Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Big Data Institute Building, Old Road Campus, OX3 7LF, Oxford, UK.
Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, UK.
Environ Health. 2023 Mar 27;22(1):30. doi: 10.1186/s12940-023-00978-9.
Existing evidence on long-term ambient air pollution (AAP) exposure and risk of cardio-respiratory diseases in China is mainly on mortality, and based on area average concentrations from fixed-site monitors for individual exposures. Substantial uncertainty persists, therefore, about the shape and strength of the relationship when assessed using more personalised individual exposure data. We aimed to examine the relationships between AAP exposure and risk of cardio-respiratory diseases using predicted local levels of AAP.
A prospective study included 50,407 participants aged 30-79 years from Suzhou, China, with concentrations of nitrogen dioxide (NO), sulphur dioxide (SO), fine (PM), and inhalable (PM) particulate matter, ozone (O) and carbon monoxide (CO) and incident cases of cardiovascular disease (CVD) (n = 2,563) and respiratory disease (n = 1,764) recorded during 2013-2015. Cox regression models with time-dependent covariates were used to estimate adjusted hazard ratios (HRs) for diseases associated with local-level concentrations of AAP exposure, estimated using Bayesian spatio-temporal modelling.
The study period of 2013-2015 included a total of 135,199 person-years of follow-up for CVD. There was a positive association of AAP, particularly SO and O, with risk of major cardiovascular and respiratory diseases. Each 10 µg/m increase in SO was associated with adjusted hazard ratios (HRs) of 1.07 (95% CI: 1.02, 1.12) for CVD, 1.25 (1.08, 1.44) for COPD and 1.12 (1.02, 1.23) for pneumonia. Similarly, each 10 µg/m increase in O was associated with adjusted HR of 1.02 (1.01, 1.03) for CVD, 1.03 (1.02, 1.05) for all stroke, and 1.04 (1.02, 1.06) for pneumonia.
Among adults in urban China, long-term exposure to ambient air pollution is associated with a higher risk of cardio-respiratory disease.
现有关于长期环境空气污染（AAP）暴露与中国心肺疾病风险的证据主要集中在死亡率上，并且基于固定站点监测器针对个体暴露的区域平均浓度。因此，当使用更个性化的个体暴露数据进行评估时，关于这种关系的形状和强度仍然存在很大的不确定性。我们旨在使用预测的局部 AAP 水平来检查 AAP 暴露与心肺疾病风险之间的关系。
一项前瞻性研究纳入了来自中国苏州的 50407 名年龄在 30-79 岁的参与者，在 2013-2015 年期间记录了二氧化氮（NO）、二氧化硫（SO）、细颗粒物（PM）和可吸入颗粒物（PM）、臭氧（O）和一氧化碳（CO）的浓度以及心血管疾病（CVD）（n=2563）和呼吸道疾病（n=1764）的发病情况。使用时变协变量的 Cox 回归模型，使用贝叶斯时空建模来估计与 AAP 暴露局部水平相关的疾病的调整后的风险比（HR）。
2013-2015 年的研究期间，共随访了 CVD 患者 135199 人年。AAP 尤其是 SO 和 O 与主要心血管和呼吸道疾病的风险呈正相关。SO 每增加 10μg/m，CVD 的调整后的危险比（HR）为 1.07（95%CI：1.02，1.12），COPD 为 1.25（1.08，1.44），肺炎为 1.12（1.02，1.23）。同样，O 每增加 10μg/m，CVD 的调整后的 HR 为 1.02（1.01，1.03），所有卒中为 1.03（1.02，1.05），肺炎为 1.04（1.02，1.06）。
在中国城市成年人中，长期暴露于环境空气污染与心肺疾病风险增加有关。
