Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Sci Total Environ. 2022 Feb 25;809:152205. doi: 10.1016/j.scitotenv.2021.152205. Epub 2021 Dec 8.
Evidence for the association between long-term exposure to ambient particulate matter components and mortality from natural causes is sparse and inconsistent. We evaluated this association in six large administrative cohorts in the framework of the Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) project. We analyzed data from country-wide administrative cohorts in Norway, Denmark, the Netherlands, Belgium, Switzerland and in Rome (Italy). Annual 2010 mean concentrations of copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V) and zinc (Zn) in fine particulate matter (PM) were estimated using 100 × 100 m Europe-wide hybrid land use regression models assigned to the participants' residential addresses. We applied cohort-specific Cox proportional hazard models controlling for area- and individual-level covariates to evaluate associations with natural mortality. Two pollutant models adjusting for PM total mass or nitrogen dioxide (NO) were also applied. We pooled cohort-specific estimates using a random effects meta-analysis. We included almost 27 million participants contributing more than 240 million person-years. All components except Zn were significantly associated with natural mortality [pooled Hazard Ratios (HRs) (95% CI): 1.037 (1.014, 1.060) per 5 ng/m Cu; 1.069 (1.031, 1.108) per 100 ng/m Fe; 1.039 (1.018, 1.062) per 50 ng/m K; 1.024 (1.006, 1.043) per 1 ng/m Ni; 1.036 (1.016, 1.057) per 200 ng/m S; 1.152 (1.048, 1.266) per 100 ng/m Si; 1.020 (1.006, 1.034) per 2 ng/m V]. Only K and Si were robust to PM or NO adjustment [pooled HRs (95% CI) per 50 ng/m in K: 1.025 (1.008, 1.044), 1.020 (0.999, 1.042) and per 100 ng/m in Si: 1.121 (1.039, 1.209), 1.068 (1.022, 1.117) adjusted for PM and NO correspondingly]. Our findings indicate an association of natural mortality with most components, which was reduced after adjustment for PM and especially NO.
长期暴露于环境细颗粒物成分与自然原因死亡率之间的关联证据稀缺且不一致。我们在“低水平空气污染影响研究：欧洲项目”（ELAPSE）框架内，对六个大型行政队列中的这种关联进行了评估。我们分析了来自挪威、丹麦、荷兰、比利时、瑞士和罗马（意大利）全国性行政队列的数据。使用分配给参与者居住地址的欧洲范围内混合土地使用回归模型，估算了 2010 年每年平均浓度为 5 纳克/立方米的铜（Cu）、铁（Fe）、钾（K）、镍（Ni）、硫（S）、硅（Si）、钒（V）和锌（Zn）在细颗粒物（PM）中的浓度。我们应用队列特异性 Cox 比例风险模型，控制区域和个体水平的协变量，评估与自然死亡率的关联。还应用了调整 PM 总质量或二氧化氮（NO）的两个污染物模型。我们使用随机效应荟萃分析汇总了队列特异性估计值。我们纳入了近 2700 万名参与者，贡献了超过 2.4 亿人年的数据。除锌外，所有成分均与自然死亡率显著相关[汇总危险比（HR）（95%置信区间）：每 5ng/m Cu 增加 1.037（1.014，1.060）；每 100ng/m Fe 增加 1.069（1.031，1.108）；每 50ng/m K 增加 1.039（1.018，1.062）；每 1ng/m Ni 增加 1.024（1.006，1.043）；每 200ng/m S 增加 1.036（1.016，1.057）；每 100ng/m Si 增加 1.152（1.048，1.266）；每 2ng/m V 增加 1.020（1.006，1.034）]。只有 K 和 Si 在调整 PM 或 NO 后仍然具有稳健性[每 50ng/m K 的汇总 HR（95%置信区间）：1.025（1.008，1.044），1.020（0.999，1.042）和每 100ng/m Si 的汇总 HR（95%置信区间）：1.121（1.039，1.209），1.068（1.022，1.117）分别调整 PM 和 NO]。我们的研究结果表明，自然死亡率与大多数成分之间存在关联，而在调整 PM 尤其是 NO 后，这种关联有所减弱。
