Anhui Provincial Center for Disease Control and Prevention, Anhui, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
Environ Sci Pollut Res Int. 2022 Jun;29(30):45716-45729. doi: 10.1007/s11356-022-19027-y. Epub 2022 Feb 11.
Recently, the burden of lung cancer (LC) has attracted global attention. Meanwhile, LC has become the leading cause of death in China. Many studies found a strong link between air pollutants and the risk of LC mortality in some large cities, but the results have been inconsistent, and most studies have only focused on the daily effects of six pollutants in large cities, ignoring their potential cumulative effects. This study was to investigate the weekly effects of six air pollutants (CO, NO, O, PM, PM, and SO) on LC mortality in rural areas of eastern China and to further clarify which population groups were susceptible to air pollution and seasonal trends. First, a generalized additive model was combined with a distributed lag nonlinear model to evaluate the individual impact of air pollution on LC deaths in each area. The random-effect model was then used to pool the associations between air pollutants and LC mortality risk in ten counties or districts. The results showed that six air pollutants had a statistically significant effect on the risk of LC mortality at different lag weeks. The effects of NO, PM, and CO on weekly LC mortality were strongest at a cumulative lag of 1, 0, and 1 week, respectively, the maximum cumulative risk ratio (RR) of 1.37 (95%CI: 1.23 to 1.52), 1.30 (95%CI: 1.15 to 1.46), and 1.30 (95%CI: 1.17 to 1.43), with interquartile concentrations increasing. In summary, air pollution was an important factor in LC mortality, and the effect was stronger on males, the elderly, and during cold season. It was suggested that relevant departments should formulate air pollution management measures for the elderly, males, and in different seasons in rural areas and reduce the burden of lung cancer caused by air pollution.
近年来，肺癌（LC）负担引起了全球关注。同时，LC 已成为中国的主要死亡原因。许多研究发现，在一些大城市，空气污染物与 LC 死亡率之间存在很强的关联，但结果并不一致，而且大多数研究仅关注六大污染物在大城市的日影响，忽略了它们潜在的累积效应。本研究旨在调查中国东部农村地区六种空气污染物（CO、NO、O、PM、PM 和 SO）对 LC 死亡率的周影响，并进一步阐明哪些人群易受空气污染和季节性趋势影响。首先，将广义相加模型与分布式滞后非线性模型相结合，评估每种污染物对各地区 LC 死亡的个体影响。然后，使用随机效应模型汇总十个县或区之间空气污染物与 LC 死亡率风险之间的关联。结果表明，六种空气污染物对不同滞后周 LC 死亡率的风险有统计学意义。NO、PM 和 CO 对每周 LC 死亡率的影响在累积滞后 1、0 和 1 周时最强，最大累积风险比（RR）分别为 1.37（95%CI：1.23 至 1.52）、1.30（95%CI：1.15 至 1.46）和 1.30（95%CI：1.17 至 1.43），随着浓度的增加，RR 也随之增加。综上所述，空气污染是 LC 死亡率的一个重要因素，对男性、老年人和寒冷季节的影响更强。建议相关部门针对农村地区的老年人、男性和不同季节制定空气污染管理措施，降低空气污染导致的肺癌负担。
