瑞士成年人接触多种空气污染物、交通噪声与特定原因死亡率之间的关联。
Association between exposure to multiple air pollutants, transportation noise and cause-specific mortality in adults in Switzerland.
机构信息
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland.
University of Basel, Basel, Switzerland.
出版信息
Environ Health. 2023 Mar 27;22(1):29. doi: 10.1186/s12940-023-00983-y.
BACKGROUND
Long-term exposure to air pollution and noise is detrimental to health; but studies that evaluated both remain limited. This study explores associations with natural and cause-specific mortality for a range of air pollutants and transportation noise.
METHODS
Over 4 million adults in Switzerland were followed from 2000 to 2014. Exposure to PM, PM components (Cu, Fe, S and Zn), NO, black carbon (BC) and ozone (O) from European models, and transportation noise from source-specific Swiss models, were assigned at baseline home addresses. Cox proportional hazards models, adjusted for individual and area-level covariates, were used to evaluate associations with each exposure and death from natural, cardiovascular (CVD) or non-malignant respiratory disease. Analyses included single and two exposure models, and subset analysis to study lower exposure ranges.
RESULTS
During follow-up, 661,534 individuals died of natural causes (36.6% CVD, 6.6% respiratory). All exposures including the PM components were associated with natural mortality, with hazard ratios (95% confidence intervals) of 1.026 (1.015, 1.038) per 5 µg/m PM, 1.050 (1.041, 1.059) per 10 µg/m NO, 1.057 (1.048, 1.067) per 0.5 × 10/m BC and 1.045 (1.040, 1.049) per 10 dB Lden total transportation noise. NO, BC, Cu, Fe and noise were consistently associated with CVD and respiratory mortality, whereas PM was only associated with CVD mortality. Natural mortality associations persisted < 20 µg/m for PM and NO, < 1.5 10/m BC and < 53 dB Lden total transportation noise. The O association was inverse for all outcomes. Including noise attenuated all outcome associations, though many remained significant. Across outcomes, noise was robust to adjustment to air pollutants (e.g. natural mortality 1.037 (1.033, 1.042) per 10 dB Lden total transportation noise, after including BC).
CONCLUSION
Long-term exposure to air pollution and transportation noise in Switzerland contribute to premature mortality. Considering co-exposures revealed the importance of local traffic-related pollutants such as NO, BC and transportation noise.
背景
长期暴露于空气污染和噪声对健康有害，但评估两者的研究仍然有限。本研究探讨了一系列空气污染物和交通噪声与自然和特定原因死亡率的关系。
方法
2000 年至 2014 年期间，瑞士有超过 400 万成年人被纳入研究。根据欧洲模型评估 PM、PM 成分（Cu、Fe、S 和 Zn）、NO、黑碳（BC）和臭氧（O）的暴露情况，并根据瑞士特定源模型评估交通噪声的暴露情况。在基线时，将这些暴露情况分配给家庭住址。使用 Cox 比例风险模型，根据个体和区域水平的协变量进行调整，评估与每种暴露因素和自然、心血管疾病（CVD）或非恶性呼吸道疾病导致的死亡之间的关系。分析包括单因素和双因素模型，以及亚组分析以研究较低的暴露范围。
结果
在随访期间，有 661534 人死于自然原因（36.6%为 CVD，6.6%为呼吸道疾病）。所有暴露因素，包括 PM 成分，都与自然死亡率相关，每增加 5µg/m 的 PM 风险比（95%置信区间）为 1.026（1.015，1.038），每增加 10µg/m 的 NO 为 1.050（1.041，1.059），每增加 0.5×10/m 的 BC 为 1.057（1.048，1.067），每增加 10dB Lden 总交通噪声为 1.045（1.040，1.049）。NO、BC、Cu、Fe 和噪声与 CVD 和呼吸道死亡率始终相关，而 PM 仅与 CVD 死亡率相关。PM 和 NO 的自然死亡率相关性在<20µg/m 时仍然存在，BC 的<1.5 10/m 和总交通噪声的<53dB Lden 时仍然存在。O 的相关性与所有结果均呈负相关。纳入噪声后，虽然许多结果仍然显著，但所有结果的相关性都有所减弱。在所有结果中，噪声对空气污染的调整仍然稳健（例如，自然死亡率为 1.037（1.033，1.042）/10dB Lden 总交通噪声，在包括 BC 后）。
结论
在瑞士，长期暴露于空气污染和交通噪声会导致过早死亡。考虑到共同暴露，揭示了当地与交通有关的污染物（如 NO、BC 和交通噪声）的重要性。
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