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高臭氧暴露相关的超额死亡率:中国一项全国性队列研究

Excess mortality associated with high ozone exposure: A national cohort study in China.

作者信息

Yuan Yang, Wang Kai, Sun Haitong Zhe, Zhan Yu, Yang Zhiming, Hu Kejia, Zhang Yunquan

机构信息

Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China.

Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK.

出版信息

Environ Sci Ecotechnol. 2023 Jan 21;15:100241. doi: 10.1016/j.ese.2023.100241. eCollection 2023 Jul.


DOI:10.1016/j.ese.2023.100241
PMID:36761466
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9905662/
Abstract

Emerging epidemiological studies suggest that long-term ozone (O) exposure may increase the risk of mortality, while pre-existing evidence is mixed and has been generated predominantly in North America and Europe. In this study, we investigated the impact of long-term O exposure on all-cause mortality in a national cohort in China. A dynamic cohort of 20882 participants aged ≥40 years was recruited between 2011 and 2018 from four waves of the China Health and Retirement Longitudinal Study. A Cox proportional hazard regression model with time-varying exposures on an annual scale was used to estimate the mortality risk associated with warm-season (April-September) O exposure. The annual average level of participant exposure to warm-season O concentrations was 100 μg m (range: 61-142 μg m). An increase of 10 μg m in O was associated with a hazard ratio (HR) of 1.18 (95% confidence interval [CI]: 1.13-1.23) for all-cause mortality. Compared with the first exposure quartile of O, HRs of mortality associated with the second, third, and highest exposure quartiles were 1.09 (95% CI: 0.95-1.25), 1.02 (95% CI: 0.88-1.19), and 1.56 (95% CI: 1.34-1.82), respectively. A J-shaped concentration-response association was observed, revealing a non-significant increase in risk below a concentration of approximately 110 μg m. Low-temperature-exposure residents had a higher risk of mortality associated with long-term O exposure. This study expands current epidemiological evidence from China and reveals that high-concentration O exposure curtails the long-term survival of middle-aged and older adults.

摘要

新出现的流行病学研究表明,长期暴露于臭氧(O)可能会增加死亡风险,而此前的证据并不一致,且主要来自北美和欧洲。在本研究中,我们调查了中国一个全国性队列中长期暴露于臭氧对全因死亡率的影响。2011年至2018年期间,从中国健康与养老追踪调查的四轮调查中招募了一个由20882名年龄≥40岁的参与者组成的动态队列。使用具有年度尺度时变暴露的Cox比例风险回归模型来估计与暖季(4月至9月)臭氧暴露相关的死亡风险。参与者暖季臭氧浓度暴露的年平均水平为100μg/m(范围:61 - 142μg/m)。臭氧每增加10μg/m,全因死亡率的风险比(HR)为1.18(95%置信区间[CI]:1.13 - 1.23)。与臭氧暴露的第一个四分位数相比,与第二个、第三个和最高暴露四分位数相关的死亡率HR分别为1.09(95%CI:0.95 - 1.25)、1.02(95%CI:0.88 - 1.19)和1.56(95%CI:1.34 - 1.82)。观察到一种J形浓度 - 反应关联,表明在浓度约110μg/m以下风险无显著增加。低温暴露居民长期暴露于臭氧时死亡风险更高。本研究扩展了来自中国的现有流行病学证据,并揭示高浓度臭氧暴露会缩短中老年人的长期生存时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/fbc077d0cbd3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/4219cf731b69/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/7f25c85560e6/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/e1cd0e282180/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/fbc077d0cbd3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/4219cf731b69/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/7f25c85560e6/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/e1cd0e282180/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0023/9905662/fbc077d0cbd3/gr3.jpg

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Excess mortality associated with high ozone exposure: A national cohort study in China.

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引用本文的文献

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Loss of life expectancy attributed to long-term ozone exposure in Chinese older adults: Cross-cohort analysis from 3 national cohorts.

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[2]
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Key factors in epidemiological exposure and insights for environmental management: Evidence from meta-analysis.

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[4]
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[5]
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[6]
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[7]
The Influence of Airborne Particulate Matter on the Risk of Gestational Diabetes Mellitus: A Large Retrospective Study in Chongqing, China.

Toxics. 2023-12-24

[8]
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本文引用的文献

[1]
Yaohui Zhao: dedicated to delivering healthy ageing in China.

Lancet. 2022-11-18

[2]
Multi-stage ensemble-learning-based model fusion for surface ozone simulations: A focus on CMIP6 models.

Environ Sci Ecotechnol. 2021-9-15

[3]
Long-term exposure to ozone and cardiovascular mortality in China: a nationwide cohort study.

Lancet Planet Health. 2022-6

[4]
Long-term exposure to ozone and cardiovascular mortality in a large Chinese cohort.

Environ Int. 2022-7

[5]
Cohort-based long-term ozone exposure-associated mortality risks with adjusted metrics: A systematic review and meta-analysis.

Innovation (Camb). 2022-4-20

[6]
Long-term exposure to low ambient air pollution concentrations and mortality among 28 million people: results from seven large European cohorts within the ELAPSE project.

Lancet Planet Health. 2022-1

[7]
Low-Concentration Air Pollution and Mortality in American Older Adults: A National Cohort Analysis (2001-2017).

Environ Sci Technol. 2022-6-7

[8]
Novel Method for Ozone Isopleth Construction and Diagnosis for the Ozone Control Strategy of Chinese Cities.

Environ Sci Technol. 2021-12-7

[9]
Long-term nitrogen dioxide exposure and cause-specific mortality in the U.S. Medicare population.

Environ Res. 2022-5-1

[10]
Variability in the association between long-term exposure to ambient air pollution and mortality by exposure assessment method and covariate adjustment: A census-based country-wide cohort study.

Sci Total Environ. 2022-1-15

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