纽约州的超细颗粒物与慢性下呼吸道疾病患者的医院就诊情况
Ultrafine Particles and Hospital Visits for Chronic Lower Respiratory Diseases in New York State.
作者信息
Trees Ian, Yu Fangqun, Deng Xinlei, Luo Gan, Zhang Wangjian, Lin Shao
机构信息
Department of Environmental Health Sciences and.
Department of Atmospheric and Environmental Sciences, University at Albany, State University of New York, Albany, New York; and.
出版信息
Ann Am Thorac Soc. 2024 Aug;21(8):1147-1155. doi: 10.1513/AnnalsATS.202303-267OC.
Exposure to particulate matter is associated with various adverse health outcomes. Ultrafine particles (UFPs; diameter <0.1 μm) are a unique public health challenge because of their size. However, limited studies have examined their impacts on human health, especially across seasons and demographic characteristics. To evaluate the effect of UFP exposure on the risk of visiting the emergency department (ED) for a chronic lower respiratory disease (CLRD) in New York State in 2013-2018. We used a case-crossover design and conditional logistic regression to estimate how UFP exposure led to CLRD-related ED visits. GEOS-Chem Advanced Particle Microphysics, a state-of-the-art chemical transport model with a size-resolved particle microphysics model, generated air pollution simulation data. We then matched UFP exposure estimates to geocoded health records for asthma, bronchiectasis, chronic bronchitis, emphysema, unspecified bronchitis, and other chronic airway obstructions in New York State from 2013 through 2018. In addition, we assessed interactions with age, ethnicity, race, sex, meteorological factors, and season. Each 1-(interquartile range [IQR]) increase in UFP exposure led to a 0.37% increased risk of a respiratory-related ED visit on lag 0-0, or the day of the ED visits, (95% confidence interval [CI], 0.23-0.52%) and a 1.81% increase on lag 0-6, or 6 days before the ED visit, (95% CI, 1.58-2.03%). The highest risk was in the emphysema subtype (lag 0-5, 4.18%; 95% CI, 0.16-8.37%), followed by asthma (lag 0-6, 2.00%), chronic bronchitis (lag 0-6, 1.78%), other chronic airway obstructions (lag 0-6, 1.60%), and unspecified bronchitis (lag 0-6, 1.49%). We also found significant interactions between UFP health impacts and season (Fall, 3.29%), temperature (<90th percentile, 2.27%), relative humidity (>90th percentile, 4.63%), age (children aged <18 yr, 3.19%), and sex (men, 2.06%) on lag 0-6. In this study, UFP exposure increased CLRD-related ED visits across all seasons and demographic characteristics, yet these associations varied according to various factors, which requires more research.
接触颗粒物与多种不良健康后果相关。超细颗粒物（UFPs；直径<0.1μm）因其尺寸而成为独特的公共卫生挑战。然而，对其对人类健康影响的研究有限，尤其是跨季节和人口特征方面。为评估2013 - 2018年纽约州超细颗粒物暴露对因慢性下呼吸道疾病（CLRD）前往急诊科（ED）就诊风险的影响。我们采用病例交叉设计和条件逻辑回归来估计超细颗粒物暴露如何导致与CLRD相关的ED就诊。GEOS - Chem高级粒子微观物理学是一种具有尺寸分辨粒子微观物理学模型的先进化学传输模型，生成空气污染模拟数据。然后，我们将超细颗粒物暴露估计值与2013年至2018年纽约州哮喘、支气管扩张、慢性支气管炎、肺气肿、未特指的支气管炎以及其他慢性气道阻塞的地理编码健康记录进行匹配。此外，我们评估了与年龄、种族、民族、性别、气象因素和季节的相互作用。超细颗粒物暴露每增加1个四分位间距（IQR），在滞后0 - 0天（即ED就诊当天）导致与呼吸相关的ED就诊风险增加0.37%（95%置信区间[CI]，0.23 - 0.52%），在滞后0 - 6天（即ED就诊前6天）增加1.81%（95% CI，1.58 - 2.03%）。最高风险出现在肺气肿亚型（滞后0 - 5天，4.18%；95% CI，0.16 - 8.37%），其次是哮喘（滞后0 - 6天，2.00%）、慢性支气管炎（滞后0 - 6天，1.78%）、其他慢性气道阻塞（滞后0 - 天（即ED就诊当天）导致与呼吸相关的ED就诊风险增加0.37%（95%置信区间[CI]，0.23 - 0.52%），在滞后0 - 6天（即ED就诊前6天）增加1.81%（95% CI，1.58 - 2.03%）。最高风险出现在肺气肿亚型（滞后0 - 5天，4.18%；95% CI，0.16 - 8.37%），其次是哮喘（滞后0 - 6天，2.00%）、慢性支气管炎（滞后0 - 6天，1.78%）、其他慢性气道阻塞（滞后0 - 6天，1.60%）和未特指的支气管炎（滞后0 - 6天，1.49%）。我们还发现超细颗粒物对健康的影响与季节（秋季，3.29%）、温度（<第90百分位数，2.27%）、相对湿度（>第90百分位数，4.63%）、年龄（<18岁儿童，3.19%）和性别（男性，2.06%）在滞后0 - 6天存在显著相互作用。在本研究中，超细颗粒物暴露在所有季节和人口特征中均增加了与CLRD相关的ED就诊，但这些关联因各种因素而异，这需要更多研究。 6天，1.60%）和未特指的支气管炎（滞后0 - 6天，1.49%）。我们还发现超细颗粒物对健康的影响与季节（秋季，3.29%）、温度（<第90百分位数（此处重复，疑有误），2.27%）、相对湿度（>第90百分位数，4.63%）、年龄（<18岁儿童，3.19%）和性别（男性，2.06%）在滞后0 - 6天存在显著相互作用。在本研究中，超细颗粒物暴露在所有季节和人口特征中均增加了与CLRD相关的ED就诊，但这些关联因各种因素而异，这需要更多研究。
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