Tan Jialong, Chen Nuo, Bai Jing, Yan Peizhe, Ma Xinyu, Ren Meiling, Maitland Elizabeth, Nicholas Stephen, Cheng Wenjing, Leng Xue, Chen Chen, Wang Jian
Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China.
Economics and Management School, Wuhan University, Wuhan, China.
J Environ Manage. 2023 Jun 15;336:117619. doi: 10.1016/j.jenvman.2023.117619. Epub 2023 Mar 14.
Ambient air pollution is a major public health concern impacting all aspects of human health. There is a lack of studies on the impact of ambient air pollution on health-related quality of life (HRQoL) of older Chinese adults. Our study answers two questions: How concentrations of ambient air pollutants are associated with HRQoL among older adults in China and, second, what are the possible mechanisms through which ambient air pollution affects HRQoL. From the 2018 National Health Service Survey, we sampled 5717 aged 65 years or older residents for the eastern province of Shandong, China. Data on individual exposures to PM and PM (particulate matter with diameter less than or equal to 2.5 μm and 10 μm) and sulfur dioxide (SO) were collected from the ChinaHighAirPollutants (CHAP) datasets. Mixed-effects Tobit regression models and mixed-effects ordered Probit regression models were employed to examine the associations of long-term exposure to ambient air pollution with the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) scale comprising mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Socioeconomic, demographic and behavioral factors relating to HRQoL were also examined. The results show that for each 1 μg/m increase, EQ-5D-3L scores fell 0.002 for PM; 0.001 for PM and 0.002 for SO. Long term exposure to PM, PM and SO were also associated with increased prevalence of pain/discomfort and anxiety/depression. The reduced HRQoL effects of ambient air pollution were exacerbated by higher socioeconomic status (affluent, urban and higher level of education). Our findings suggested that HRQoL of older Chinese adults was not only associated with demographic, socioeconomic, and health-related factors, but also negatively correlated with air pollution, especially through increased pain/discomfort and anxiety/depression. The paper proposes policy recommendations.
环境空气污染是一个重大的公共卫生问题，影响着人类健康的各个方面。目前缺乏关于环境空气污染对中国老年成年人健康相关生活质量（HRQoL）影响的研究。我们的研究回答了两个问题：中国老年成年人中环境空气污染物浓度如何与HRQoL相关联，其次，环境空气污染影响HRQoL的可能机制是什么。我们从2018年国家卫生服务调查中，抽取了中国东部省份山东省5717名65岁及以上的居民作为样本。个体接触细颗粒物（PM₂.₅）和可吸入颗粒物（PM₁₀）以及二氧化硫（SO₂）的数据，是从中国高空气污染物（CHAP）数据集中收集的。我们采用混合效应托比特回归模型和混合效应有序概率单位回归模型，来检验长期接触环境空气污染与欧洲生活质量五维度三级版本（EQ - 5D - 3L）量表之间的关联，该量表包括行动能力、自我护理、日常活动、疼痛/不适以及焦虑/抑郁。我们还研究了与HRQoL相关的社会经济、人口统计学和行为因素。结果显示，每增加1μg/m³，PM₂.₅使EQ - 5D - 3L得分下降0.002；PM₁₀使得分下降0.001，SO₂使得分下降0.002。长期接触PM₂.₅、PM₁₀和SO₂还与疼痛/不适以及焦虑/抑郁患病率的增加有关。较高的社会经济地位（富裕、城市居民以及较高教育水平）会加剧环境空气污染对HRQoL的降低影响。我们的研究结果表明，中国老年成年人的HRQoL不仅与人口统计学、社会经济和健康相关因素有关，还与空气污染呈负相关，特别是通过增加疼痛/不适和焦虑/抑郁来体现。本文提出了政策建议。
