Centre for Research on Environment, Society and Health, School of Geosciences, The University of Edinburgh, Edinburgh, UK.
Centre for Research on Environment, Society and Health, School of Geosciences, The University of Edinburgh, Edinburgh, UK; Longitudinal Studies Centre - Scotland, School of GeoSciences, The University of Edinburgh, Edinburgh, UK.
Environ Res. 2023 Dec 1;238(Pt 1):117021. doi: 10.1016/j.envres.2023.117021. Epub 2023 Aug 31.
Living in areas with high air pollution concentrations is associated with all-cause and cause-specific mortality. Exposure in sensitive developmental periods might be long-lasting but studies with very long follow-up are rare, and mediating pathways between early life exposure and life-course mortality are not fully understood.
Data were drawn from the Scottish Longitudinal Study Birth Cohort of 1936, a representative record-linkage study comprising 5% of the Scottish population born in 1936. Participants had valid age 11 cognitive ability test scores along with linked mortality data until age 86. Fine particle (PM) concentrations estimated with the EMEP4UK atmospheric chemistry transport model were linked to participants' residential address derived from the National Identity Register in 1939 (age 3). Confounder-adjusted Cox regression estimated associations between PM and mortality; regression-based causal mediation analysis explored mediation through childhood cognitive ability.
The final sample consisted of 2734 individuals with 1608 deaths registered during the 1,833,517 person-months at risk follow-up time. Higher early life PM exposure increased the risk of all-cause mortality (HR = 1.03, 95% CI: 1.01-1.04 per 10 μg m increment), associations were stronger for mortality between age 65 and 86. PM increased the risk of cancer-related mortality (HR = 1.05, 95% CI: 1.02-1.08), especially for lung cancer among females (HR = 1.11, 95% CI: 1.02-1.21), but not for cardiovascular and respiratory diseases. Higher PM in early life (≥50 μg m) was associated with lower childhood cognitive ability, which, in turn, increased the risk of all-cause mortality and mediated 25% of the total associations.
In our life-course study with 75-year of continuous mortality records, we found that exposure to air pollution in early life was associated with higher mortality in late adulthood, and that childhood cognitive ability partly mediated this relationship. Findings suggest that past air pollution concentrations will likely impact health and longevity for decades to come.
生活在空气污染浓度高的地区与全因死亡率和特定病因死亡率有关。在敏感的发育阶段暴露可能是持久的，但具有非常长随访时间的研究很少，并且早期生活暴露与整个生命过程死亡率之间的中介途径尚不完全清楚。
数据来自于 1936 年苏格兰纵向研究出生队列，这是一项具有代表性的记录链接研究，包括 1936 年出生的苏格兰人口的 5%。参与者在 11 岁时具有有效的认知能力测试分数，并在 86 岁之前与链接的死亡率数据相关联。使用 EMEP4UK 大气化学输送模型估算的细颗粒物 (PM) 浓度与参与者的居住地址相关联，这些地址是从国家身份登记处（1939 年，年龄 3 岁）获得的。经混杂因素调整的 Cox 回归估计了 PM 与死亡率之间的关联；基于回归的因果中介分析探索了通过儿童认知能力的中介作用。
最终样本包括 2734 人，在 1833517 人月的风险随访时间内登记了 1608 例死亡。早期生活中较高的 PM 暴露增加了全因死亡率的风险（HR=1.03，95%CI：每增加 10μg/m，1.01-1.04），65 岁至 86 岁之间的死亡率关联更强。PM 增加了癌症相关死亡率的风险（HR=1.05，95%CI：1.02-1.08），尤其是女性肺癌（HR=1.11，95%CI：1.02-1.21），但心血管疾病和呼吸道疾病则不然。早期生活中（≥50μg/m）较高的 PM 与儿童认知能力较低有关，而认知能力的下降又增加了全因死亡率的风险，并部分解释了总关联的 25%。
在我们具有 75 年连续死亡率记录的生命历程研究中，我们发现早期生活中的空气污染暴露与晚年更高的死亡率有关，而儿童认知能力在一定程度上解释了这种关系。研究结果表明，过去的空气污染浓度可能会在未来几十年内对健康和寿命产生影响。
