短期 PM 暴露与中国赣州循环系统疾病日住院人数的关联：一项时间序列研究。
Associations between short-term PM exposure and daily hospital admissions for circulatory system diseases in Ganzhou, China: A time series study.
机构信息
Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
出版信息
Front Public Health. 2023 Mar 9;11:1134516. doi: 10.3389/fpubh.2023.1134516. eCollection 2023.
OBJECTIVE
Previous epidemiological studies have shown that both long-term and short-term exposure to fine particulate matters (PM) were associated with the morbidity and mortality of circulatory system diseases (CSD). However, the impact of PM on CSD remains inconclusive. This study aimed to investigate the associations between PM and circulatory system diseases in Ganzhou.
METHODS
We conducted this time series study to explore the association between ambient PM exposure and daily hospital admissions for CSD from 2016 to 2020 in Ganzhou by using generalized additive models (GAMs). Stratified analyses were also performed by gender, age, and season.
RESULTS
Based on 201,799 hospitalized cases, significant and positive associations were found between short-term PM2.5 exposure and hospital admissions for CSD, including total CSD, hypertension, coronary heart disease (CHD), cerebrovascular disease (CEVD), heart failure (HF), and arrhythmia. Each 10 μg/m increase in PM concentrations was associated with a 2.588% (95% confidence interval [CI], 1.161%-4.035%), 2.773% (95% CI, 1.246%-4.324%), 2.865% (95% CI, 0.786%-4.893%), 1.691% (95% CI, 0.239%-3.165%), 4.173% (95% CI, 1.988%-6.404%) and 1.496% (95% CI, 0.030%-2.983%) increment in hospitalizations for total CSD, hypertension, CHD, CEVD, HF, and arrhythmia, respectively. As PM concentrations rise, the hospitalizations for arrhythmia showed a slow upward trend, while other CSD increased sharply at high PM levels. In subgroup analyses, the impacts of PM on hospitalizations for CSD were not materially changed, although the females had higher risks of hypertension, HF, and arrhythmia. The relationships between PM exposure and hospitalizations for CSD were more significant among individuals aged ≤65 years, except for arrhythmia. PM had stronger effects on total CSD, hypertension, CEVD, HF, and arrhythmia during cold seasons.
CONCLUSION
PM exposure was positively associated with daily hospital admissions for CSD, which might provide informative insight on adverse effects of PM.
目的
先前的流行病学研究表明，长期和短期暴露于细颗粒物（PM）均与循环系统疾病（CSD）的发病率和死亡率有关。然而，PM 对 CSD 的影响仍不确定。本研究旨在探讨赣州地区 PM 与循环系统疾病之间的关系。
方法
我们进行了这项时间序列研究，通过广义加性模型（GAMs）探讨了 2016 年至 2020 年期间环境 PM 暴露与赣州地区 CSD 每日住院人数之间的关系。还按性别、年龄和季节进行了分层分析。
结果
基于 201,799 例住院病例，发现短期 PM2.5 暴露与 CSD 住院之间存在显著正相关，包括总 CSD、高血压、冠心病（CHD）、脑血管病（CEVD）、心力衰竭（HF）和心律失常。PM 浓度每增加 10μg/m，总 CSD、高血压、CHD、CEVD、HF 和心律失常的住院率分别增加 2.588%（95%置信区间 [CI]，1.161%-4.035%）、2.773%（95% CI，1.246%-4.324%）、2.865%（95% CI，0.786%-4.893%）、1.691%（95% CI，0.239%-3.165%）、4.173%（95% CI，1.988%-6.404%）和 1.496%（95% CI，0.030%-2.983%）。随着 PM 浓度的升高，心律失常的住院人数呈缓慢上升趋势，而其他 CSD 在高 PM 水平时急剧增加。在亚组分析中，尽管女性患高血压、HF 和心律失常的风险较高，但 PM 对 CSD 住院人数的影响并没有实质性改变。对于年龄≤65 岁的个体，PM 暴露与 CSD 住院人数之间的关系更为显著，除心律失常外。在寒冷季节，PM 对总 CSD、高血压、CEVD、HF 和心律失常的影响更强。
结论
PM 暴露与 CSD 每日住院人数呈正相关，这可能为 PM 的不良影响提供了有价值的见解。
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