工业化地区的心肺疾病：一项基于人群的回顾性队列研究。

Cardiorespiratory diseases in an industrialized area: a retrospective population-based cohort study.

机构信息

Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, 56124, Italy.

Institute of Atmospheric Sciences and Climate, National Research Council, Strada Prov.le Lecce-Monteroni Km 1,200, Lecce, 73100, Italy.

出版信息

BMC Public Health. 2023 Oct 18;23(1):2031. doi: 10.1186/s12889-023-16925-9.

DOI:10.1186/s12889-023-16925-9

PMID:37853368

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10585785/

Abstract

BACKGROUND

Atmospheric pollution has been recognized as the greatest environmental threat to human health. The population of the Venafro Valley, southern Italy, is exposed to emissions from a Waste-To-Energy (WTE) and a cement plant and potentially also to another WTE located in the neighboring region of Lazio; also, the vehicular atmospheric pollution situation is critical. In order to assess the environmental health risk of residents in eight municipalities of the Venafro Valley, a retrospective residential cohort study during 2006-2019 was carried out.

METHODS

Four exposure classes were defined by natural-break method, using a dispersion map of nitrogen dioxides (chosen as proxy of industrial pollution). The association between the industrial pollution and cause-specific mortality/morbidity of the cohort was calculated using the Hazard Ratio (HR) through a multiple time-dependent and sex-specific Cox regression adjusting for age, proximity to main roads and socio-economic deprivation index.

RESULTS

Results showed, for both sexes, mortality and morbidity excesses in the most exposed class for diseases of the circulatory system and some signals for respiratory diseases. Particularly, mortality excesses in both sexes in class 3 for diseases of the circulatory system [men: HR = 1.37 (1.04-1.79); women: HR = 1.27 (1.01-1.60)] and for cerebrovascular diseases [men: HR = 2.50 (1.44-4.35); women: HR = 1.41 (0.92-2.17)] were observed and confirmed by morbidity analyses. Mortality excesses for heart diseases for both sexes [men-class 3: HR = 1.32 (0.93-1.87); men-class 4: HR = 1.95 (0.99-3.85); women-class 3: HR = 1.49 (1.10-2.04)] and for acute respiratory diseases among women [HR = 2.31 (0.67-8.00)] were observed. Morbidity excesses in both sexes for ischemic heart diseases [men-class 3: HR = 1.24 (0.96-1.61); women-class 4: HR = 2.04 (1.04-4.02)] and in class 4 only among men for respiratory diseases [HR = 1.43 (0.88-2.31)] were also found.

CONCLUSIONS

The present study provides several not-negligible signals indicating mitigation actions and deserve further investigations. For future studies, the authors recommend enriching the exposure and lifestyle profile using tools such as questionnaires and human biomonitoring.

摘要

背景

大气污染已被认为是对人类健康的最大环境威胁。意大利南部瓦纳弗罗谷的居民暴露在废物转化能源（WTE）和一家水泥厂的排放物中，而且还可能暴露在邻近拉齐奥地区的另一家 WTE 排放物中；此外，车辆造成的大气污染情况也很严峻。为了评估瓦纳弗罗谷八个城市居民的环境健康风险，对 2006 年至 2019 年期间进行了回顾性居住队列研究。

方法

通过二氧化氮的扩散图（选择作为工业污染的代表），采用自然断裂法将四个暴露类定义为四类。通过多时间依赖和性别特异性 Cox 回归，调整年龄、靠近主要道路和社会经济剥夺指数，计算工业污染与队列特定死亡率/发病率之间的关联，使用危害比（HR）表示。

结果

结果表明，对于两性，在循环系统疾病和一些呼吸道疾病的最暴露类中，死亡率和发病率都有增加。特别是，在 3 类循环系统疾病中，两性的死亡率都有所增加[男性：HR=1.37（1.04-1.79）；女性：HR=1.27（1.01-1.60）]和脑血管疾病[男性：HR=2.50（1.44-4.35）；女性：HR=1.41（0.92-2.17）]，并且通过发病率分析得到了证实。两性的心脏病死亡率都有所增加[男性-3 类：HR=1.32（0.93-1.87）；男性-4 类：HR=1.95（0.99-3.85）；女性-3 类：HR=1.49（1.10-2.04）]和女性的急性呼吸道疾病[HR=2.31（0.67-8.00）]。两性的缺血性心脏病发病率都有所增加[男性-3 类：HR=1.24（0.96-1.61）；女性-4 类：HR=2.04（1.04-4.02）]，仅在男性中，呼吸道疾病发病率也有所增加[HR=1.43（0.88-2.31）]。