Li Dawei, Yang Lili, Wang Nan, Hu Yuegu, Zhou Yumeng, Du Ning, Li Na, Liu Xiaoling, Yao Chunyan, Wu Na, Xiang Ying, Li Yafei, Ji Ailing, Zhou Laixin, Cai Tongjian
Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
Department of Information, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China.
Chemosphere. 2023 Jun;327:138484. doi: 10.1016/j.chemosphere.2023.138484. Epub 2023 Mar 22.
Growing evidence indicates that short-term ozone (O) exposure has substantial health consequences, but the relationship between short-term ambient O and insomnia, a common sleep disorder, is not clear. This study aimed to investigate the short-term effects of ambient O exposure on outpatient visits for adult insomnia and to explore the potential modifiers. A large-scale multihospital-based study was carried out in Chongqing, the largest city in Southwest China. Daily data on outpatient visits for adult insomnia, average concentrations of ambient air pollutants and meteorological factors were collected. We conducted quasi-Poisson regression with generalized additive model to assess the association between ambient O and outpatient visits for adult insomnia in varied windows of exposure. Subgroup analyses were applied to identify its modifiers. Totally, 140,159 adult insomnia outpatient visits were identified. The daily maximum 8-h average concentration of O was 69 μg/m during the study period, which greatly below the updated Chinese and WHO recommended limits (daily maximum 8-h average, O: 100 μg/m). Short-term O exposure was significantly negatively associated with outpatient visits for adult insomnia in different lag periods and the greatest decrease of outpatient visits for adult insomnia was found at lag 02 [0.93% (95% CI: 0.48%, 1.38%)]. Additionally, stronger links between O and adult insomnia outpatient visits were presented in cool seasons, and we did not observe any significant modified effects of gender and age. Moreover, the negative O-insomnia association remained robust after controlling for other common air pollutants and comorbidities. In summary, short-term exposure to lower level of ambient O, was associated with reduced daily outpatient visits for adult insomnia and such association showed to be more obvious in cool seasons.
越来越多的证据表明，短期接触臭氧（O₃）会对健康产生重大影响，但短期环境中的O₃与失眠（一种常见的睡眠障碍）之间的关系尚不清楚。本研究旨在调查环境O₃暴露对成人失眠门诊就诊的短期影响，并探索潜在的影响因素。在中国西南部最大的城市重庆开展了一项基于多医院的大规模研究。收集了成人失眠门诊就诊的每日数据、环境空气污染物的平均浓度和气象因素。我们采用广义相加模型进行拟泊松回归，以评估不同暴露窗口期环境O₃与成人失眠门诊就诊之间的关联。应用亚组分析来确定其影响因素。总共确定了140159例成人失眠门诊就诊病例。研究期间O₃的每日最大8小时平均浓度为69μg/m³，远低于中国和世界卫生组织更新后的推荐限值（每日最大8小时平均浓度，O₃：100μg/m³）。短期O₃暴露在不同滞后时期与成人失眠门诊就诊显著负相关，在滞后02时发现成人失眠门诊就诊减少最多[0.93%（95%置信区间：0.48%，1.38%）]。此外，在凉爽季节，O₃与成人失眠门诊就诊之间的联系更强，并且我们未观察到性别和年龄的任何显著修饰作用。此外，在控制其他常见空气污染物和合并症后，O₃与失眠的负相关关系仍然稳健。总之，短期暴露于较低水平的环境O₃与成人失眠每日门诊就诊减少有关，并且这种关联在凉爽季节更为明显。
