率是其他哥伦比亚城市的两倍,这意味着处于风险之中的人口不断增加。采用城市作为观察单位,对疾病负担进行了描述性研究。根据流行病学证据和与 PM 相关的人群归因分数的可获得性,选择了健康事件。死亡率记录取自单一健康系统附属机构登记册的死亡模块;发病率记录取自个人卫生服务登记册。为了估算疾病负担,遵循了当前的全球疾病负担指南。归因于环境 PM 污染的伤残调整生命年(DALYs )占城市总负担的 13.8%。由于急性事件,男性显示出最大的 DALYs 损失,而女性则由于慢性事件导致最大的 DALYs 损失。缺血性心脏病、下呼吸道慢性疾病以及流感和肺炎是导致 DALYs 最多的疾病。71.4%的 DALYs 归因于死亡,主要发生在 65 岁以上的人群中。关于归因于发病,男女两性都更常见急性事件,尤其是呼吸道疾病。老年人的过早死亡对归因于环境 PM 污染的疾病负担的影响最大,主要是由于呼吸道和心血管疾病,性别之间没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b084/8649971/fc0a70001acf/f1000research-10-79164-g0000.jpg

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